眼内窥镜协助行人工晶状体睫状沟缝线固定术

目的:对比研究在眼内窥镜协助下行人工晶状体睫状沟缝线固定术与传统手术方法的手术效果及并发症。方法:选取30例要求进行人工晶状体植入而没有足够囊膜支撑的患者,随机分成A,B两组,每组各15例。A组按照传统方法进行人工晶状体睫状沟缝线固定术,B组在眼内窥镜的监视下进行人工晶状体睫状沟缝线固定术,对其手术并发症及术后效果进行定期观察和分析。结果:所有患者均顺利完成手术,1mo随访时的术后裸眼视力:A组为0.1～0.6,B组为0.15～0.8,两组患者术后裸眼视力均较术前裸眼视力有不同程度提高,两组间裸眼视力相比差异有统计学意义(t=2.351,P<0.05)。1mo随访时的术后最佳矫正视力:A组为0.3～0.6,B组为0.3～0.8,两组间患者的最佳矫正视力相比差异没有统计学意义(t=1.327,P>0.05)。A组出现较多并发症:3例角膜水肿、3例葡萄膜炎、4例前房积血、2例玻璃体积血、3例人工晶状体偏位或倾斜、1例虹膜周边前粘连、2例眼压升高。B组仅出现少量轻微并发症,包括5例角膜水肿、2例葡萄膜炎。结论:在眼内窥镜的协助下进行人工晶状体睫状沟缝线固定术可以确保手术缝线固定的位置位于睫状沟,与传统方法相比手术并发症明显减少,手术效果较好。

Surgery effect of endoscope-assisted transscleral suture fixation intraocular lens

AIM: To research surgery effect and complications of transscleral suture fixation intraocular lens(IOL)assisted with endoscope or with the traditional method.

METHODS: Thirty cases need IOL implantation without sufficient posterior lens capsule membrane support were chosen. These patients were divided into two groups randomly and every group had 15 patients. Group A underwent surgery of transscleral suture fixation IOL with the traditional method. Group B had surgery of transscleral suture fixation IOL assisted with endoscope. The surgical complications and postoperative effect were regularly observed and analyzed.

RESULTS: All patients were successfully completed surgery. The mean naked visual acuity(NVA)of group A was 0.26±0.14(from 0.1 to 0.6)one month after operation. The mean NVA of group B was 0.37±0.16(from 0.15 to 0.8). The postoperative NVA of two group patients was improved different degree than preoperative NVA. The differences of postoperative NVA between the two groups had statistical significance(t=2.351, P<0.05). The mean best-corrected visual acuity(BCVA)of group A and group B were 0.45±0.13(from 0.3 to 0.6)and 0.47±0.14(from 0.3 to 0.8)one month after operation. The differences of postoperative BCVA between the two groups had statistical significance(t=1.327, P>0.05). Group A appeared more complications included 3 cases of corneal edema, 3 cases of uveitis, 4 cases of anterior chamber hemorrhage, 2 cases of vitreous hemorrhage, 3 cases of IOL deviation or tilted, 1 case of the peripheral iris anterior adhesion, 2 cases of elevated intraocular pressure. Group B appeared only a few minor complications including 5 cases of corneal edema, 2 cases of uveitis.

CONCLUSION: With the help of endoscope for transscleral suture fixation IOL can ensure sutures fixed position is located in the ciliary sulcus, surgery complications decrease significantly and surgical effect is better compared with the traditional method.