摘要
目的观察不同手术方式治疗白内障术后严重囊袋收缩综合征的临床效果。方法对23例（23只眼）严重囊袋收缩综合征进行手术治疗。根据患者病情，12例行前囊口松解，囊袋内人工晶状体复位术，6例行前囊口松解并人工晶状体睫状沟植入术，5例行人工晶状体摘出、玻璃体切除并人工晶状体悬吊术。术后观察视力变化、前房反应、人工晶状体位置及前后囊变化，随访3个月。结果术后视力均有不同程度提高。行前囊口松解术者，前囊口较术前明显扩大，6只眼于术后1个月加行后囊激光切开术，眩光及单眼复视等不良主诉消失。3种手术方式下，术后1个月最佳矫正视力均较术前有明显提高，差异有统计学意义（P〈0．05）。而不同手术方式间的手术前后视力差值比较，无显著性差异（F=2．463，P〉0．05）。术后前房反应以人工晶体悬吊术患者最为明显，经治疗，1周内全部恢复正常。随访3个月，人工晶状体居中稳定、无倾斜，无明显手术并发症。结论不同手术方式治疗严重囊袋收缩综合征安全，临床效果良好。应根据患者病情，选择不同方式应对。
Objective To observe the clinical effect of different surgical methods for the treatment of severe capsule contraction syndrome. Methods Twenty-three eyes of 23 cases of severe capsule contrac- tion syndrome were treated with operation. According to the condition of patients, 12 eyes underwent anterior capsulotomy with intraocular lens （IOL） adjustion in the capsule, 6 eyes underwent anterior capsulotomy with IOL ciliary sulcus fixation, and 5 eyes underwent IOL removal with vitrectomy and IOL ciliary sulcus suture fixation. The follow-up time was 3 months, and the visual acuity, anterior chamber reaction, position of in- traocular lens, condition of the anterior and posterior capsule were measured respectively. Results The visual acuity improved postoperatively in all eyes. The size of the transparent area of the capsularhexis holes which underwent anterior capsulotomy significantly increased comparing with that before surgery. The com- plications such as glare and monocular diplopia in 6 cases disappeared after Nd：YAG laser posterior capsu- lotomy 1 month after the operation. Among the three different kinds of surgery procedures, postoperative best corrected visual acuity were all improved evidently one month after the surgery. The differences were statisti- cally significant when compared with that of preoperation （ P 〈 0.05 ）. And the difference in vision before and after operation of different surgical procedures had no statistically significant difference（ F = 2. 463 ,P 〉 0.05）. Anterior chamber reaction of IOL ciliary sulcus suture fixation cases was the most obvious one, and it returned to normal within a week after appropriate treatment. The IOL were all centered in the capsule, and no other complication was observed during the follow-up of 3 months after operation. Conclusion Va- rious surgical methods for severe capsular contraction syndrome are effective, satisfactory and safe. The rightoperation methods should be chosen according to the patients＇ condition.
出处
《中华眼外伤职业眼病杂志》
2015年第6期424-427,共4页
Chinese Journal of Ocular Trauma and Occupational Eye Disease
关键词
白内障
囊袋收缩综合征
治疗
手术
Cataract
Capsule contraction syndrome
Treatment, surgical
