瞳孔成形联合虹膜夹人工晶状体植入术治疗外伤性无晶状体眼疗效观察

目的 观察瞳孔成形联合虹膜夹人工晶状体植入术治疗外伤性无晶状体眼的疗效.方法 回顾性分析在我院采用瞳孔成形联合虹膜夹人工晶状体植入术治疗的外伤后无晶状体眼患者17例17眼的临床资料.观察术后视力、角膜内皮细胞计数、眼压、人工晶状体位置、瞳孔情况及术后并发症.结果 17例患者均顺利修补损伤虹膜,瞳孔成形后成功植入虹膜夹人工晶状体,未发生严重手术并发症,人工晶状体位置稳定.术后6个月裸眼视力(0.52 +0.17),较术前视力(0.04±0.02)及术前最佳矫正视力(0.44±0.13)提高.术后6个月角膜内皮细胞计数为(1993.88±127.24)个·mm-1,较术前(2178.88±132.61)个·mm-2减少(P＜0.05),但术后未发现角膜失代偿.术前眼压(15.91 ±2.73)mmHg(1 kPa=7.5 mmHg)与术后眼压(16.69±2.61) mmHg无明显差异(P＞0.05).术后瞳孔大小(4.4±0.2)mm较术前(5.5 +0.3)mm缩小(P＜0.05),患者术后无明显畏光、眩光、复视等不适症状.结论 瞳孔成形联合虹膜夹人工晶状体植入术是治疗外伤虹膜损伤并无有效晶状体囊膜支持的无晶状体眼的安全有效方法.

Iris-claw intraocular lens implantation after pupil re construction for aphakic eyes caused by ocular trauma

Objective To observe the effect of implantation of iris-claw intraocu lax lens combined with pupil reconstruction on aphakic eyes caused by ocular trauma.Methods The clinical data of 17 patients (17 eyes) of aphakic eyes treated with irisclaw intraocular lens implantation and pupil reconstruction were analyzed retrospectively,and the visual acuity,corneal endothelial cell count,intraocular pressure,intraocular lens location,pupil condition and postoperative complications were observed.Results Intraocular lens were implanted and pupils were repaired in all 17 patients (17 eyes) successfully,with no complications of intraocular lens dislocation and corneal decom pensation.The postoperative uncorrected visual acuity (0.52 + 0.17) was better than the preoperative visual acuity (0.04 + 0.02) and preoperative best corrected visual acui ty (0.44 +0.13).The corneal endothelial cell count was (1993.88 + 127.24) mm-2 6 months after operation,which was lower than that of preoperative date (2178.88 + 132.61)mm-2 (P ＜ 0.05).Preoperative intraocular pressure (15.91 + 2.73) mmHg (1 kPa =7.5 mmHg) was not significantly different from postoperative intraocular pressure (16.69 + 2.61) mmHg (1 kPa =7.5 mmHg) (P ＞ 0.05).The postoperative pupil size (4.4 + 0.2) mm] was smaller than that of preoperative date (5.5 + 0.3) mm] (P ＜ 0.05).The symptoms of photophobia,glare and diplopia did not occur postoperatively.Conelusion Pupil reconstruction combined with iris-claw intraocular lens implanta tion is a safe and effective method for aphalic eyes combined with absence of capsule support and ruptured iris.