CAJ | 학술논문

目的探讨Artisan虹膜夹持型人工晶状体(IOL)植入术治疗马凡综合征晶状体半脱位的有效性和安全性.方法回顾性病例研究.2007年12月至2011年7月在广东省人民医院眼科确诊的马凡综合征晶状体半脱位患者16例(25眼),行连续环形撕囊后,完成晶状体吸除、晶状体囊膜切除、前段玻璃体切割、Artisan IOL前房虹膜夹持固定和虹膜周边切除术.比较手术前后裸眼视力(UCVA)、最佳矫正视力(BCVA)、眼压、角膜内皮细胞计数,记录术后虹膜夹持型IOL位置、角膜内皮细胞丢失率,术中、术后并发症情况.随访时间6个月.采用非参数检验(Wilcoxon检验)对手术前后UCVA和BCVA进行比较.结果术后6个月UCVA和BCVA均较术前明显提高,术前和术后6个月UCVA(logMAR)分别为1.05±0.26和0.46±0.29,两者相比差异有统计学意义(Z=-4.530,P＜0.01).术前和术后6个月BCVA(logMAR)分别为0.68-±0.32和0.27±0.22,两者相比差异具有统计学意义(Z=-2.208,P＜0.01).术后所有患眼虹膜夹持型IOL位置居中,单眼复视症状消失.术后2眼出现一过性高眼压,1眼出现脉络膜脱离,1眼出现视网膜脱离,未发生IOL移位、角膜失代偿等严重并发症.术后6个月平均角膜内皮细胞丢失率为5.6％.结论 Artisan虹膜夹持型IOL植入治疗晶状体严重脱位可提高视力,消除单眼复视且安全有效.
목적 탐토Artisan홍막협지형인공정상체(IOL)식입술치료마범종합정정상체반탈위적유효성화안전성.방법 회고성병례연구.2007년12월지2011년7월재광동성인민의원안과학진적마범종합정정상체반탈위환자16례(25안),행련속배형시낭후,완성정상체흡제、정상체낭막절제、전단파리체절할、Artisan IOL전방홍막협지고정화홍막주변절제술.비교수술전후라안시력(UCVA)、최가교정시력(BCVA)、안압、각막내피세포계수,기록술후홍막협지형IOL위치、각막내피세포주실솔,술중、술후병발증정황.수방시간6개월.채용비삼수검험(Wilcoxon검험)대수술전후UCVA화BCVA진행비교.결과 술후6개월UCVA화BCVA균교술전명현제고,술전화술후6개월UCVA(logMAR)분별위1.05±0.26화0.46±0.29,량자상비차이유통계학의의(Z=-4.530,P＜0.01).술전화술후6개월BCVA(logMAR)분별위0.68-±0.32화0.27±0.22,량자상비차이구유통계학의의(Z=-2.208,P＜0.01).술후소유환안홍막협지형IOL위치거중,단안복시증상소실.술후2안출현일과성고안압,1안출현맥락막탈리,1안출현시망막탈리,미발생IOL이위、각막실대상등엄중병발증.술후6개월평균각막내피세포주실솔위5.6％.결론 Artisan홍막협지형IOL식입치료정상체엄중탈위가제고시력,소제단안복시차안전유효.
Objective To evaluate the efficacy and safety of Artisan aphakic intraocular lens (IOL) implantation for subluxated lenses in patients with Marfan syndrome (MFS).Methods In this retrospective study,25 eyes of 16 patients with subluxated lenses due to MFS accepted continuous circular capsulorhexis (CCC),lens aspiration,lens capsule removal,anterior vitrectomy,Artisan IOL implantation,and peripheral iridectomy between December 2007 and July 2011 in Guangdong General Hospital.The patients were followed for uncorrected visual acuity (UCVA),best corrected visual acuity (BCVA) and endothelial cell counts,Artisan IOL position,and occurrence of complications.The average follow-up period was 6.0 months.Non-parameteric test (Wilcoxon signed ranks) was used to compare UCVA and BCVA before and after operation.Results Six months after Artisan IOL implantation,UCVA improved from 1.05±0.26 to 0.46±0.29 (Z=-4.530,P＜0.01); BCVA improved from 0.68±0.32 to 0.27±0.22 (Z=-2.208,P＜0.01).The symptoms of monocular diplopia disappeared and mean endothelial cell loss was 5.6％ 6 months postoperatively.Postoperative complications included temporary high intraocular pressure (2 eyes),choroidal detachment (1 eye) and retinal detachment (1 eye).No significant postoperative complications were observed,such as displacement of IOL and corneal decompensation.Conclusion Artisan aphakic intraocular lens implantation for subluxated lenses is a kind of safe and effective technique for recovering vision and eliminating monocular diplopia as far as possible.