带虹膜隔人工晶状体在严重眼外伤中的应用价值

目的 探讨带虹膜隔人工晶状体在外伤性无虹膜无晶状体眼中的应用价值。方法 2000年4月～2003年4月应用Morcher公司生产的带虹膜隔人工晶状体治疗13例严重外伤后无虹膜无晶状体眼．均行人工晶状体二期植入术。探讨带虹膜隔人工晶状体植入术的适应证、手术方法、并发症防治及效果。结果 所有病例畏光症状改善或消失，视力均有不同程度的提高。结论 带虹膜隔人工晶状体治疗严重外伤后无虹膜眼有重要的临床意义，不仅畏光症状改善或消失，而且重建了眼前段，挽救了濒于残疾的伤眼，获得了较好的视力。     

虹膜固定型人工晶状体二期植入治疗无晶状体眼的疗效

目的评价二期植入虹膜固定型人工晶状体治疗各种原因导致的无晶状体眼的疗效。方法选取无晶状体眼患者15例(16眼),均植入虹膜固定型人工晶状体,术后观察患者视力、眼压、角膜内皮细胞计数及并发症情况。结果 15例均一次性成功植入虹膜固定型人工晶状体,显微镜观察人工晶状体位于瞳孔中央。术后裸眼视力0.02-0.80,平均0.35,与术前裸眼视力(手动-0.12)比较差异有统计学意义(P<0.001),与术前矫正视力比较差异无统计学意义(P>0.05)。术后6个月角膜内皮细胞平均丢失率为9.87%。仅1例术后发生瞳孔区玻璃体阻滞。手术前后眼压差异无统计学意义(P>0.05)。结论实施虹膜固定型人工晶状体二期植入术治疗无晶状体眼,能够安全、有效地提高患者的术后视力,但人工晶状体对角膜内皮、虹膜等组织的长期影响还需进一步观察。     

儿童外伤性白内障人工晶状体植入术探讨

目的 探讨儿童外伤性白内障人工晶状体植入的手术时机、方法和人工晶状体的选择。方法 对６２例６４眼儿童外伤性白内障人工晶状体植入术进行回顾性分析。结果 术前视力〈０．０５者占９６．６％,术后占６．８％;视力≥０．３者术前无,术后占７２．９％,矫正后占８１．４％;视力≥０．８者术后占２５．４％,矫正后占３９．０％。结论 儿童外伤性白内障应植入人工晶状体且时间宜早,外伤使眼部条件差需妥善手术,人工晶状体     

二期植入前房型人工晶状体与巩膜固定型人工晶状体的比较

目的：评价二期植入前房型人工晶状体和巩膜固定型人工晶状体的效果及并发症。 方法：无足够囊膜支撑无晶状体眼患者117例117眼，1997-03／2002-12二期植入人工晶状体。组1植入柔韧开放袢前房型人工晶状体，组2植入单片式巩膜固定型人工晶状体。所有患者均随访1a以上，在每次随访中，进行视力和眼压检查；对术后结果和并发症进行分析和比较。 结果：术后裸眼视力在0．5以上者中组2优于组1，但两组最佳矫正视力在0．5以上者两组无差异；组1（16／56）并发症发生多于组2（8／61）；与术前角膜内皮细胞密度相比，人工晶状体植入2wk后组1（5．0％）的内皮损失多于组2（2．5％），但术后1a随访两组角膜内皮损失无差异。 结论：相比于前房型人工晶状体，植入巩膜固定型人工晶状体会有较好的结果和较少的并发症发生。     

虹膜型人工晶状体治疗外伤性无虹膜无晶状体眼

目的探讨虹膜型人工晶状体对外伤性无虹膜无晶状体眼的治疗作用。方法观察31例（31眼）虹膜型人工晶状体植入术后的视力情况及并发症。结果术后患者视力有不同程度提高，最光症状明显改善。结论虹膜型人工晶状体对治疗外伤性无虹膜无晶状体眼具有较好的临床价值。     

Toric markers-assisted implantation of the scleral-fixated intraocular lens

AIM: To evaluate the efficacy of toric intraocular lens markers-assisted implantation of the scleral-fixated intraocular lens (SFIOL). METHODS: From October 2010 to December 2013, all patients who had undergone secondary SFIOL implantation were assigned to group 1 and 2, in group 1 SFIOL was performed with the assist of radial keratotomy (RK)-marker, and in group 2 SFIOL was performed with the assisted of toric intraocular lens markers (T-and axis markers). Patients’ demographic data and information on baseline preoperative visual acuity, indication for surgery and latest postoperative visual acuity were collected and analyzed. The haptic and optic positions were determined by ultrasound biomicroscopy. The optic tilt angle and decentration distance were measured. RESULTS: The study evaluated 43 eyes of 43 patients ranging in age from 3 to 66y. Group 1 comprised 24 eyes (24 patients) and group 2, 19 eyes (19 patients). Uncorrected reoperative acuity was improved on all the eyes postoperatively. The improved postoperative acuity was significantly more in group 2 than that in group 1 (1.11±0.38 vs 0.82±0.45 logMAR; F=4.85, P=0.03). Ultrasonic biomicrograph examination showed that the rate of haptic asymmetry was significantly higher in group 1 (42%, 10/24) than that in group 2 (11%; 2/19) (Chi square=3.68, P=0.04). The mean tilted degree in group 1 was significantly higher than that in group 2 (P=0.04). Mean decentration distance in group 1 was greater than that in group 2 (P=0.03). CONCLUSION: During SFIOL the toric markers help the surgeon identify the placement of fixation more precisely than that with the use of RK marker.     

儿童Ⅱ期人工晶状体植入术两种手术方式的对比研究

目的探讨儿童无晶状体眼Ⅱ期人工晶状体植入术的两种手术方式的效果。方法3．5～9岁儿童白内障术后无晶状体眼58例（71眼）,随机分成2组：A组36眼,行后囊切开、前段玻璃体切除及后房人工晶状体植入;B组35眼,单纯行后囊切开及人工晶状体植入。结果术后3月,矫正视力〉10．05者,A组30跟（83．33％）,B组30眼（85．71％）;≥0．3者,A组21眼（58．33％）,B组20眼（57．14％）。脱盲率及脱残率2组之间差异均无显著性（P〉0．05）,但两组分别与术前相比差异均有统计学意义（P〈0．01）。两组术后各种并发症之间差异也无统计学意义。结论儿童无晶状体眼Ⅱ期人工晶状体植入术的两种术式均是安全的、有效的,单纯的后囊切开更符合患儿的生理特点。     

带虹膜人工晶体在外伤性无虹膜无晶体眼的应用

目的 :改善外伤性无虹膜、无晶体眼或白内障患者的羞明症状 ,提高视力。方法 :使用德国MORCHER公司生产的带虹膜人工晶体为 3 7例无虹膜、无晶体或合并外伤性白内障、玻璃体出血的患者施行了白内障摘除或晶体、玻璃体切除联合带虹膜人工晶体植入术及带虹膜人工晶体二期植入术。结果 :术后患者羞明症状明显改善 ,视力有不同程度的提高。结论 :带虹膜人工晶体对治疗外伤性无虹膜、无晶体眼具有良好的实用价值 ,其术后并发症值得关注     

Vertical fixation with fibrin glue-assisted secondary posterior chamber intraocular lens implantation in a case of surgical aphakia

We report the first case of vertical fixation by fibrin glue-assisted secondary posterior chamber intraocular lens implantation in a case of surgical aphakia. Advantages of vertical fixation are discussed.     

软性虹彩片联合透气性半硬性角膜接触镜矫治外伤性无虹膜无晶状体眼

目的 评价软性虹彩片联合透气性半硬性角膜接触镜(RGPCL)对外伤性无虹膜无晶状体眼的矫治效果.设计回顾性病例系列.研究对象 角膜内皮细胞密度在2500个/mm2以上外伤性无虹膜无晶状体眼患者59例(59眼).方法患者联合戴用软性虹彩片和RGPCL,比较初诊时的插片视力和RGPCL矫正视力,随诊5年,非接触性角膜内皮计...     

外伤性白内障一期后房型人工晶体植入术

目的：探讨外伤性白内障人工晶体植入的疗效。 方法５７例外伤性白内障一期植入后房型人工晶体，术后随访３～３５ｍｏ。 结果６４％患者术后视力≥０．５，无严重并发症发生。 结论术中处理前囊膜、分离虹膜后粘连及预防后囊膜的破裂，对外伤性白内障人工晶体植入的疗效起着重要的作用。     

Jagat and Bala intraocular lens supporting system: An artificial platform for intraocular lens implantation in an aphakic patient with inadequate capsular support

We describe a novel device, Jagat and Bala Intraocular lens Supporting System (JBISS), an artificial Intraocular lens (IOL) platform that facilitates IOL fixation in an aphakic patient with poor capsular support and also facilitates IOL exchange in case of myopic shift or refractive surprise. Implantation of JBISS along with IOL was carried out in four patients and results are promising without any adverse events.     

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。     

改良YAMANE式巩膜层间无缝线后房型人工晶状体固定术的疗效观察

目的:观察YAMANE式巩膜层间无缝线后房型人工晶状体固定术的术后效果、安全性及并发症。方法:病例随访观察。选取2017-12/2018-09于华西医院眼科行YAMANE式巩膜层间无缝线后房型人工晶状体固定术患者5例,定期随访患者术后的裸眼视力(LogMAR)、最佳矫正视力(LogMAR)、等效球镜度数、眼压及人工晶状体位置等。结果:患者3例术后矫正视力达0.0,术后等效球镜度数与目标屈光度相差为0.11~0.62D。术后3mo,1例患者裸眼视力达术前最佳矫正视力0.2,另1例患者术前存在角膜白斑及黄斑前膜牵拉水肿,矫正视力达到了术前验光最佳矫正效果。随访期间所有患者的人工晶状体袢凸缘及袢均保持在巩膜层间良好的位置,人工晶状体位置居中,未见明显偏心及倾斜。所有病例术后均未出现低眼压及其它并发症。结论:YAMANE式巩膜层间无缝线后房型人工晶状体固定术切口小,无需制作巩膜瓣,不使用缝线及生物胶,手术时间短,人工晶状体位置居中且固定良好。此手术方式需要经过一定的学习曲线,掌握术中关键点操作,可以为患者带来快速、良好、稳定的术后效果,且术后并发症少。     

带虹膜膈人工晶状体治疗无晶状体眼并虹膜缺失的初步报告

目的评价无晶状体眼并虹膜缺失患者眼中植入带虹膜膈人工晶状体的临床效果.方法对18例(18眼)由于外伤、手术等原因造成的无晶状体眼并虹膜缺失患者行带虹膜膈人工晶状体的植入,观察手术前后视力和各种手术并发症.结果平均随访1.1±0.6a,18眼术后裸眼视力为0.1～0.5,与术前比较差异有非常显著性意义(P＜0.01);术后最佳矫正视力不能达到术前最佳矫正视力,差异有非常显著性意义(P＜0.01);全部患者的畏光症状改善.结论带虹膜膈人工晶状体植入治疗无晶状体眼并虹膜缺失有效而安全,可使患者获得较好的视觉质量.但其仍存在损失最佳矫正视力的缺点.     

Implantation of scleral‐fixated posterior chamber intraocular lenses in adults

Purpose: To report the results of transscleral fixation of posterior chamber intraocular lenses in adults. Methods: We carried out a retrospective analysis of 91 eyes of 81 patients who underwent implantation of posterior chamber lenses with transscleral sutures between 1997 and 2006. The mean age of the patients was 62 years (range 19–94 years). Sixty‐eight eyes (74.7%) were aphakic at the time of surgery. In 10 patients (11.0%) an intracapsular cataract extraction and in six patients (6.6%) a pars plana lensectomy was performed prior to the fixation of the posterior chamber intraocular lens. In seven eyes (7.7%) a previously implanted IOL was removed. The mean follow‐up was 36 months (range 6–116 months). Results: The mean preoperative best corrected visual acuity (BCVA) was 0.37 (range counting fingers to 1.0), which improved to 0.5 (range light perception to 1.0) postoperatively. At the end of follow‐up, BCVA was unchanged or improved in 81 eyes (89.0%), reduced by 2 Snellen lines in four eyes (4.4%), and between finger counting and light perception in four eyes (4.4%). The most serious complication was suprachoroidal haemorrhage, which occurred in two eyes. Retinal detachment occurred in three eyes, all of which successfully reattached after surgery. Suture erosion or spontaneous dislocation caused by suture degradation or breakage was not seen. Conclusions: Secondary implantation of posterior chamber intraocular lenses with transscleral fixation is a reasonably safe procedure in adults, with relatively few serious complications. Even in patients with longterm follow‐up, suture breakage was not seen.     

外伤性白内障二期前房型人工晶状体植入

目的 探讨外伤性白内障二期植入弹性开放襻前房型人工晶状体的效果和安全性。方法 28例28眼外伤性白内障行二期弹性开放襻前房型人工晶状体植入联合周边虹膜切除术。术后随访3月以上。结果 术后3月裸眼视力≥0．5者20眼(71．4％)，达到术前最佳矫正视力者24眼(85．7％)。术后常见并发症为角膜水肿、葡萄膜炎和眼压升高。结论 外伤性白内障二期植入弹性开放襻前房型人工晶状体是一种简便、安全、有效的方法。     

无晶状体眼内植入人工晶状体的理论值探讨

目的：探讨无晶状体眼内植入人工晶状体的理论值计算方法。
　　方法：以Gullstrand （1号）模型眼及标准人工晶状体眼部分数据为基础,应用几何光学理论进行数理推导,从无晶状体眼内植入后房型人工晶状体理论值计算入手,总结出个性化角膜数据计算法;得出无晶状体眼内植入人工晶状体的理论值与角膜前表面曲率半径（ r1）、角膜后表面曲率半径（r2）、角膜厚度（T）、眼视轴长（L）、有效人工晶状体位置（ ELP）的数理关系。
　　结果：应用个性化角膜数据计算法,可计算出无晶状体眼内植入人工晶状体的理论值。
　　结论：各类无晶状体屈光不正眼,通过植入适度的人工晶状体,均可成为配合性正视眼。