人工晶状体置换术的临床分析

目的 探讨临床行人工晶状体置换术的原因、手术方法和效果。方法 回顾性分析20例（21眼）人工晶状体置换术的原因和手术方法，并对手术效果进行观察。结果 行人工晶状体置换术的原因为人工晶状体位置异常10例10眼（47．6％），人工晶状体瞳孔夹持6例7眼（33．3％），屈光度数误差2例21眼（9．5％），人工晶状体襻脱落2例2眼（9．5％）。手术置换人工晶状体的方法包括晶状体囊袋内植入5眼（23．8％），睫状沟固定6眼（28．6％），植入前房型人工晶状体10眼（47．6％）。术后裸眼远视力≥0．5者12眼（57．1％），0．1～0．4者8眼（38．1％），〈0．1者1眼（4．8％）。术后并发症包括术后一过性高眼压1例，前房出血1例，晶状体后囊膜混浊1例。结论 人工晶状体位置异常、瞳孔夹持、屈光度数误差及人工晶状体襻异常是行人工晶状体置换术的主要原因；掌握操作技巧可减少白内障摘除人工晶状体植入术后人工晶状体异常情况发生；人工晶状体置换术是处理人工晶状体异常的有效方法。

Clinical analysis of intraocular lens exchange surgery

Objective To explore the causes,surgical principle and effect of lens exchange surgery.Methods The causes for 20 cases(21eyes) of lens exchange were retrospectively analyzed,which included 10 eyes in10 cases with eccentric or dislocated intraocular lens(IOL,47.6%),7eyes in 6 cases with iris capture(33.3%),2 eyes in 2 cases with incorrect power(9.5%) and 2eyes in 2 cases with abnormal loop of IOL(9.5%).There were 11 males and 9 females aged 6 to 82 years(average 63).Results After extraction of the original implant,the second IOL was inserted in the lens bag in 5 eyes(28.5%),in the ciliary sulcus in 6 eyes(28.5%),in the anterior chamber in 10 eyes(47.6%),In the follow up of 3-72 months,the visual acuity over 0.5 was achieved in 12 eyes(57.1%),0.1-0.4 in 8 eyes(38.1%),under 0.1 in 1 eye(4.8%).The surgical complications included high intraocular pressure in 1 eye,hyphema in 1 eye and posterior capsular opacification in 1 eye.Conclusions The eccentric or dislocated IOL,iris capture,incorrect power and abnormal loop of IOL are the major causes of lens exchange.Meticulous operative technique can avoid the abnormality of IOL,and the lens exchange is an effec-tive way to manage the situation.