[1]苏锐锋,谭小波,郭立涛,等.超声生物显微镜辅助折叠人工晶状体单襻悬吊术治疗残留部分囊膜无晶状体眼患者临床疗效分析[J].眼科新进展,2017,37(2):175-178.[doi:10.13389/j.cnki.rao.2017.0046]
　SU Rui-Feng,TAN Xiao-Bo,GUO Li-Tao,et al.Therapeutic effects of ultrasound biomicroscopy assisted intraocular lens suspension surgery with one loop suturing for residual lens capsule aphakia[J].Recent Advances in Ophthalmology,2017,37(2):175-178.[doi:10.13389/j.cnki.rao.2017.0046]
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超声生物显微镜辅助折叠人工晶状体单襻悬吊术治疗残留部分囊膜无晶状体眼患者临床疗效分析/HTML
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
37卷
期数:
2017年2期
页码:
175-178
栏目:
应用研究
出版日期:
2017-02-05

文章信息/Info

Title:
Therapeutic effects of ultrasound biomicroscopy assisted intraocular lens suspension surgery with one loop suturing for residual lens capsule aphakia
作者:
苏锐锋; 谭小波; 郭立涛; 董微丽
067000　河北省承德市，承德医学院附属医院眼科
Author(s):
SU Rui-Feng; TAN Xiao-Bo; GUO Li-Tao; DONG Wei-Li
Department of Ophthalmology,the Affiliated Hospital of Chengde Medical University,Chengde 067000,Hebei Province,ChinaResponsible author:TAN Xiao-Bo,E-mail：Tanxiaobofirst@163.com；ORCID：0000-0002-2602-8509
关键词:
超声生物显微镜; 人工晶状体; 单襻悬吊术; 缝合固定
Keywords:
ultrasound biomicroscopy; intraocular lens; suspension with one loop; surturing fixation
分类号:
R776
DOI:
10.13389/j.cnki.rao.2017.0046
文献标志码:
A
摘要:
目的　评价超声生物显微镜(ultrasound biomicroscopy,UBM)辅助折叠人工晶状体单襻悬吊术治疗残留部分囊膜无晶状体眼患者的临床疗效。方法　收集2012年10月至2015年1月于我院行二期人工晶状体植入术的患者50例（50眼）,UBM检查显示晶状体囊膜残余大于等于180°。采用随机数字表法将患者分为2组，每组25例（25眼）。两组均行人工晶状体单襻悬吊术。试验组根据术前UBM结果选择进针缝合部位，对照组根据经验选择进针缝合部位。分别观察术前和术后1周、1个月、3个月的裸眼视力（uncorrected visual acuity，UCVA）和散光度，比较术后3个月UBM测量计算所得的人工晶状体偏心值和倾斜度，观察两组术后并发症情况。结果　同术前相比较，两组患者术后各个时间点的UCVA均明显升高（均为P<0.05），且术后随着时间的延长，UCVA逐渐提高（均为P<0.05）；两组间相比较，术前和术后1周的UCVA差异无统计学意义（P>0.05）。术后1个月、3个月试验组UCVA明显高于对照组（均为P<0.05）。两组间术前和术后1周散光度差异无统计学意义（均为P>0.05）。术后1个月、3个月试验组散光度明显低于对照组（均为P<0.05）。试验组人工晶状体确切植入睫状沟的比例明显高于对照组（P<0.01）。术后3个月时试验组偏心值为（0.36±0.17)mm、倾斜度（2.13±0.90）°；对照组偏心值为（0.69±0.17）mm、倾斜度（4.78±1.90）°。试验组人工晶状体的偏心值和倾斜度均明显小于对照组（均为P<0.01）。术后对照组中有3例出现前房或玻璃体少量积血；试验组有1例、对照组有2例术后早期出现眼压升高，给予降眼压药物，3个月后眼压均降至正常，停药后无复发。结论　UBM辅助折叠人工晶状体单襻悬吊术可以明显提高术后视觉质量且安全稳定，可以作为人工晶状体悬吊术的常规术前检查。UBM为人工晶状体偏心值和倾斜度的计算提供了一种可供选择的方法。
Abstract:
Objective　To evaluate the therapeutic effects of ultrasound biomicroscopy (UBM) assisted intraocular lens suspension surgery with one loop suturing for residual lens capsule aphakia.Methods　Fifty aphakia patients (50 eyes) with residual lens capsular equal or greater than 180 degrees were chosen.The patients were randomly divided into 2 groups and underwent intraocular lens suspension surgery with one loop suturing:Trial group (25 cases,25 eyes) selected suture site according to the preoperative UBM results,and control group (25 cases,25 eyes) selected the suture site according to the clinical experience.The uncorrected visual acuity (UCVA),astigmatism at preoperative and postoperative 1 week,1 month and 3 months were observed,the eccentric and tilt value of the lens were calculated by UBM measurement at 3 month after operation,and the postoperative complications of the two groups were observed.Results　UCVA at each time point after operation were higher than that before operation,and gradually increased with time.There was no significant difference between the two groups at 1 week before and after the operation of UCVA (P>0.05).At 1 month and 3 months after operation,UCVA in trial group were significantly higher than those of control group (all P<0.05).The astigmatism value at 1 week after operation in two groups was higher than that before operation and gradually decreased with time.The astigmatism value in trial group at 1 month and 3 months after operation had no significant difference with that of preoperative (P>0.05),while the astigmatism value in control group increased (all P<0.05).The astigmatism values had no significant difference between the two groups before and 1 week after operation (all P>0.05),which were significantly lower in trial group at 1 month and 3 months after operation (all P<0.05).Three months after surgery,the proportion of lens accurately implanted in the ciliary sulcus was significantly higher than control group (P<0.01),the eccentric and tilt values of the lens in trial group were significantly less than control group (P<0.01).No serious complication was observed in all patients.Conclusion　UBM assisted intraocular lens suspension surgery with one loop suturing can significantly improve the postoperative visual quality,safety and lens stability,which can be used as a routine preoperative examination of intraocular lens suspension surgery.In addition,UBM provides an alternative method for the calculation of the eccentricity and tile value of the intraocular lens after the implantation of the intraocular lens.

参考文献/References:

［1］　李君，原公强，董晓光.悬吊式人工晶状体睫状沟固定术治疗青少年眼外伤疗效观察 ［J］.山东医药，2009，49(6)：101-102.
LI J,YUAN GQ,DONG XG.Treatment of ocular trauma in children with suspension intraocular lens fixed in ciliary sulcus［J］.Shandong Med J，2009，49(6)：101-102.
［2］　周林，孙昊，徐岬，康健芳.玻璃体切除联合后房人工晶状体缝线固定术治疗晶状体脱位［J］.眼外伤职业眼病杂志，2010，32(12)：901-904.
ZHOU L,SUN H,XU J,KANG JF.Management of dislocated lenses with vitrectomy and scleral suture fixation of posterior chamber intraocular lens(IOL)［J］.Chin J Ocul Traum Occup Eye Dis，2010，32(12)：901-904.
［3］　PAVLIN CJ,SHERAR MD,FOSTER FS.Subsurface ultrasound microscopy imaging of the intact eye［J］.Ophthalmology,1990,97(2):244-250.
［4］　孟瓅，孟永安，郭永红.UBM在II期人工晶状体植入术前检查中的应用［J］.中国实用眼科杂志，2007，25(2)：2013-215.
MENG L,MENG YA,GUO YH.Application of UBM in preoperative examination of II stage intraocular lens implantation［J］.Chin J Pract Ophthalmol,2007，25(2)：2013-215.
［5］　KAMAL AM,HANAFY M,EHSAN A,TOMERAK RH.Ultrasound biomicroscopy comparison of ab interno and abexterno scleral fixation of posterior chamber intraocular lens［J］.J Cataract Refract Surg,2009,35(5):881-884.
［6］　MANABE S,OH H,AMINO K,HATA N,YAMAKAWA R.Ultrasound biomicroscopic analysis of posterior champer intraocular lens with transscleral sulcus suture［J］.Ophthalmology,2000,107(12):2172-2178.
［7］　郑广瑛，万光明，张卫霞，张楠.外伤性白内障人工晶状体睫状沟植入解剖学研究［J］.眼外伤职业眼病杂志，2004，26(1)：10-12.
ZHENG GY,WAN GM,ZHANG WX,ZHANG N.The anatomical study on sulcus fixation of PC-IOL in traumatic cataracts［J］.Chin J Ocul Traum Occup Eye Dis,2004,26(1)：10-12.
［8］　STEINER A,STEINHORST UH,STEINER M,THEISCHEN M,WINTER R.Ultrasound biomicroscopy for localization of artificial lens haptics after trans-scleral suture fixation［J］.Ophthalmology,1997,94(1):41-44.
［9］　姚长海，王庆瑛.超声生物显微镜协助人工晶状体单襻睫状沟缝线固定术［J］.中华眼外伤职业眼病杂志，2015，37（10）：764-766.
YAO CH,WANG QY.Single haptic suture fixation of intraocular lens at ciliary sulcus aided by ultrasound biomicroscopy［J］.Chin J Ocul Traum Occupat Eye Dis，2015，37（10）：764-766.
［10］　张志清，龙崇德.比较两种前段仪器在人工晶状体固定术的运用［J］.吉林医学，2012，33（19）：4066-4068.
ZHANG ZQ,LONG CD.To compare the result of two kinds of anterior ocular segment instrument to observe intraocular lens fixation［J］. Jilin Med J,2012，33（19）：4066-4068.
［11］　WANG X,DONG J,WANG X,WU Q.IOL tilt and decentration estimation from 3 dimensional reconstruction of OCT image［J］.PLoS One,2013,8(3):e59109.
［12］　KUMAR DA,AGARWAL A,PACKIALAKSHMI S,AGARWAL A.In vivo analysis of glued intraocular lens position with ultrasound biomicroscopy［J］.J Cataract Refract Surg,2013,39（7）:1017-1022.

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更新日期/Last Update: 2017-03-01