摘要
目的评价超声生物显微镜(ultrasound biomicroscopy,UBM)辅助下的改良睫状沟缝线固定人工晶状体植入术的临床疗效。方法收集2015年1月至2016年12月于我院就诊的行睫状沟缝线固定人工晶状体植入术的患者21例(21眼)。术前行UBM检查,了解睫状沟位置结构,选择睫状沟固定位点。在固定位点旁制作口袋样板层巩膜隧道。行晶状体摘出及人工晶状体悬吊术,结扎缝线关闭巩膜隧道,同时将线结埋藏于隧道内。观察术前和术后1周、1个月、3个月、12个月的裸眼视力,术中及术后并发症。通过Pentacam检查及Image Pro Plus软件分析人工晶状体的位置。结果患者术后裸眼视力除2眼外(1眼为高度近视视网膜病变、1眼为老年性黄斑变性)均有一定程度的提高。术中及术后均未见严重并发症发生。线结埋藏切口闭合满意。术后1 d人工晶状体偏心量为(0.61±0.26) mm,术后1 d、1周、1个月、3个月偏心量无明显差异,术后12个月偏心量增大,为(0.64±0.27) mm,与其他时间点相比差异均有统计学意义(均为P <0.05)。术后1 d倾斜度为5. 71°±2. 05°,术后1周、1个月,3个月、12个月倾斜度明显减小,与术后1 d时相比差异均有统计学意义(均为P<0.05)。结论 UBM术前检查能够提高手术安全性,能够辅助选择合适的缝合位点从而提高术后视觉质量。改良的口袋样板层巩膜隧道埋线法,关闭切口及埋线同时完成,操作简便,并发症少。
Objective To evaluate the clinical efficacy of improved ciliary sulcus suture fixed intraocular lens implantation assisted by ultrasound biomicroscopy(UBM).Methods A total of 21 patients(21 eyes)who received ciliary sulcus suture fixation and intraocular lens implantation from January 2015 to December 2016 in our hospital were collected.Preoperative UBM examination was performed to understand the location of ciliary sulcus for the selection of ciliary sulcus fixation site.A pocket lamellar layer sclera tunnel was made near the fixed site.Cataract extraction and intraocular lens suspension were performed.Ligature and suture were used to close the scleral tunnel and bury the thread knot in the tunnel.The visual acuity(uncorrected visual acuity,UCVA),intraoperative and postoperative complications,and the position of intraocular lens were observed before and 1 week,1 month,3 months,and 12 months after the operation.And finally,analysis of the position of the intraocular lens was performed by Pentacam examination and Imageproplus software.Results The vision of the naked eye was improved to a certain extent except for 2 eyes,of which 1 eye was high near retinal retinopathy and the other was senile macular degeneration.There was no obvious complication during and after the operation.Thread buried incision closed satisfactorily.After surgery,the eccentricity of 1D intraocular lens was(0.61±0.26)mm.There was no significant difference at 1 day,1 week,1 month,and 3 months after surgery.The eccentricity increased to(0.64±0.27)mm at 12 months after surgery,which was statistically different from other time points(all P<0.05).The average inclination for 1 day after surgery was 5.71°±2.05°,the inclination for 1 week,1 month,3 months,were all decreased,which was statistically different from the data at 1 day after operation.Conclusion Preoperative UBM examination can improve the safety of operation and assist in selecting suitable suture sites,so as to improve postoperative visual quality.Meanwhile,the close of the incision and the bury of thread knot can be performed at the same time by the improved pocket lamellar layer sclera tunnel embedding method,which can make the procedures simple and less complication.
作者
罗艳
程旭康
杨慧
金翼
冯劼
LUO Yan;CHENG Xu-Kang;YANG Hui;JIN Yi;FENG Jie(Department of Ophthalmology,Wuhan No.1 Hospital,Wuhan 430015,Hubei Province,China)
出处
《眼科新进展》
CAS
北大核心
2018年第11期1076-1079,共4页
Recent Advances in Ophthalmology
基金
武汉市卫生计生科研基金资助(编号:WX15B18
WX16C35)~~
