玻璃体晶状体切除联合人工晶状体睫状沟固定术治疗眼挫伤所致晶状体脱位

目的探讨玻璃体晶状体切除联合人工晶状体睫状沟固定术治疗眼挫伤所致晶状体脱位临床效果。方法对眼挫伤致晶状体脱位32例(32眼)作回顾性研究,均采用闭合式三切口玻璃体晶状体切除联合人工晶状体睫状沟固定术,伴视网膜脱离者,同时行视网膜复位手术。结果所有患者均成功摘出脱位晶状体,患眼视力均有提高。合并继发青光眼者,眼压得到控制;合并视网膜脱离者,术后视网膜复位。术后并发症有角膜水肿6例,虹膜炎症反应2例。结论眼挫伤所致晶状体脱位导致视力障碍、继发性青光眼、伴有视网膜脱离、玻璃体积血时,采用玻璃体晶状体切除联合人工晶状体睫状沟固定术治疗效果良好。手术成功的关键在于选择适应证及掌握娴熟的操作技巧。     

玻璃体切除联合超声乳化术治疗脱位晶状体疗效分析

目的 探讨玻璃体切除联合超声乳化粉碎术治疗脱位晶状体的临床疗效.方法 对晶状体脱位46例(46只眼).其中晶状体不全脱位28只眼中单纯超声乳化12只眼,前玻璃体切除联合超声乳化5只眼,前玻璃体切除11只眼,均植入人工晶体;晶状体全脱位18只眼均采用标准三通道经睫状体扃平部玻璃体切除联合超声乳化粉碎术,人工晶体睫状沟固定术12只眼.结果 全部病例术后视力均较术前提高,未发生严重并发症.结论 对脱位的晶状体根据程度选择单纯超声乳化或玻璃体切除超声乳化粉碎、人工晶体睫状沟固定术,是一种安全、有效的治疗方法.     

晶状体脱位的联合手术治疗

目的：探讨晶状体脱位的联合手术治疗方案的可行性和疗效。方法：对29例（33只眼）晶状体脱位眼采用不同联合手术治疗方案，包括玻璃体切割术联合晶状体切除术以及人工晶状体一期睫状沟缝线固定术。结果：术后病人随访3-24个月（平均10个月），术后29只眼（87.87％）视力均不同程度提高，矫正视力达0.2级以上者20只眼（60.6％），无严重并发症发生。结论：联合手术治疗晶状体脱位是行之有效的，尤其在一期人工晶状体或睫状沟固定者可取得良好治疗效果。选择不同手术的适应证及掌握娴熟的操作技巧是手术成功的关键。     

玻璃体切除联合后房人工晶状体缝线固定术治疗晶状体脱位

目的探讨玻璃体切除联合后房型人工晶状体缝线固定术治疗晶状体脱位的临床效果。方法各种原因所致的晶状体脱位30例（全脱位11眼,不全脱位22眼,共33眼）,进行玻璃体切除及晶状体切除或晶状体摘出。其中7眼采用三通道睫状体平坦部入口,26眼采用角膜缘入口。30例（33眼）均同时行Ⅰ期睫状沟缝线固定后房人工晶状体植入术。术后随访时间2~24个月,平均9个月,观察术后视力及并发症等。结果术后视力提高31眼,视力不变2眼,术后均未发现严重并发症。结论玻璃体切除联合后房型人工晶状体缝线固定术是治疗晶状体脱位最为安全和有效的治疗方法。熟练的手术技巧和术中稳定的眼内压是手术成功的保证。     

外伤性晶状体脱位的手术治疗

目的 评价晶状体、玻璃体联合手术治疗外伤性晶状体脱位的临床疗效。方法 对2000年1月～2005年1月收治的外伤性晶状体脱位30例患者的临床资料作回顾性研究。所有患眼根据晶状体脱位的程度采用不同的术式摘除晶状体，包括囊内摘除、超声乳化吸除、睫状体扁平部切口晶状体切割，同时根据病情需要联合玻璃体视网膜手术，小梁切除或青光眼减压阀门植入术治疗继发性青光眼，Ⅰ期植入睫状沟缝线固定人工晶体3例，后房型人工晶体21例，Ⅱ期植入睫状沟缝线固定人工晶体6例。结果 所有患眼成功地摘除脱位晶状体并植入人工晶体，视力有不同程度提高，24患眼视力≥0．3，患者术后眼压获得控制，6例视网膜脱离全部复位。结论 晶状体、玻璃体联合手术治疗外伤性晶状体脱位，临床效果好。     

晶状体超声乳化吸出联合前部玻璃体切除治疗睫状环阻塞性青光眼

目的探讨抗青光眼术后经保守治疗无效睫状环阻塞性青光眼的手术方法。方法采用晶状体超声乳化吸出和囊袋内人工晶状体植入联合前部玻璃体切除手术治疗抗青光眼术后睫状环阻塞性青光眼11例（13眼）。随诊3—24个月,分析手术效果。结果11例（13眼）均一次手术成功,前房恢复正常,眼压全部控制在20mmHg以下,视力均有不同程度的提高。结论晶状体超声乳化吸出和囊袋内人工晶状体植入联合前部玻璃体切除手术治疗抗青光术后睫状环阻塞性青光眼效果肯定。     

Ahmed青光眼阀植入联合手术治疗外伤性晶状体半脱位继发青光眼

目的:回顾性评价Ahmed青光眼阀植入、晶状体玻璃体切除联合手术治疗外伤性晶状体半脱位继发青光眼的临床疗效。方法:对9眼外伤性晶状体半脱位继发青光眼患者行Ahmed青光眼阀植入、晶状体及前部玻璃体切除、人工晶状体睫状沟固定联合手术。结果:术后视力提高8眼;眼压由术前的44.11±8.85mmHg降至14.78±5.52mmHg;并发症主要有一过性低眼压、引流管内口阻塞和引流盘周纤维包裹等,经过处理均得到良好的恢复。结论:Ahmed青光眼阀植入、晶状体及前部玻璃体切除联合人工晶状体睫状沟固定手术是治疗外伤性晶状体半脱位继发青光眼安全有效的手术方法。     

玻璃体切割联合后段晶状体超声粉碎治疗外伤性晶状体全脱位

目的 评价闭合式三切口玻璃体切割和眼后段晶状体超声粉碎治疗外伤性晶状体全脱位的手术疗效。方法 2002年9月至2004年2月对11例(11只眼)外伤性晶状体全脱位病例，先进行常规闭合式后段玻璃体切割，然后在重水辅助下行晶状体超声粉碎术，其中2例同时行视网膜脱离复位术，5例同时行Ⅰ期睫状沟缝线固定型人工晶状体。结果 全部病例脱位的晶状体均顺利完成超声粉碎。随访3～16个月，最佳矫正视力0．5～1．0者3例，0．1～0．4者5例，0．1以下者3例。术后眼压均得到控制，其中1例锯齿缘截离再次手术后视网膜复位。结论 外伤性晶状体全脱位在设备条件允许下采用此项技术安全有效。     

半脱位透明晶状体切除术联合折叠式人工晶状体缝线固定术14例

目的:探讨前部玻璃体切除系统切除半脱位透明晶状体联合折叠式人工晶状体缝线固定手术技术要点、效果及可行性。方法:对14例(15眼)半脱位透明晶状体(>18°,<360°或2/4～3/4象限)行晶状体切除术联合后房型折叠式人工晶状体睫状沟缝线固定术。结果:术后视力均有不同程度提高,并发症较少,提示手术效果令人满意。结论:对晶状体脱离范围(2/4～3/4)象限的患者行脱位晶状体切除术联合人工晶状体缝线固定并适当行前部玻璃体切割具有提高手术安全性,防止人工晶状体偏位,减少手术并发症的优点。     

玻璃体切割联合晶状体切除术治疗严重晶状体不全脱位

目的观察玻璃体切割联合晶状体切除术治疗严重晶状体不全脱位的临床疗效。方法回顾性分析我院2010年6月至2013年6月收治的严重晶状体不全脱位28例（32只眼）,晶状体悬韧带断裂均超过180°。所有患者均经睫状体平坦部作闭合式玻璃体切割术,切除玻璃体及脱位的晶状体。其中22只眼联合折叠人工晶状体睫状沟缝线固定术。术后随访6~20个月,平均（10.5±2.4）个月。观察患者术后最佳矫正视力、内皮细胞计数、眼压、人工晶状体、眼底及并发症情况。结果术后与术前最佳矫正视力相比提高27只眼（84.38%）,不变4只眼（12.50%）,下降1只眼（3.13%）。术后6个月内皮细胞数与术前相比差异均无统计学意义（P〉0.05）。术后患者眼压均控制正常。术后所有患者前房未见玻璃体疝。结论玻璃体切割联合晶状体切除术治疗严重晶状体不全脱位术中、术后并发症少,联合行后房型折叠人工晶状体植入可取得较好临床效果。     

玻璃体切除联合晶体超声碎核术治疗晶体半脱位合并葡萄膜炎

目的：探讨玻璃体切除联合晶体超声碎核术治疗晶体半脱位合并葡萄膜炎的临床治疗效果。方法：对我院1998年6月至2001年12月期间共收治的9例(11眼)晶体半脱位合并葡萄膜炎的患者行玻璃体切除联合晶体超声碎核术，其中7例(9眼)未I期植入人工晶体，另2例(2眼)植入缝线型人工晶体，术后随访3个月到24个月，观察术后视力及并发症等。结果：术后3月所有患者最佳矫正视力均有不同程度的提高，其中≥0．6的6眼，0．3～0．6的3眼，另2眼最佳矫正视力0．1～0.3；术后并发症有手术后一周内前房的纤维索性渗出4例(5眼)，经药物治疗后很快吸收；术后复发性葡萄膜炎2例(2眼)均为植入缝线型人工晶体眼，药物治疗效果不佳。结论：玻璃体切除联合晶体超声碎核术是治疗晶体半脱位合并葡萄膜炎最为安全和有效的治疗方法，术后并发症少，视力恢复满意，但I期植入缝线型人工晶体可能导致葡萄膜炎复发。     

Implantation of black diaphragm intraocular lenses in congenital and traumatic aniridia

PURPOSE: To evaluate the safety and efficacy of the black diaphragm intraocular lens (IOL) implantation for the treatment of congenital and traumatic aniridia. MATERIAL AND METHODS: Seven black diaphragmatic IOLs were implanted in the eyes of 6 patients between 1997 and 1998. There were 5 males and 1 female. The mean age of them was 42.8 years (range: 22-54 years). Follow-up ranged from 9 to 20 months (mean: 14.2 months). Traumatic aniridia was present in 4 eyes and congenital aniridia in 3 eyes. Pars plana vitrectomy was combined with the simple outside-in method of scleral fixation of IOLs in 6 cases. Three of these eyes were aphakic (all with traumatic aniridia) and in 3 eyes (two congenital cases, one traumatic case) subluxated lens was simultaneously removed. In one case of congenital aniridia with mature cataract, ECCE and ciliary sulcus implantation without scleral fixation were performed. RESULTS: There were very few complications. Ciliary sulcus bleeding appeared in 2 cases during scleral fixation. Transient post-operative corneal oedema was observed in 2 eyes, raised intraocular pressure in 3 eyes, and dispersed blood in vitreous cavity in 2 eyes. All IOLs were well centred. The improvement in best corrected visual acuity was achieved in 5 cases, while good pre-operative best corrected visual acuity was maintained in 2 cases. CONCLUSIONS: Diaphragmatic IOL can be fixated to the sclera in cases without capsular support or it can be implanted into ciliary sulcus after ECCE. Reconstruction of 5 mm pupil and intraocular correction of aphakia enable good visual rehabilitation of patients. The combined procedure of pars plana vitrectomy and scleral fixation of diaphragmatic lens is safe and effective in traumatic and congenital aniridia.     

Multiple methods of surgical treatment combined with primary IOL implantation on traumatic lens subluxation/dislocation in patients with secondary glaucoma

METHODS:Non-comparative retrospective observational case series. Participants:30 cases (30 eyes) of lens subluxation/dislocation in patients with secondary glaucoma were investigated which accepted the surgical treatment by author in the Ophthalmology of Xi'an No.4 Hospital from 2007 to 2011. According to the different situations of lens subluxation/dislocation, various surgical procedures were performed such as crystalline lens phacoemulsification, crystalline lens phacoemulsification combined anterior vitrectomy, intracapsular cataract extraction combined anterior vitrectomy, lensectomy combined anterior vitrectomy though peripheral transparent cornea incision, pars plana lensectomy combined pars plana vitrectomy, and intravitreal cavity crystalline lens phacofragmentation combined pars plana vitrectomy. And whether to implement trabeculectomy depended on the different situations of secondary glaucoma. The posterior chamber intraocular lenses (PC-IOLs) were implanted in the capsular-bag or trassclerally sutured in the sulus decided by whether the capsular were present. Main outcome measures:visual acuity, intraocular pressure, the situation of intraocular lens and complications after the operations.RESULTS: The follow-up time was 11-36mo (21.4±7.13). Postoperative visual acuity of all eyes were improved; 28 cases maintained IOP below 21 mm Hg; 2 cases had slightly IOL subluxation, 4 cases had slightly tilted lens optical area; 1 case had postoperative choroidal detachment; 4 cases had postoperative corneal edema more than 1wk, but eventually recovered transparent; 2 cases had mild postoperative vitreous hemorrhage, and absorbed 4wk later. There was no postoperative retinal detachment, IOL dislocation, and endophthalmitis.CONCLUSION:To take early treatment of traumatic lens subluxation/dislocation in patients with secondary glaucoma by individual surgical plan based on the different eye conditions would be safe and effective, which can effectively control the intraocular pressure and restore some vision.     

外伤性晶状体脱位的联合手术治疗

目的：评价晶状体、玻璃体联合手术治疗外伤性晶状体脱位或半脱位的临床疗效。方法：对1993年10月－2000年5月连续收治的外伤性晶状体脱位或半脱位36例作回顾性研究。所有患眼根据病情均采用不同的术式去除脱位晶状体,包括角巩缘切口圈套娩出、睫状体扁平部切口行晶状体切除或超声晶状体粉碎,同时切割玻璃体,并应用小梁切除、阀门管植入术、玻璃体视网膜手术联合治疗因晶状体脱位引起的并发症,17例I期植入前房或后房型人工晶状体。结果：所有患眼成功的去除晶状体,91．7％患眼视力有不同程度提高,52．3％患眼视力≥0．3,继发青光眼患者术后眼压获得控制,6例视网膜脱离全部复位。结论：各种手术方法联合应用治疗外伤性晶状体脱位及其所致并发症,视力增进效果明显。阀门管植入术是治疗严重眼外伤顽固性青光眼的有效手术方法。     

人工晶状体脱位49例临床分析

目的 探讨人工晶状体（IOL）脱位的临床特点。 设计 回顾性病例系列。 研究对象  北京同仁医院2004-2011年治疗的IOL脱位 49例49眼。 方法 对IOL脱位患者的临床资料进行回顾性分析。 主要指标 年龄、原IOL植入原因,发病时间,脱位IOL位置及类型,IOL脱位诱因,手术治疗方法及并发症。 结果  49眼IOL脱位中,老年性白内障和外伤性白内障摘除联合IOL植入术者较多,分别占46.9%、28.6%。6例睫状沟固定IOL脱位均发生于手术1年后。脱位IOL53.1%位于玻璃体腔内。89.8%为C形襻IOL。IOL脱位75.5%由原眼部因素及手术因素引起。47眼（95.9%）实施 了IOL睫状沟缝线固定或再次缝线固定术治疗,术后2周裸眼视力0.1以上者占59.6%。结论   IOL脱位的发生与原眼部因素及手术因素有关。睫状沟缝线固定IOL术是治疗IOL脱位的有效手段,但睫状沟固定的IOL仍会发生脱位。（眼科,2012,21：47-51）     

Posterior chamber lens implantation following pars plana lensectomy and vitrectomy in severe proliferative diabetic retinopathy

In two patients secondary cataracts developed after pars plana vitrectomy. In both cases the lens was removed from the pars plana, and the anterior capsule was kept intact. In one patient a posterior chamber lens was placed in the ciliary sulcus 3 months after the lens had been removed, and in the other patient a posterior chamber lens was implanted intraoperatively after pars plana lensectomy and vitrectomy. Improved visual results were obtained in both cases, and there was no evidence of rubeosis or elevated intraocular pressure. In selected cases preservation of the anterior capsule may be important to implant posterior chamber lenses in eyes requiring pars plana lensectomy and vitrectomy. To our knowledge this technique has not previously been reported.     

外伤性晶状体脱位手术方法的探讨

目的探讨不同手术方法治疗外伤性晶状体脱位的效果。方法对外伤性晶状体脱位，根据其晶状体脱位的部位和程度的不同，采用不同的手术方法摘出脱位的晶状体，植入后房型人工晶状体。包括：角膜缘切口摘出脱位于前房的晶状体；巩膜隧道切口超声乳化；平坦部切口晶状体切除，合并进行玻璃体切除；联合人工晶状体囊袋内植入或睫状沟缝线固定等。结果22例（22眼）术后矫正视力低于0．05者3眼（13．64％），0．05—0．25者9眼（40．915），0．3—1．0者10眼（45．45％）；有19眼（86．36％）视力有不同程度的提高。未见严重并发症。结论外伤性晶状体脱位的手术方法根据脱位晶状体位置及有无并发症而定。选择不同手术的适应证及掌握熟练的操作技巧是手术成功的关键。