CAJ | 학술논문

目的探讨在无晶状体眼中前房植入ARTISAN虹膜夹型人工晶状体的术后屈光矫正效果和手术安全性.方法回顾性分析9例(9只眼)无晶状体眼患者接受ARTISAN虹膜夹型人工晶状体二期前房植入后的视力、眼压、角膜内皮细胞计数、等效球镜、术源性散光以及术后并发症等.结果经过8～20个月(平均15.3个月)的术后随访,所有病例术后裸眼视力均较术前有显著提高(术前0.05±0.03,术后0.32±0.19,t=4.63,P=0.0017).最佳矫正视力手术前、后无显著变化(术前 0.41±0.29,术后0.58±0.27,t=1.53,P=0.1652).所有病例未次随访的平均等效球镜距目标等效球镜存在±2.0 D的偏差.末次随访的平均术源性散光度数为(2.11±0.56)D.平均角膜内皮细胞密度术前1560.89±552.41个/mm2,术后(1423.67±517.15)个/mm2(t=2.79,P=0.0237),末次随访平均角膜内皮细胞计数比术前减少10.9％.除术后1只眼出观短暂的轻度前房渗出反应、1只眼发生袢的脱位外,无其它并发症发生.结论在缺乏足够后囊膜支持和存在大范围晶状体悬韧带断裂的无晶状体眼中二期植入ARTISAN虹膜夹型前房人工晶体可以安全有效地矫正无晶状体眼的屈光状态,但存在有一定的医源性散光.
목적 탐토재무정상체안중전방식입ARTISAN홍막협형인공정상체적술후굴광교정효과화수술안전성.방법 회고성분석9례(9지안)무정상체안환자접수ARTISAN홍막협형인공정상체이기전방식입후적시력、안압、각막내피세포계수、등효구경、술원성산광이급술후병발증등.결과 경과8～20개월(평균15.3개월)적술후수방,소유병례술후라안시력균교술전유현저제고(술전0.05±0.03,술후0.32±0.19,t=4.63,P=0.0017).최가교정시력수술전、후무현저변화(술전 0.41±0.29,술후0.58±0.27,t=1.53,P=0.1652).소유병례미차수방적평균등효구경거목표등효구경존재±2.0 D적편차.말차수방적평균술원성산광도수위(2.11±0.56)D.평균각막내피세포밀도술전1560.89±552.41개/mm2,술후(1423.67±517.15)개/mm2(t=2.79,P=0.0237),말차수방평균각막내피세포계수비술전감소10.9％.제술후1지안출관단잠적경도전방삼출반응、1지안발생번적탈위외,무기타병발증발생.결론 재결핍족구후낭막지지화존재대범위정상체현인대단렬적무정상체안중이기식입ARTISAN홍막협형전방인공정체가이안전유효지교정무정상체안적굴광상태,단존재유일정적의원성산광.
Objective To investigate postoperative visual rehabilitation and the safety of the operation in aphakia after secondary ARTISAN iris claw intraocular lens anterior chamber implantation.Methods A retrospective analysis of 9 cases (9 aphakic eyes) accepted ARTISAN iris claw intraocular lens anterior chamber implantation was documented.Their eyesight,intraocular pressure,corneal endothelial cell count,equivalent spherical,surgically induced astigmatism (SIA) and postoperative complications were analyzed.Results After 8-20 months (mean 15.3 months) follow-up,all cases postoperative uncorrected visual acuity significantly improved (preoperative 0.05±0.03,postoperative 0.32±0.19,t =4.63,P=0.0017).The best-corrected visual acuity had no significant change (preoperative 0.41±0.29,postoperative 0.58±0.27,t=1.53,P=0.1652).Mean postoperative spheric equivalent at the last visit was 0.96±1.54D,and differ from the target spheric equivalent ±2.0D.The SIA at the last visit was 2.11±0.56D.Mean postoperative endothelial cell density (ECD) was 1423.67±517.15 cell/mm2,preoperative ECD was 1560.89±552.41 cell/mm2,(t =2.79,P =0.0237).Mean endothelial cell density loss at the last visit was 10.9％.Except one case had transient anterior chamber effusion reaction within one week after operation and one case happened the dislocation of the loop after operation,all cases had no obvious postoperative complications.Conclusions Secondary ARTISAN iris claw intraocular lens implantation is clinically safe and effective to correct aphakic eyes which lack of enough capsule support or exist suspensory ligament of lens disruption,though exist surgically induced astigmatism (SIA) in some cases.