复杂眼球穿孔伤人工晶状体植入的类型和时机

目的 探讨复杂眼球穿孔伤植人人工晶状体(IOL)的类型和时机选择。方法 对78例(78眼)复杂眼球穿孔伤致外伤性白内障及玻璃体视网膜病变的患者行玻璃体切除联合Ⅰ期IOL植入术(12例)、Ⅱ期前房型IOL(57例)及虹膜隔IOL植入术(9例)。术后随访6—36月，平均12.8月。结果 术后视力均较术前明显提高，视力预后与眼后段损伤程度密切相关。无一例发生视网膜脱离或角膜内皮功能失代偿。结论 复杂眼球穿孔伤植入IOL应建立在具有良好视功能的基础上，不要盲目追求Ⅰ期植入。对于无视网膜脱离或化脓性眼内炎者可Ⅰ期植入，否则均应Ⅱ期植入。晶状体囊保留者可选择后房型IOL囊缺失者可选择前房型IOL；伴外伤性无虹膜者则建议选择虹膜隔IOL。

A clinical study on the surgery indication and IOL selection after complicatedglobal penetrating injury

Objective To study the indication and the intraocular lens (IOL) selection after complicated global penetrating injury. Clinical results were evaluated. Methods 78 eyes (78 patients) with traumatic cataract and vitreoretinopathy after complicated global penetrating injury were treated with pars plana vitrectomy, 12 eyes with primary IOL implantation, 57 eyes with secondary anterior chamber IOL implantation and 9 eyes with secondary black diaphragm IOL implantation. The mean follow-up after IOL placement was 12. 8 months. Results The visual acuity afte IOL implantation was much elevated than that after trauma. It was closely related with the traumatic degree of posterior segment. No retinal detachment and bullous keratopathy were observed. Conclusion It is safe and effective to implant IOL for traumatic cataract after complicated global penetrating injury if an optimal operative treatment and an optimal type of IOL are selected.