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人工晶状体脱位的临床特征与预后:一项八年回顾性研究

Clinical characteristics and outcomes of intraocular lens dislocation: an eight-year retrospective study.

作者信息

Xu Su, Shao Jingzhi, Zhang Yuhang, Si Wei, Mao Yi, Du Shanshan, Zhang Fengyan

机构信息

Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, Henan, China.

出版信息

PLoS One. 2025 Jun 25;20(6):e0327210. doi: 10.1371/journal.pone.0327210. eCollection 2025.

Abstract

OBJECTIVE

To investigate the clinical characteristics, risk factors, and short-term visual outcomes following surgical management of intraocular lens (IOL) dislocation, aiming to inform risk stratification and individualized treatment strategies.

METHODS

A retrospective analysis was conducted on 155 patients (166 eyes) diagnosed with IOL dislocation between 2016 and 2024. Data collected included demographic information, ocular and systemic risk factors, surgical interventions, uncorrected distance visual acuity (UDVA) before and after surgery, and postoperative complications. Comparative analyses were performed to assess the short-term efficacy and safety of different surgical approaches.

RESULTS

The mean patient age was 55 years, with 86.75% presenting unilateral dislocation. Predominant risk factors identified were high myopia (38.55%) and prior vitrectomy (17.47%). A total of 89.16% of IOL dislocations were classified as late-onset. Of the 154 eyes that underwent surgical intervention, both IOL repositioning and exchange procedures resulted in significant improvements in UDVA (P < 0.05). Postoperative transient intraocular pressure elevations were observed without significant differences between surgical methods, resolving within three days in all cases.

CONCLUSION

High myopia and prior vitrectomy are significant risk factors for IOL dislocation. Surgical correction, whether through repositioning or exchange, is effective and safe, leading to substantial visual acuity improvements. Proactive identification and management of high-risk individuals are crucial for preventing IOL dislocation and optimizing patient outcomes.

摘要

目的

探讨人工晶状体(IOL)脱位手术治疗后的临床特征、危险因素及短期视觉效果,旨在为风险分层和个体化治疗策略提供依据。

方法

对2016年至2024年间诊断为IOL脱位的155例患者(166只眼)进行回顾性分析。收集的数据包括人口统计学信息、眼部和全身危险因素、手术干预、手术前后的未矫正远视力(UDVA)以及术后并发症。进行比较分析以评估不同手术方法的短期疗效和安全性。

结果

患者平均年龄为55岁,86.75%为单侧脱位。确定的主要危险因素为高度近视(38.55%)和既往玻璃体切除术(17.47%)。89.16%的IOL脱位被归类为迟发性。在接受手术干预的154只眼中,IOL复位和置换手术均使UDVA有显著改善(P < 0.05)。观察到术后短暂眼压升高,手术方法之间无显著差异,所有病例均在三天内缓解。

结论

高度近视和既往玻璃体切除术是IOL脱位的重要危险因素。手术矫正,无论是通过复位还是置换,都是有效且安全的,可显著提高视力。积极识别和管理高危个体对于预防IOL脱位和优化患者预后至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3080/12193011/c8f441f6bfd6/pone.0327210.g001.jpg

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