二期悬吊式人工晶体植入及瞳孔成形术在外伤性瞳孔散大中的临床观察

目的观察外伤性瞳孔散大眼行玻璃体和晶状体切除术后二期悬吊式人工晶体植入联合瞳孔成形术的临床疗效。方法回顾性分析40例（40眼）眼外伤患者，所有患者瞳孔直径≥5mm，均行二期人工晶体睫状沟缝线固定并虹膜缝合瞳孔成形术。结果所有术眼均顺利植入人工晶体，并成功修补缺损虹膜。术后第2天有6眼的眼压在30～40mmHg之间，药物治疗后眼压恢复正常。术后随访3～12个月，视力均达到或超过术前预测视力，矫正视力≥0．6共27眼（67.5％）。瞳孔正常生理功基本得到恢复，畏光、眩光、复视等不适症状消失。随访中未见眼压再升高者，未见虹膜线结导致的刺激反应。结论人工晶体植入联合虹膜缺损修补术是治疗无晶体眼并虹膜缺损的有效复明手术方法。

Clinical Observation of Secondary Suspensory Intraocular Lens Implantation Combined with Coreoplasty for Traumatic Mydriasis

Objective To assess the clinical effect of iris suture during secondary suspensory intraocular lens implantation after vitrectomy for traumatic mydriasis. Methods The clinical data of 40 patients （40 eyes ） treated with secondary suspensory intraocular lens implantation and iris suture were analyzed retrospectively. The pupils were larger than or equal to 5mm in diameter. Results All patients were implanted by intraocular lens（IOL） and their iris were repaired successfully. After Operation,6 eyes had higher intraocular pressure （IOP,30 - 40mmHg ） which recovered soon after drug treatment. With 6 -24 months follow-up,visual acuity was better than or equql to the preoperative predictable vision. There were 22 eyes （ 67.5 % ） of which the corrected vision acuity was better than 0.6 Photophobia, dazzling sensation and other symptoms disappeared. There was no irritant reaction caused by the knots of polypropylene line in iris. The glare and polyopia due to larger pupil and iridosteresis did not occur again. Conclusion IOL implantation combined with neoplasty of iridoschisis is an effective way for visual recovery.