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。

Different surgical treatment of traumatic lens dislocation

Objective To evaluate the effect of different operative techniques for the treatment of traumatic lens dislocation.Methods According to different position and degree of the lens dislocation,different surgical managements were performed to extract the dislocated lens and implant posterior chamber intraocular lens(IOL),including the extraction of the lens dislocated into the anterior chamber through corneal limbus approach,phacoemulsification through scleral tunnel approach,lensectomy combined with vitrectomy and intracapsular lens implantation or ciliary sulcus suture fixation of the IOL through pars plana approach. Results Of the 22 cases(22 eyes) posoperatively, final best corrected visual acuity was lower than 0.05 in 3 eyes(13.64%),and 0.05-0.25 in 9 eyes(40.91%),0.3-1.0 in 10 eyes(45.45%).The visual acuity improved to different degrees in 19 eyes(86.36%),no significant complications were observed. Conclusions The surgical treatment method of traumatic lens dislocation should be chosen according to the location of the dislocated lens and the existence of complications. To choose suitable techniques according to different indications and grasp them proficiently is the most important factor for success.