后房型人工晶体襻所致周边前粘连

为研究后房型人工晶体植入术后前房角及眼前节改变，对术后不同时期的１３０只眼及白内障囊外摘除术后２０只眼进行前房角镜、散瞳前后裂隙灯以及视力、眼压及眼底等项检查。结果发现，５０．８％发生襻性周边前粘连（ＰＡＳ）。襻性ＰＡＳ易于辨认，为宽基底的周边虹膜向前隆起，并与房角前壁相粘连，其范围约为０．５￣１个钟点，个别为１．５￣２个钟点。术后各时间组间襻性ＰＡＳ发生率的差异无显著性（Ｐ〉０．０５）。睫状沟固     

后房型人工晶体植入术后房角镜观察

用Ｇｏｌｄｍａｎｎ房角镜观察老年性 白内障囊外摘除及后房型人工晶体植入术后半 年３０只眼，结果显示，虹膜周边前粘连１７只眼（５６％）。１５只眼中的２０个襻与粘连的部位相应。睫状沟垂直轴位固定的人工晶体眼易发生虹膜周边前粘连，简要讨论了虹膜周边前粘发生的原因及后果，建议房角镜检查应列为后房型人工晶体植入术后随访常规。     

应用超声生物显微镜观察后房型人工晶体植入术后的房角改变

目的用超声生物显微镜观察老年性白内障囊外摘除术及后房型人工晶体植入术后房角的变化及相关因素。方法用超声生物显微镜观察老年性白内障囊外摘除术及后房型人工晶体植入术后,３１例（４１只眼）的房角改变。结果虹膜周边前粘连６只眼,瞳孔变形１２只眼,均与人工晶体襻的位置有关;并非所有非囊袋内固定的人工晶体襻均位于睫状体沟;术后残留的晶体皮质,术后３个月仍存留,较多晶体皮质的残留可引起周边虹膜膨隆、房角变窄。结论后房型人工晶体植入术后房角的改变与人工晶体襻的位置及残留的晶体皮质有关;建议尽可能采用囊袋内植入人工晶体,避免过多的晶体皮质残留。     

应用超声生物显微镜观察后房型人工晶体植入术后的房？…

目的 用超声生物显微镜观察老年性白内障囊外摘除术及后房型人工晶体植入术后房角的变化及相关因素。方法 用超声生物显微镜观察老年性白内障囊外滴除术及后房型人工晶体植入术后，３１例（４１只眼）的房角改变。结果 虹膜周边前粘连６只眼，瞳孔变形１２只眼，均与人工晶体襻的位置有关；关非所有非囊袋内固定的人工晶体襻均位于睫状体沟；术后残留的晶体皮质，术后３个月仍存留，较多晶体皮质的残留可引起周连虹膜膨隆、房角变     

后房型人工晶状体植入术后前房角形态改变及临床意义

目的 研究后房型人工晶状体植入术后前房角的形态改变及其临床意义。方法 ５０眼常规白内障囊外摘出（ＥＣＣＥ）及３０例超声乳化联合后房型人工晶状体植入（ＰＨＡＣＯ）术后半年,作眼部系统检查及前房角镜检查。结果 ＥＣＣＥ组攀性相关的周边前粘连（ＰＡＳ）发生率明显高于ＰＨＡＣＯ组（Ｐ〈０．０５）。囊袋内固定攀性ＰＡＳ发生率明显低于睫状沟固定组（Ｐ〈０．０５）。结论 后房型人工晶状体植入术后前房角镜检查对视察攀性ＰＡＳ及其影响因素、研究减少此并发症等方面具有重要的临床意义。     

角巩缘无缝线隧道切口白内障超声乳化人工晶体植入术后房角镜观察

目的：观察角巩膜缘无缝线隧道切口白内障超声乳化及后房型人工晶体植入术后前房角的变化。方法：用Goldmann房角膜观察了107眼通过5mm巩膜缘无缝线隧道切口进行白内障超声乳化及后房型人工晶体植入术后1个月前房角的变化。结果：107眼（100％）可见内切口位于Schwalbe线前的透明角膜上,48眼（44．86％）内切口平整,59眼（55．14％）,内切口后唇轻度卷曲,42眼（39．25％）角膜后弹力层不同程度脱离,9眼（8．41％）发生周边虹膜周边前粘连,但未见有粘连至巩膜突上,3眼（2．8％）虹膜周边粘连致术后瞳孔呈梨形。结论：白内障超声乳化及后房型人工晶体植入术后角巩膜缘无缝线隧道切口是 一种较好的手术方法,但也存在着角膜后弹力层不同程度脱离、虹膜周边前粘连等并发症。     

后房型人工晶体植入术后瞳孔和房角的改变

目的了解老年性白内障后房型人工晶体植入术后瞳孔和房角的改变。方法对术后随机随访54眼（42例）进行裂隙灯、眼压、Goldmann房角镜及眼底检查。结果瞳孔变形移位16眼（29．6％）。不同程度的周边虹膜前粘连20眼（37％）．其中与切口有关15眼，占周边虹膜前粘连的75％（15／20），与襻位置有关5眼（9．2％）。周边前房发现切口缝线及线结9眼。结论人工晶体植入术后前房周边虹膜前粘连和瞳孔变形移位主要是角巩缘切口和术中损伤引起。     

前房型人工晶体植入术后对房角结构及房水流畅系数影响

目的：了解前房型人工晶体植入术后对眼压、房角及房水流畅系数的影响情况。方法：追踪观察５０眼植入ＡＣ－ＩＯＬ术前、术后眼压、房角、房水浪畅系数的变化，眼部着重检查房角，采用Ｃｏｌｄｍａｎｎ房角镜。随访期为３～１２个月，平均１０．５个月。白内障类型以外伤性及老年性为主。结果：术后房角粘连发生率７０％，垂直轴向虹膜根部固定的人工晶体眼易发生房角粘连。有青光眼病史者术后易出现眼压升高。结论：新型弹性开襻式     

后房型人工晶体手术前后的房角镜观察

后房型人工晶体手术前后的房角镜观察南京军区福州总院杨丽霞，高建华据文献报导，后房型人工晶体植入术后可发生房角结构的改变，如虹膜周边前粘连、色素层受损、房角色素沉着等，甚至引起继发性青光眼。我们从１９９４年２月始对后房型人工晶体植入术的３６例病人进行了...     

型人工晶体植入术后对房角结构及房水流畅系数影响

目的了解前房型人工晶体植人术后对眼压、房角及房水流畅系数的影响情况.方法追踪观察50眼植入AC-IOL术前、术后眼压、房角、房水流畅系数的变化,眼部着重检查房角,采用Goldmann房角镜.随访期为3～12个月,平均10.5个月.白内障类型以外伤性及老年性为主.结果术后房角粘连发生率70%,垂直轴向虹膜根部固定的人工晶体眼易发生房角粘连.有青光眼病史者术后易出现眼压升高.结论新型弹性开襻式前房型人工晶体对房角的影响不会造成眼压升高及房水流畅系数的改变.有青光眼病史者应慎行AC-IOL植入术.     

超声乳化术中人工晶状体前囊夹持植入的临床观察

目的:观察超声乳化术中人工晶状体前囊夹持植入法的临床效果。方法:对白内障超声乳化术中撕囊口过小21例21眼、后囊破裂6例6眼、囊袋宽松1例2眼采用前囊夹持法植入后房型人工晶状体,术后观察视力、人工晶状体位置及后发性白内障情况,术后随访6～24mo。结果:术后3mo视力0.3以上6眼,0.5以上13眼,0.8以上10眼,人工晶状体位置稳定,后发性白内障发生率与囊袋内植入相近,未发现其它与固定有关的并发症。结论:白内障超声乳化术中采用前囊夹持法植入后房型人工晶状体效果良好,是超声乳化术中出现撕囊口过小、后囊膜破裂等并发症的一种有效补充手段。     

白内障后囊破裂人工晶状体睫状沟固定与植入前房疗效比较

目的:比较睫状沟缝线固定人工晶状体术和前房人工晶状体植入术治疗白内障后囊破裂的疗效。方法:回顾性分析采用睫状沟缝线固定人工晶状体术、前房人工晶状体植入术治疗白内障后囊破裂45例45眼,比较两组手术的疗效。结果:睫状沟缝线固定人工晶状体术组和前房人工晶状体植入术组均能有效治疗白内障后囊破裂。但后者术后有2例6mo后出现虹膜睫状体炎及眼压升高,其余视力均改善。前者视力均改善,未见有明显的并发症。结论:睫状沟缝线固定人工晶状体术和前房人工晶状体植入术均能有效治疗白内障后囊破裂,改善视力,但前者更接近于生理位置,术后并发症更少。     

白内障术中后囊膜破裂行后囊膜连续曲线形撕囊术

目的：讨论白内障囊外摘除、超声乳化摘除及针吸摘除术中后囊膜破裂时行后囊膜连续曲线形撕囊术（ｐｏｓｔｅｒｉｏｒ ｃｏｎｔｉｎｕｏｕｓ ｃｕｒｖｉｌｉｎｅａｒ ｃａｐｓｕｌｏｒｈｅｘｉｓ,ＰＣＣＣ）的方法和作用。方法：利用撕囊镊对１０例（１０眼）白内障摘除术中后囊膜破裂眼行ＰＣＣＣ,５例联合行前段玻璃体切除术。结果：１０例后囊膜破裂后行ＰＣＣＣ眼９例成功完成ＰＣＣＣ,１ 均植入后房人工晶体。术后观察１月～３年（平均１６月）,９例行ＰＣＣＣ眼视轴均清晰,未发生视网脱离及后发性白内障,无明显的人工晶体光学部偏中心或人工晶体异位。结论：ＰＣＣＣ可有效避免后囊膜破孔进一步无限放射状撕裂,保持周边后囊膜的完整性。使人工晶体稳固于囊袋内。     

Artisan虹膜夹持型人工晶状体植入术及后房型人工晶状体睫状沟缝线固定术治疗无晶状体眼的比较

目的:比较Artisan虹膜夹持型人工晶状体植入术及后房型人工晶状体睫状沟缝线固定术治疗无晶状体眼的疗效及并发症。方法:2007-03/2009-03我院住院患者中连续24例24眼无后囊膜支持的无晶状体眼患者,随机分为两组。一组11眼行Artisan虹膜夹持型人工晶状体植入术,另一组13眼选择后房型人工晶状体睫状沟缝线固定术。观察手术前及手术后1d;1wk;1mo的裸眼视力(visual acuity,VA)、最佳矫正视力(best corrected visual acuity,BCVA)、眼压(intraocularpressure,IOP)、角膜内皮细胞计数(corneal endothelial cells,CECs)。结果:两组间比较,术前VA,BCVA,CECs差异无统计学意义,术后BCVA,CECs差异无统计学意义。Artisan组手术后VA优于术前BCVA,差异有统计学意义。睫状沟缝线固定组手术后VA与手术前BCVA差异无统计学意义。两组手术前后IOP差异无统计学意义。结论:Artisan虹膜夹持型人工晶状体植入术与后房型人工晶状体睫状沟缝线固定术都是治疗无晶状体眼有效方法。两者比较,Artisan虹膜夹持型人工晶状体植入术手术操作相对简单,组织损伤小,更加安全,是治疗无后囊膜支持的无晶状体眼的比较理想的治疗方法。     

青光眼白内障联合手术预置小梁切口的疗效

目的：探讨小切口白内障囊外摘出和后房型人工晶状体囊袋内植入联合预置小梁切口小梁切除术治疗青光眼合并白内障的临床疗效。 方法：对21例青光眼合并白内障患者实施白内障囊外摘出和后房型人工晶状体囊袋内植入联合预置小梁切口小梁切除术,观察术后患者视力、眼压及并发症情况。 结果：所有患者术后眼压均降至正常范围内。术后视力均有不同程度的提高。术后1眼发生早期人工晶状体前膜,2眼暂时性角膜水肿。 结论：预置小梁切口和小切口白内障摘除及后房型人工晶状体植入联合小梁切除是安全、有效、经济的治疗方法,值得推广。     

外伤性白内障后囊破裂人工晶体植入的手术方式选择

目的探讨外伤性白内障晶体后囊不存在时,采用前房型人工晶体植入,抑或后房型人工晶体巩膜缝线固定术。方法外伤性白内障患者８６例（８６只眼）,其中前房型人工晶体（新型弹性开放襻）植入５６例,Ⅰ期植入２９例,Ⅱ期植入２７例;后房型人工晶体巩膜缝线固定（大Ｃ型襻,两根缝线睫状沟固定）３０例,Ⅰ期植入１４例,Ⅱ期植入１６例。结果术后随访１～４２个月。矫正视力≥０．５者,前房型人工晶体组４０例,占７１．４％;缝线固定组２７例,占９０．０％。矫正视力≥１．０者,前房型人工晶体组２２例,占３９．３％;缝线固定组１４例,占４６．７％。结论新型前房型人工晶体植入和后房型人工晶体巩膜缝线固定术均不失为常规后房型人工晶体植入失败的补救措施,但前房型人工晶体适用于年龄较大、眼前段（角膜、虹膜和前房角）条件较好,而眼后段（玻璃体、视网膜）条件较差者;后房型人工晶体巩膜缝线固定术则适用于年龄较小、眼前段条件较差而眼后段条件较好者。     

Extracapsular cataract extraction and implantation in the capsular sac during vitrectomy in diabetics]

Removal of the lens is often performed during pars plana vitrectomy for complications of proliferative diabetic retinopathy, but correction of aphakia often remains unsatisfactory. Some authors have reported posterior chamber intraocular lens implantation during pars plana vitrectomy in diabetic patients who presented with coexisting cataract and vitreoretinal complications from proliferative diabetic retinopathy. Some patients were operated by pars plana lensectomy and vitrectomy followed by posterior chamber intraocular lens implantation in the ciliary sulcus, others by extracapsular extraction, posterior chamber intraocular lens implantation in the ciliary sulcus, and pars plana vitrectomy. Other authors have described phacoemulsification through the limbus, pars plana vitrectomy and implantation in the capsular bag in one operation in various indications, including complications of proliferative diabetic retinopathy. We inserted a posterior chamber intraocular lens into the capsular bag in 18 eyes of 16 patients with complications of proliferative diabetic retinopathy after extracapsular cataract extraction and pars plana vitrectomy in a single session. A standard extracapsular cataract extraction was performed before pars plana vitrectomy. Sufficient anterior capsule was left in place in order to facilitate implantation in the capsular bag after pars plana vitrectomy. The anterior chamber was filled with sodium hyaluronate in order to maintain anterior chamber depth, corneal clarity, and good mydriasis during the continuation of the procedure. A standard three port pars plana vitrectomy was performed in all cases. After closure of superior sclerotomies, superior corneal incision was partially reopened, an intraocular lens specifically designed for the capsular bag with an optic size of 7 mm was inserted, and the corneal incision was closed with interrupted 10/0 sutures.(ABSTRACT TRUNCATED AT 250 WORDS)     

超声乳化白内障摘除术中后囊破裂的Ⅰ期后房型人工晶体植入术

目的评价超声乳化白内障摘除术中后囊破裂的Ⅰ期后房型人工晶体植入术的疗效。方法对１８４例（２００只眼）施行超声乳化白内障摘除术中后囊破裂者２９例（２９只眼）行Ⅰ期后房型人工晶体植入术。结果１０例囊袋内植入,１９例睫状沟植入。术后３个月随访,裸眼视力１．０以上者１７例（５８．６２％）,０．５～０．９者１０例（３４．４８％）;矫正视力１．０以上者２２例（７５．８６％）,０．５～０．９者５例（１７．２４％）。本组并发症主要为角膜水肿,瞳孔缘虹膜咬伤,前段玻璃体炎症等。结论对于后囊破裂及玻璃体脱出的患者,适当利用残留的前、后囊作为支撑,清除前段玻璃体,仍可植入后房型人工晶体。     

糖尿病患者后房型人工晶状体体植入术眼前段并发症探讨

目的：观察糖尿病患者中行后房型人工晶状体植入术后眼前段并发症及预后。方法：对31例（40只眼）糖尿病组后房型人工晶状体植入与28例（35只眼）对照组老年白内障患者手术效果及并发症进行对比观察。结果：糖尿病组白内障前段手术并发症发生率高于对照组，其术前准备、术中及术后处理均有其特殊性。但总体预后两组并无显著差异。结论：糖尿病患者人工晶状体植入安全可靠、手术预后良好。     

Spontaneous late dislocation of intraocular lens within the capsular bag in pseudoexfoliation patients

PURPOSE: To identify a delayed complication of cataract surgery in patients with zonular weakness caused by pseudoexfoliation syndrome. DESIGN: Retrospective observational case series. PARTICIPANTS: Eight eyes in seven patients with clinically diagnosed pseudoexfoliation syndrome who had undergone previous uncomplicated cataract extraction and placement of a posterior chamber intraocular lens. METHODS: This study evaluated eight cases of late spontaneous dislocation of posterior chamber intraocular lenses within the capsular bag in patients with pseudoexfoliation syndrome. Data were gathered retrospectively from patients' operative reports, medical records, and pathology reports. MAIN OUTCOME MEASURES: (1) Interval between original surgery and dislocation; (2) final best-corrected visual acuity and ocular outcome. RESULTS: All patients had a diagnosis of pseudoexfoliation syndrome and had previously undergone uncomplicated cataract surgery. No patient had any other predisposing factors that would lead to zonular dehiscence or weakness. Delayed dislocation of the entire capsular bag containing the intraocular lens (IOL) occurred spontaneously in all cases. Mean time from IOL implantation to dislocation was approximately 85 months (7 years and 1 month; range, 57-115 months) after surgery. Seven eyes were treated successfully with IOL exchange: six with placement of an anterior chamber IOL and one with scleral fixation of a posterior chamber IOL. The remaining case was treated by scleral fixation of the dislocated IOL. Gross pathology analysis of seven cases confirmed the presence of the IOL within the intact capsular bag. Six eyes have achieved final best-corrected visual acuity of 20/40 or better. CONCLUSION: Patients with pseudoexfoliation syndrome may be at risk for delayed spontaneous dislocation of IOL within the capsular bag after uncomplicated cataract surgery. Awareness of this newly recognized long-term complication may justify a reevaluation of surgical considerations for cataract removal in these patients.