中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
CHINESE JOURNAL OF PRACTICAL OPHTHALMOLOGY
2014年
10期
1197-1201
,共5页
郑科%刘学群%程昕%杨承勋
鄭科%劉學群%程昕%楊承勛
정과%류학군%정흔%양승훈
无晶状体眼%叠型人工晶状体%玻璃体切割术%人工晶状体植入25 G前灌注%微创
無晶狀體眼%疊型人工晶狀體%玻璃體切割術%人工晶狀體植入25 G前灌註%微創
무정상체안%첩형인공정상체%파리체절할술%인공정상체식입25 G전관주%미창
Aphakia%Foldable intraocular lens%Vitrectomy%IOL implantation%Minimally invasive%25 gauge anterior-irrigation
目的 探讨25G前灌注联合折叠推注型人工晶状体(IOL)微创悬吊术治疗玻璃体切割(简称玻切)术后无晶状体眼的手术技巧、疗效及注意事项.方法 对2011年10月至2013年9月在爱尔英智眼科医院,就诊的20例(21只眼)玻切术后无晶状体眼,行25G前灌注联合折叠推注型IOL微创悬吊术进行回顾性分析,术前、后观察裸眼视力、最佳矫正视力、屈光状态、角膜内皮细胞密度及IOL位置和并发症发生情况.结果 术后随访3-24月,手术除1例因IOL误装引起IOL前襻损伤而重新植入外,其余手术均一次性顺利植入,术中术后无严重并发症,术前裸眼视力为指数/眼前-0.1,术后3月裸眼视力为0.1～1.0,术前最佳矫正视力为0.51±0.30,术后3个月的最佳矫正视力为0.52±0.27,两者差异无统计学意义(P =0.379＞0.05),术后3月裸眼视力为0.50±0.28,与术前最佳矫正视力相比差异无统计学意义(P =0.526 ＞0.05).术后轻度偏中心2只眼,轻度倾斜2只眼,余IOL位置居中.结论 该术式角巩膜缘巩膜瓣无需打开结膜,创伤小,术后恢复较快,在25 G前灌注保护下,经3 mm切口缝合植入折叠注入式IOL,避免了术中眼压波动、易出血、术后切口愈合慢、散光大的缺点,术毕切口自闭,无需缝合,避免了以往25 G后灌注切口渗漏所引起的术后低眼压,安全有效、创伤小、无须缝合、无结膜瘢痕、术后恢复快等优点,为患者提供了较好地术后裸眼视力,提高了患者的视觉质量.
目的 探討25G前灌註聯閤摺疊推註型人工晶狀體(IOL)微創懸弔術治療玻璃體切割(簡稱玻切)術後無晶狀體眼的手術技巧、療效及註意事項.方法 對2011年10月至2013年9月在愛爾英智眼科醫院,就診的20例(21隻眼)玻切術後無晶狀體眼,行25G前灌註聯閤摺疊推註型IOL微創懸弔術進行迴顧性分析,術前、後觀察裸眼視力、最佳矯正視力、屈光狀態、角膜內皮細胞密度及IOL位置和併髮癥髮生情況.結果 術後隨訪3-24月,手術除1例因IOL誤裝引起IOL前襻損傷而重新植入外,其餘手術均一次性順利植入,術中術後無嚴重併髮癥,術前裸眼視力為指數/眼前-0.1,術後3月裸眼視力為0.1～1.0,術前最佳矯正視力為0.51±0.30,術後3箇月的最佳矯正視力為0.52±0.27,兩者差異無統計學意義(P =0.379＞0.05),術後3月裸眼視力為0.50±0.28,與術前最佳矯正視力相比差異無統計學意義(P =0.526 ＞0.05).術後輕度偏中心2隻眼,輕度傾斜2隻眼,餘IOL位置居中.結論 該術式角鞏膜緣鞏膜瓣無需打開結膜,創傷小,術後恢複較快,在25 G前灌註保護下,經3 mm切口縫閤植入摺疊註入式IOL,避免瞭術中眼壓波動、易齣血、術後切口愈閤慢、散光大的缺點,術畢切口自閉,無需縫閤,避免瞭以往25 G後灌註切口滲漏所引起的術後低眼壓,安全有效、創傷小、無鬚縫閤、無結膜瘢痕、術後恢複快等優點,為患者提供瞭較好地術後裸眼視力,提高瞭患者的視覺質量.
목적 탐토25G전관주연합절첩추주형인공정상체(IOL)미창현조술치료파리체절할(간칭파절)술후무정상체안적수술기교、료효급주의사항.방법 대2011년10월지2013년9월재애이영지안과의원,취진적20례(21지안)파절술후무정상체안,행25G전관주연합절첩추주형IOL미창현조술진행회고성분석,술전、후관찰라안시력、최가교정시력、굴광상태、각막내피세포밀도급IOL위치화병발증발생정황.결과 술후수방3-24월,수술제1례인IOL오장인기IOL전반손상이중신식입외,기여수술균일차성순리식입,술중술후무엄중병발증,술전라안시력위지수/안전-0.1,술후3월라안시력위0.1～1.0,술전최가교정시력위0.51±0.30,술후3개월적최가교정시력위0.52±0.27,량자차이무통계학의의(P =0.379＞0.05),술후3월라안시력위0.50±0.28,여술전최가교정시력상비차이무통계학의의(P =0.526 ＞0.05).술후경도편중심2지안,경도경사2지안,여IOL위치거중.결론 해술식각공막연공막판무수타개결막,창상소,술후회복교쾌,재25 G전관주보호하,경3 mm절구봉합식입절첩주입식IOL,피면료술중안압파동、역출혈、술후절구유합만、산광대적결점,술필절구자폐,무수봉합,피면료이왕25 G후관주절구삼루소인기적술후저안압,안전유효、창상소、무수봉합、무결막반흔、술후회복쾌등우점,위환자제공료교호지술후라안시력,제고료환자적시각질량.
Objective To evaluate the therapeutic efficacy of minimally invasive sutured intraocular lens placement without conjunctival incision in aphakic post-vitrectomy eyes via 3mm incision surgery and 25G anterior-irrigation.Methods Twenty patients(21 eyes)were aphakic post-vitrectomy eyes.Before the operation,the uncorrected distance visual acuity was from counting fingers to 0.1,and the best corrected visual acuity was from 0.1 to 1.0,All cases were performed the surgery which a Akreos foldable IOL was used to facilitate 2-point fixation through a 3mm incision,with 25G anterior-irrigating without conjunctival incision.Post-operation uncorrected visual acuity,best corrected visual acuity,IOP,diopter,IOL location and complication were observed.Results Followed-up 3-24 months post-operation,uncorrected VA was from 0.1-1.0,better than pre-operation,uncorrected VA and best corrected VA were both similar to pre-operation(P =0.526＞0.05,P =0.379＞0.05).Seventeen IOLs were good centration,2 IOLs with gently dislocation,2 IOLs with gently tilt and no one with the uncomfortable complains.Conclusions With 25 G anterior-irrigating,minimally invasive sutured intraocular lens placement without conjunctival incision in aphakic post-vitrectomy eyes via 3mm incision surgery is a safe,efficient and simple surgery,with small wound and recovery soon,no conjunctival scar.It provides good uncorrected visual acuity.
