Xiong Q, Guo R, Feng Z, Quan Y, Yang J
Department of Ophthalmology, Affiliated Second Hospital, Xi'an Medical University, Xi'an 710004, China.
Zhonghua Yan Ke Za Zhi. 2000 Mar;36(2):88-90.
To evaluate the methods and effects of anterior segment reconstruction and secondary posterior chamber intraocular lens (IOL) implantation supported by fibromembrane in pupillary area.
Anterior segment was reconstructed in 86 eyes with different anterior segment disorders. Anterior segment reconstruction includes: partial penetrating keratoplasty, loosing front adhesion, suturing detached peripheral iris, loosing rear adhesion, reshaping pupil, perforating fibromembrane in the pupillary area. The IOL was secondarily implanted into the posterior chamber, and the patients were followed up in 3 - 32 months.
The surgery was successful in all patients. The postoperative visual acuities in 71 eyes were >or= 0.5 (82.6%), including >or= 0.9 (39.5%) in 34 eyes and <or= 0.2 in 15 eyes (17.4%). After IOL implantation, the IOL correctly centered was in 68 eyes (79.1%), and deviated in 18 eyes (20.9%). Anterior chamber hemorrhage occurred in 5 eyes, 4 of them were recovered by conservative treatment and the blood membrane in another eye was sucked out through its primary incision. All patients had slight postoperative inflammation and without severe long term complications.
With the support of enough fibromembrane in pupillary area, anterior segment reconstruction and secondary posterior chamber IOL implantation can be performed, thus IOL suture fixation is not necessary, and its associated complications can be avoided.
评估瞳孔区纤维膜支持下的前段重建及二期后房型人工晶状体植入术的方法及效果。
对86例存在不同前段病变的患眼进行前段重建。前段重建包括：部分穿透性角膜移植术、松解前部粘连、缝合周边虹膜离断、松解后部粘连、瞳孔重塑、瞳孔区纤维膜穿孔。二期将人工晶状体植入后房，并对患者随访3至32个月。
所有患者手术均成功。术后71只眼（82.6%）视力≥0.5，其中34只眼（39.5%）视力≥0.9，15只眼（17.4%）视力≤0.2。人工晶状体植入后，人工晶状体位置居中良好的有68只眼（79.1%），位置偏移的有18只眼（20.9%）。5只眼发生前房出血，其中4只眼经保守治疗后恢复，另1只眼的血膜通过原切口吸出。所有患者术后均有轻度炎症，无严重远期并发症。
在瞳孔区有足够纤维膜支持的情况下，可进行前段重建及二期后房型人工晶状体植入术，无需行人工晶状体缝线固定，且可避免相关并发症。
