白内障合并晶状体脱位范围>2个象限患者的术式选择和术后疗效

目的:探讨白内障合并晶状体脱位范围>2个象限的患者,Ⅰ期行白内障囊内摘除术+前部玻璃体切割术,术后3mo矫正视力>0.3者,Ⅱ期行小切口两点固定人工晶状体悬吊术的临床疗效.方法:对2014-07/2016-12我院白内障科就诊的34例34眼白内障合并晶状体脱位范围>2个象限的患者,Ⅰ期行白内障囊内摘除术+前部玻璃体切割术,3mo后矫正视力>0.3者,Ⅱ期行小切口两点固定人工晶状体悬吊术,分别观察患者术后1wk,1、3mo裸眼视力、最佳矫正视力、眼压、角膜散光度、术后并发症情况.结果:随着术后恢复时间的延长,患者各期的裸眼视力和最佳矫正视力均较术前有明显提高.术后3mo最佳矫正视力0.1~<0.3者1眼,0.3~<0.5者8眼,0.5~<0.7者16眼,>0.7者9眼,达到或接近术前的最佳矫正视力.术后1wk,1、3mo眼压处于正常范围内.手术并没有明显增加角膜的散光度.结论:对于白内障合并晶状体脱位范围>2个象限的患者,Ⅰ期行白内障囊内摘除术+前部玻璃体切割术,3mo后矫正视力>0.3者,Ⅱ期行小切口两点固定人工晶状体悬吊术能有效确切地提高视力,稳定眼压,术后并发症少,是较为安全可靠的治疗方式.

Surgical effect observation of lens dislocation greater than 2 quadrants

AIM: To investigate the clinical effect of cataract combined lens dislocation greater than 2 quadrants'' patients after having phase I intracapsular cataract extraction and anterior vitrectomy, postoperative corrected vision greater than 0.3, and then taking phase II small incision suture-fixation of intraocular lens suspension.

METHODS: Totally 34 cases with cataract combined lens dislocation greater than 2 quadrants had been treated in our hospital from July 2014 to December 2016. We investigated their 1wk, 1 and 3mo postoperative complications and the uncorrected visual acuity, best corrected visual acuity, intraocular pressure, corneal astigmatism who took phase II small incision suture-fixation of intraocular lens suspension with corrected vision greater than 0.3 after having phase I intracapsular cataract extraction and anterior vitrectomy.

RESULTS: Along with the recovery time extension, patients'' uncorrected visual acuity and best corrected visual acuity increased obviously than preoperative in each phase. On the 3mo postoperatively, the best corrected visual acuity of 1 eyes was between 0.3 and 0.1, 8 eyes was between 0.5 and 0.3, 16 eyes was between 0.7 and 0.5, and 9 eyes was better than 0.7. The best corrected visual acuity was achieved or near the best corrected visual acuity before surgery. Intraocular pressure rechecked became in the normal range at 1wk, 1 and 3mo postoperative. Surgery did not significantly increase the corneal astigmatism.

CONCLUSION: It is a safe and effective way in improving eyesight effectively, with stable intraocular pressure and fewer complications towards cataract combined lens dislocation greater than 2 quadrants'' patients having phase I intracapsular cataract extraction and anterior vitrectomy, whose postoperative corrected vision greater than 0.3, and then phase II small incision suture-fixation of intraocular lens suspension.