摘要
目的观察玻璃体切除术后无晶状体眼硅油取出联合人工晶状体植入改良术式的临床效果。方法无晶状体并硅油填充眼89例（89眼），均为复杂性视网膜脱离合并晶状体浑浊已行晶状体切除联合玻璃体切除及硅油填充术，术前矫正视力〉10．02。术前进行全周周边视网膜激光光凝，然后经角膜缘隧道切口取出硅油，最后以推注器自同一切口植入人工晶状体，缝线经巩膜层间引至近穹隆部后迂回，将人工晶状体固定于睫状沟位置。术后随访3～6个月，观察视力、眼压、人工晶状体位置及视网膜有无再脱离等情况。结果本组89例均顺利完成硅油取出及人工晶状体睫状沟固定术，术中发生悬吊线穿刺部位少量出血2例，术后人工晶状体略偏位1例，但无复视、眩光等临床症状；术后裸眼视力较术前明显提高（P〈0．05）。结论经角膜缘隧道切口取出硅油联合板层巩膜迂回缝线固定人工晶状体术是无晶状体硅油填充眼安全、有效和易于操作的手术方式。术前全周周边视网膜激光光凝可能会减少视网膜脱离的复发率。
Objective To observe the clinical effect of improved method of silicone oil removal combined with intraocular lens implantation in aphakic eyes. Methods A total of 89 aphakic eyes of 89 cases with silicone oil filling were enrolled. All cases had accepted lensectomy combined with vitrectomy and silicon oil tamponade for complicated retinal detachment and lens opacity, before surgery the corrected visual acuity were ≥0.02. The laser photocoagulation on peripheral retina was done before operation. During operation, intraocular lens was implanted after silicone oil removal through a corneal limbus tunnel incision, and fixed in the ciliary sulcus by the suture was guided to the fomix with a circuitous way in the scleral layer. The patients were followed up for 3-6 months. The visual acuity, intraocular pressure, intraocular lens position and the condition of retinal redetachment were observed. Results In all 89 eyes, silicone oil removing and intraocular lens implantation were operated successfully. During operation, a small amount bleeding at the puncture site occurred in 2 eyes. Slight deviation of intraocular lens after operation occurred in 1 eyes and no diplopia, glare or other clinical symptoms. The postoperative uncorrected visual acuity was significantly improved （ P 〈 0.05 ）. Conclusion Silicone oil removal through the corneal limbus tunnel incision combined with the lamellar scleral suture to fix intraocular lens is a safe, effective and easy surgical method for aphakic eye with silicone oil filling. The preoperative laser photocoagulation on peripheral retina may reduce the rate of recurrent retinal detachment.
出处
《中华眼外伤职业眼病杂志》
2017年第5期352-356,共5页
Chinese Journal of Ocular Trauma and Occupational Eye Disease
关键词
无晶状体眼
硅油取出
晶状体
人工
视网膜脱离
Aphakic eye
Silicone oil removal
Lens, intraocular
Retinal detachment
