CAJ | 학술논문

目的利用超声生物显微镜(UBM)观察虹膜固定后房型人工晶状体的位置,评价手术安全性.方法临床病例对照研究.对2008年2月至2011年2月在山东大学第二医院眼科手术的无足够囊膜支撑的无晶状体眼患者17例17只眼,二期施行虹膜缝合固定后房型人工晶状体(PCIOL)手术,术后6个月行UBM检查,确定人工晶状体与睫状沟和睫状体的关系、前房深度(ACD)、人工晶状体倾斜情况、人工晶状体光学部与虹膜位置关系和房角情况.主要指标是襻的位置、前房深度和房角改变.结果 17个人工晶状体的34个襻中,27个(79.4％)襻位于睫状沟,5个(14.7％)襻位于睫状突,2个(5.9％)襻位于睫状体平坦部.17只眼中有11只眼(70.6％)双襻均位于睫状沟.前房深度为(3.39 ±0.47) mm.未发现虹膜周边前粘连、房角异常和晶状体光学部的倾斜.结论经UBM观察,虹膜缝合固定后房型人工晶状体的襻均位于睫状沟或睫状体,无明显的人工晶状体倾斜.这种术式不影响房角结构,无房角的关闭.前房深度与囊袋内植入人工晶状体最为接近.弄清人工晶状体位置可能有助于确定手术方式、人工晶状体度数计算和减少术后并发症.
목적 이용초성생물현미경(UBM)관찰홍막고정후방형인공정상체적위치,평개수술안전성.방법 림상병례대조연구.대2008년2월지2011년2월재산동대학제이의원안과수술적무족구낭막지탱적무정상체안환자17례17지안,이기시행홍막봉합고정후방형인공정상체(PCIOL)수술,술후6개월행UBM검사,학정인공정상체여첩상구화첩상체적관계、전방심도(ACD)、인공정상체경사정황、인공정상체광학부여홍막위치관계화방각정황.주요지표시반적위치、전방심도화방각개변.결과 17개인공정상체적34개반중,27개(79.4％)반위우첩상구,5개(14.7％)반위우첩상돌,2개(5.9％)반위우첩상체평탄부.17지안중유11지안(70.6％)쌍반균위우첩상구.전방심도위(3.39 ±0.47) mm.미발현홍막주변전점련、방각이상화정상체광학부적경사.결론경UBM관찰,홍막봉합고정후방형인공정상체적반균위우첩상구혹첩상체,무명현적인공정상체경사.저충술식불영향방각결구,무방각적관폐.전방심도여낭대내식입인공정상체최위접근.롱청인공정상체위치가능유조우학정수술방식、인공정상체도수계산화감소술후병발증.
Objective To observe the position of iris-fixated foldable lens with ultrasound biomicroscopic (UBM),and evaluate the safety of the operation.Methods Seventeen patients (17 eyes)who had insufficient posterior capsular support for intraocular lens underwent iris-fixated foldable lens implantation.Six months later,UBM was used to determinate the haptic position in relation to ciliary sulcus and ciliary body,the anterior chamber depth (ACD),lens tilt,relationship of the IOL optic to iris and angle abnormalities in these eyes.Main outcome measures were haptic position,ACD and iris anatomic changes.Results Of the 34 haptics,27 (79.4％) were positioned in the ciliary sulcus,5 (14.7％) haptics were found over the ciliary processes,and 2 (5.9％) were over pars plana.Both haptics were in the ciliary sulcus in 11 eyes of the 17 eyes (70.6％).The mean (±standard deviation) ACD was (3.84±0.36) mm.No patients were found to have peripheral anterior synechiae,angle abnormalities or tilted lens.Conclusions Iris-sutured PCIOL haptics are found to be in the ciliary sulcus or over the ciliary body with no lens tilt on UBM analysis.The procedure respects the angle anatomy,and no evidence of angle closure is found.The ACD is similar to that of in-the-bag PCIOLs.This may have implications for surgical technique,IOL power calculations,and postoperative complications.