CAJ | 학술논문

目的探讨先天性晶状体半脱位家系的病情特点和治疗方法.方法对先天性晶状体半脱位一家系中发病的3例(5眼)进行治疗,根据病情特点制定治疗方案；对晶状体半脱位＞2个象限者行晶状体囊内摘出、无线结后房人工晶状体悬吊术；对晶状体半脱位＜2个象限者行手法小切口晶状体囊外摘出、囊袋内人工晶状体睫状沟缝线无线结固定术.随访12个月观察治疗效果.结果该家系患者不伴全身发育异常,晶状体半脱位无固定方向,且存在随年龄增加,晶状体半脱位进展加重的可能.3例(5眼)术后随访1年视力0.1者1眼,0.3者2眼,0.4者1眼,0.5者1眼,无人工晶状体夹持、继发性青光眼或视网膜脱离等并发症.结论先天性晶状体半脱位早期发现,及时治疗,可避免视功能严重受损.对晶状体半脱位＜2个象限者行手法小切口晶状体囊外摘出、囊袋内人工晶状体睫状沟缝线无线结固定术是安全、有效、经济的治疗方法.
목적 탐토선천성정상체반탈위가계적병정특점화치료방법.방법 대선천성정상체반탈위일가계중발병적3례(5안)진행치료,근거병정특점제정치료방안；대정상체반탈위＞2개상한자행정상체낭내적출、무선결후방인공정상체현조술；대정상체반탈위＜2개상한자행수법소절구정상체낭외적출、낭대내인공정상체첩상구봉선무선결고정술.수방12개월관찰치료효과.결과 해가계환자불반전신발육이상,정상체반탈위무고정방향,차존재수년령증가,정상체반탈위진전가중적가능.3례(5안)술후수방1년시력0.1자1안,0.3자2안,0.4자1안,0.5자1안,무인공정상체협지、계발성청광안혹시망막탈리등병발증.결론 선천성정상체반탈위조기발현,급시치료,가피면시공능엄중수손.대정상체반탈위＜2개상한자행수법소절구정상체낭외적출、낭대내인공정상체첩상구봉선무선결고정술시안전、유효、경제적치료방법.
Objective To study the characteristics of the family congenital subluxation of lens and its treatments.Methods Three cases (5 eyes) were taken in this family,and therapies were determined based on the condition of the patients.For the patients with subluxated lens ＞ 2 quadrants the intracapsular lens extraction and non-knot scleral suture fixation of posterior chamber intraocular lens were carried out;for those with subluxated lens ＜ 2 quadrants the small incision lens extracapsular extraction and in capsular bag scleral suture non-knot fixation of posterior chamber intraocular lens through ciliary sulcus were performed.All of the cases were follow up for 1 year.Results There were not whole body upgrowth anomalies of the patient in the family,and there were no fixed directions for lens subluxation.With the increasing of age,lens subluxation may progress.Three cases (5 eyes) follow-up 1 year the visual acuity was 0.1 in 1 eye,the 0.3 in 2 eyes,the 0.4 in 1 eye,the 0.5 in 1 eye.There were not such complications as intraocular lens pupillary capture,secondary glaucoma,or retinal detachment.Conclusion Serious visual impairment can be avoided if congenital subluxated lenses can be found early,and timely treatments are given.For patients with subluxated lens ＜ 2 quadrants,it is safe,effective and economic treatment to remove the subluxated lenses with extracapsular cataract extraction in small incision and fix the intraocular lens within the capsular bag.