Ju Ruihong, Chen Yun, Yang Wei, He Mansha, Pan Yuanhong, Wu Zheming
Catract Center, Guangzhou Aier Eye Hospital, Guangzhou 510030, China.
Optometry Center, Guangzhou Aier Eye Hospital, Guangzhou 510030, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2019 Jul 30;39(7):843-849. doi: 10.12122/j.issn.1673-4254.2019.07.15.
To evaluate the application of femtosecond laser technology in the management of subluxated lens.
We retrospectively analyzed the data of the patients with subluxated lens undergoing femtosecond laser- assisted surgery at the Cataract Center of Guangzhou Aier Eye Hospital between March, 2017 and May, 2019. The LenSx femtosecond laser-assisted cataract surgery system was used to perform capsulotomy and lens fragmentation. According to the patients' eye condition, anterior vitrectomy was performed and capsular retractors was used. After phacoemulsification, I/A and insertion of the tension rings, the intraocular lens (IOL) was implanted into the capsular bag. The perioperative data, complications, visual acuity and intraocular pressure after the operation were recorded, and the stability of the capsular bag and IOLs were assessed.
We analyzed the data of 25 cases (29 eyes) of subluxated lens, including 16 (16 eyes; 55.17%) as the result of traumatic lens subluxation, 5 (9 eyes; 31.03%) of Mafan syndromes, 1 case (1 eye; 3.45%) of high myopia and 3 cases (3 eyes; 10.34%) of unknown causes. Thirteen 13 eyes (44.83%) showed mild subluxation, 7 (24.14%) had moderate subluxation, and 9 (31.03%) had severe subluxation. Femtosecond laser- assisted capsulorhexis, lens fragmentation and phacoemulsification were successfully completed for 29 eyes, of which 28 eyes (96.55%) retained the complete capsular bag and with successful implantation of the capsular tension devices and IOLs. Nine eyes (31.03%) were treated with anterior segment vitrectomy; iris hooks were used for 2 eyes (6.90%) and capsular bag hooks for 9 eyes (31.03%). The best corrected visual acuity was significantly improved in 29 eyes after operation ( < 0.05). At 1 month after the surgery, 26 eyes (89.66%) showed stably centered IOLs, 2 eyes (6.90%) showed slight tilt of the IOLs, and 3 eyes (10.34%) had anterior capsular contraction. The intraoperative complications included subconjunctival hemorrhage (75.87%), incomplete capsulotomy (17.24%) and contracted pupils (13.79%).
The application of femtosecond laser assisted technology enhances the surgical safety and effectiveness for subluxated lens, facilitates the choice of individualized surgical options, and promotes maximum recovery of the patients' visual function.
评估飞秒激光技术在半脱位晶状体治疗中的应用。
回顾性分析2017年3月至2019年5月在广州爱尔眼科医院白内障中心接受飞秒激光辅助手术的半脱位晶状体患者的数据。使用LenSx飞秒激光辅助白内障手术系统进行晶状体囊切开和晶状体破碎。根据患者眼部情况，进行前段玻璃体切除术并使用囊膜牵开器。在超声乳化、I/A及植入张力环后，将人工晶状体（IOL）植入囊袋内。记录围手术期数据、并发症、术后视力和眼压，并评估囊袋和IOL的稳定性。
分析了25例（29只眼）半脱位晶状体患者的数据，其中因外伤性晶状体半脱位16例（16只眼；55.17%），马凡综合征5例（9只眼；31.03%），高度近视1例（1只眼；3.45%），原因不明3例（3只眼；10.34%）。13只眼（44.83%）为轻度半脱位，7只眼（24.14%）为中度半脱位，9只眼（31.03%）为重度半脱位。29只眼成功完成了飞秒激光辅助的连续环形撕囊、晶状体破碎及超声乳化，其中28只眼（96.55%）保留了完整的囊袋，并成功植入了囊袋张力装置和IOL。9只眼（31.03%）接受了前段玻璃体切除术；2只眼（6.90%）使用了虹膜钩，9只眼（31.03%）使用了囊袋钩。术后29只眼的最佳矫正视力有显著提高（<0.05）。术后1个月，26只眼（89.66%）的IOL位置稳定居中，2只眼（6.90%）的IOL有轻微倾斜，3只眼（10.34%）有前囊膜收缩。术中并发症包括结膜下出血（75.87%）、囊切开不完全（17.24%）和瞳孔缩小（13.79%）。
飞秒激光辅助技术的应用提高了半脱位晶状体手术的安全性和有效性，便于选择个体化手术方案，促进患者视功能最大限度恢复。
