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[经巩膜沟缝线固定的后房型人工晶状体植入术的结果]

[Results of posterior chamber lens implantation with trans-scleral sulcus suture fixation].

作者信息

Adam R, Böhnke M, Körner F

机构信息

Universitäts-Augenklinik Bern.

出版信息

Klin Monbl Augenheilkd. 1995 May;206(5):286-91. doi: 10.1055/s-2008-1035442.

Abstract

BACKGROUND

Transscleral fixation of a posterior chamber intraocular lens has been proposed in eyes lacking adequate posterior capsular support.

METHODS

We performed a retrospective review of 38 eyes of 38 patients who had a 12 months follow-up. Visual acuity, intraocular pressure and complications have been studied. We performed a transscleral fixation of posterior chamber lens with the following indications: 1. planned intraocular cataract extraction; 2. following intraoperative complications of phacoemulsification; 3. in combination with perforating keratoplasty; 4. in combination with parsplana vitrectomy.

RESULTS

There were no serious intra- or shortly postoperative complications. 34% of the implanted lenses were not perfectly positioned. Up to 12 months, there were only minor problems in the anterior segment (suture erosions, anterior synechiae, iris capture). As longterm postoperative complications one patient developed retinal detachment, 3 others proliferative vitreoretinopathy after previous retinal detachment surgery. Two patients developed new onset glaucoma, and 3 glaucoma patients showed a medically uncontrollable intraocular pressure postoperatively.

CONCLUSIONS

The transscleral fixation of a posterior chamber intraocular lens has been performed in combination with a vitrectomy in order to minimize postoperative complications. Especially in combination with a pars-plana vitrectomy and silicone oil filing the transsclerally fixated posterior chamber intraocular lens is superior to the anterior chamber IOLs.

摘要

背景

对于缺乏足够后囊膜支撑的眼睛,已提出经巩膜固定后房型人工晶状体的方法。

方法

我们对38例患者的38只眼睛进行了回顾性研究,随访时间为12个月。研究了视力、眼压和并发症情况。我们对后房型晶状体进行经巩膜固定的适应证如下:1. 计划内的白内障摘除术;2. 超声乳化术中的并发症;3. 与穿透性角膜移植术联合;4. 与玻璃体切割术联合。

结果

术中及术后短期内均未出现严重并发症。34%的植入晶状体位置未完全理想。至12个月时,眼前节仅出现轻微问题(缝线侵蚀、虹膜前粘连、虹膜夹持)。作为术后长期并发症,1例患者发生视网膜脱离,另外3例在既往视网膜脱离手术后发生增殖性玻璃体视网膜病变。2例患者出现新发青光眼,3例青光眼患者术后眼压药物控制不佳。

结论

为尽量减少术后并发症,后房型人工晶状体经巩膜固定术已与玻璃体切割术联合应用。特别是与玻璃体切割联合硅油填充时,经巩膜固定的后房型人工晶状体优于前房型人工晶状体。

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