CAJ | 학술논문

目的观察晶状体玻璃体切除术后眼内二期植入Artisan晶状体的有效性、可预测性和安全性.方法回顾性分析16例因各种眼外伤行晶状体、玻璃体切除术后二期植入Artisan晶状体的病人.观察指标包括:手术时间,术前及术后的裸眼及矫正视力,屈光度,角膜内皮细胞计数,术中术后并发症.随访时间(26.3±3.6)个月.结果平均眼轴(22.46±0.47) mm,手术经历时间15～36 min,平均(17.3±4.4) min.术中有12例病人人工晶状体近水平放置,4例病人斜向放置.所有病人术后裸眼视力均较术前提高,术后6个月,裸眼视力等于术前最佳矫正视力的有6例,0.3及以上者13例,0.2者2例,0.1者1例.手术预留屈光度为轻度近视(-0.5 D),术前与术后6个月屈光度对比,球镜屈光度:术前(+10.2±1.09)D,术后:(-0.63±0.44)D(P＜0.05)；柱镜屈光度(绝对值),术前:(1.84±1.56)D,术后:(1.97±1.69)D(P＞0.05).4例斜向放置病人术后平均球镜屈光度为-0.75D.柱镜屈光度(绝对值),术前1.94 D,术后1.75 D.术前角膜内皮细胞计数(2377.4±279.74)个/mm2,术后1年角膜内皮细胞计数均数为(2265.7±258.65)个/mm2,损失率为4.7％；术后2年平均为(2244.4±249.32)个/mm2,第2年损失率为0.94％.并发症:2例病人少量前房出血,3例病人一过性角膜水肿,3例病人术后低眼压(＜8 mm Hg),其中1例病人伴视物晃动感,上述并发症均于1周内恢复.未观察到其它并发症.结论晶状体玻璃体切除术后二期植入Artisan晶状体有效性、预测性良好,2年随访有较好安全性.
목적 관찰정상체파리체절제술후안내이기식입Artisan정상체적유효성、가예측성화안전성.방법 회고성분석16례인각충안외상행정상체、파리체절제술후이기식입Artisan정상체적병인.관찰지표포괄:수술시간,술전급술후적라안급교정시력,굴광도,각막내피세포계수,술중술후병발증.수방시간(26.3±3.6)개월.결과 평균안축(22.46±0.47) mm,수술경력시간15～36 min,평균(17.3±4.4) min.술중유12례병인인공정상체근수평방치,4례병인사향방치.소유병인술후라안시력균교술전제고,술후6개월,라안시력등우술전최가교정시력적유6례,0.3급이상자13례,0.2자2례,0.1자1례.수술예류굴광도위경도근시(-0.5 D),술전여술후6개월굴광도대비,구경굴광도:술전(+10.2±1.09)D,술후:(-0.63±0.44)D(P＜0.05)；주경굴광도(절대치),술전:(1.84±1.56)D,술후:(1.97±1.69)D(P＞0.05).4례사향방치병인술후평균구경굴광도위-0.75D.주경굴광도(절대치),술전1.94 D,술후1.75 D.술전각막내피세포계수(2377.4±279.74)개/mm2,술후1년각막내피세포계수균수위(2265.7±258.65)개/mm2,손실솔위4.7％；술후2년평균위(2244.4±249.32)개/mm2,제2년손실솔위0.94％.병발증:2례병인소량전방출혈,3례병인일과성각막수종,3례병인술후저안압(＜8 mm Hg),기중1례병인반시물황동감,상술병발증균우1주내회복.미관찰도기타병발증.결론 정상체파리체절제술후이기식입Artisan정상체유효성、예측성량호,2년수방유교호안전성.
Objective To evaluate efficacy,predictability and safety of Artisan intraocular lens (IOL) secondary implantation for aphakic correction in eyes after vitrectomy and lensectomy.Methods Retrospectively study 16 patients underwent Artisan IOL secondary implantation for aphakic correction in eyes after vitrectomy and lensectomy due to eye trauma.Operation time,uncorrected visual acuity,best corrected visual acuity (BCVA),refraction,endothelial cell count,and clinical complications were evaluated.All the patients were followed up to 26.3±3.6 months.Results The mean axial length was 22.46±0.47mm.The mean operation time was 17.3±4.4 minutes,ranged from 15 minutes to 36 minutes.The IOL was implanted horizontally in 12 patients and implanted obliquely in 4 patients.Postoperative uncorrected visual acuity improved in all the patients,uncorrected visual acuity equal to preoperative BCVA in 6 patients,better or equal to 0.3 in 13 patients.Mean spherical degree was +10.2±1.09 diopter (D) preoperative and-0.63±0.44D postoperative (P ＜0.05).Mean degree of astigmatism was 1.84±1.56D preoperative and 1.97±1.69D postoperative (P ＞0.05).For the 4 patients IOL implanted obliquely,the mean spherical degree was-0.75D postoperative and the degree of astigmatism was 1.94D preoperative and 1.75D postoperative.Preoperative mean endothelial cell count was 2377.4±279.74 cells/mm2,mean endothelial cell loss was 4.7％ 12 months postoperatively and 0.94％ during the second year.Complications included hyphema in 2 patients,transient cornea edema in 3 patients and hypotony in 3 patients,one of which had hypotony combined with visual tremor.All the complications recovered in one week.No other complications were observed.Conclusions Artisan IOL implantation seems a predictable and effective option for eyes after vitrectomy and lensectomy without capsule support,and it is safe during 2 years follow up.