后囊破裂型外伤性白内障人工晶状体二期植入

目的探讨人工晶状体二期睫状沟植入在眼球穿孔伤所致后囊破裂型外伤性白内障手术中的应用。方法我院2011年1月至2013年1月收治眼球穿孔伤所致后囊破裂型外伤性白内障82例（82眼），在一期眼球清创缝合白内障摘出联合前段玻璃体切除手术时尽量保留残余囊袋。3～6个月后行二期人工晶状体植入术。根据囊袋残留情况分为两组：A组：残留囊袋足够支撑后房型人工晶状体者（48例），进行后房型人工晶状体睫状沟植入。B组：囊袋无残留或残留囊袋无法支撑后房型人工晶状体者（34例），进行缝线固定晶状体襻于巩膜壁的后房型人工晶状体睫状沟植入。结果两组患者术后视力均有提高。B组BCVA明显低于A组。A组2例（4．17％）人工晶状体光学中心轻度偏移，4例（8．33％）体部轻度倾斜；B组6例（17．65％）人工晶状体光学中心轻度偏移，6例（17．65％）体部倾斜，其中3例（8．82％）眼球转动时有不适感。结论对于眼球穿孔伤所致后囊破裂型外伤性白内障，于一期行眼球清创缝合、白内障摘出联合前段玻璃体切除手术时尽量保留残余囊袋组织，可为二期植入人工晶状体创造良好条件。二期手术时选择后房型人工晶状体睫状沟植入术，符合人体解剖结构，稳定性好。

Posterior chamber intraocular lens implantation in the second phase for traumatic cataract with posterior capsule rupture

Objective To investigate the application of intraocular lens implanted in ciliary sulcus in the second phase for traumatic cataract with cracked posterior capsule. Methods The debridement and cataract extraction plus anterior vitrectomy were performed in eighty-two eyes of 82 cases of cataract with cracked posterior capsule caused by penetrating eye trauma and the residual capsule was retained as well as possible while surgery. The secondary intraoeular lens implantation was done 3-6 months later, eighty-two eyes were divided into two groups based on the residual capsule： In group A （48 eyes）, the posterior chamber intraocular lens could be supported by residual capsule in ciliary sulcus; In group B （34 eyes） , the residual capsule was not enough to support the lens so the lens was sutured with stitches on the scleral wall. Results The best corrected visual acuity （BCVA） of two groups after secondary surgery was improved compared with that before surgery. The BCVA of group B was much lower than group A in each interval （P 〈 0.05 ）. The optical center was slightly shifted in 2 eyes of group A and 6 eyes of group B. The slight tilt was found in 4 eyes of group A and 6 eyes of group B with discomfort when eye moving in 3 eyes. Conclusion The debridement, cataract extraction plus anterior vitrectomy and retaining residual capsule for traumatic cataract with cracked posterior capsule, can create a good condition for the secondary intraocular lens implantation. The posterior chamber intraocular lens in ciliary sulcus is consistent with human anatomical structure and stable.