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

发布时间：2018-12-25 10:35

【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P0.05),且术后随着时间的延长,UCVA逐渐提高(均为P0.05);两组间相比较,术前和术后1周的UCVA差异无统计学意义(P0.05)。术后1个月、3个月试验组UCVA明显高于对照组(均为P0.05)。两组间术前和术后1周散光度差异无统计学意义(均为P0.05)。术后1个月、3个月试验组散光度明显低于对照组(均为P0.05)。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(P0.01)。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P0.01)。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 clinical effect of ultrasonic biomicroscopy (ultrasound biomicroscopy,UBM) assisted single loop suspension of foldable intraocular lens (IOL) in the treatment of residual partial capsular aphakic eye. Methods from October 2012 to January 2015, 50 patients (50 eyes) underwent secondary intraocular lens implantation in our hospital.), UBM examination showed that the residual lens capsule was more than or equal to 180 掳. Patients were randomly divided into two groups with 25 eyes (25 eyes) in each group. Both groups were treated with single loop suspension of intraocular lens. The experimental group selected the suture site according to the UBM results before operation, while the control group selected the suture site according to the experience. The uncorrected visual acuity (uncorrected visual acuity,UCVA) and astigmatism were observed before and 1 week, 1 month and 3 months after operation respectively. The eccentricity and inclination of intraocular lens measured by UBM at 3 months after operation were compared, and the complications of the two groups were observed. Results compared with pre-operation, the UCVA of the two groups were significantly increased at each time point after operation (P0.05), and the UCVA increased gradually with the prolongation of time (P0.05). There was no significant difference in UCVA between the two groups before and 1 week after operation (P0.05). The UCVA in the trial group was significantly higher than that in the control group at 1 month and 3 months postoperatively (P0.05). There was no significant difference in astigmatism between the two groups before operation and 1 week after operation (P0.05). The astigmatism in the experimental group was significantly lower than that in the control group at 1 month and 3 months postoperatively (P0.05). The ratio of intraocular lens implantation into ciliary sulcus in the trial group was significantly higher than that in the control group (P 0.01). The eccentricity of the experimental group was (0.36 卤0.17) mm, inclination (2.13 卤0.90) 掳, and that of the control group was (0.69 卤0.17) mm, inclination (4.78 卤1.90) 掳. The eccentricity and inclination of IOL in the experimental group were significantly lower than those in the control group (P0.01). There were 3 cases of anterior chamber or vitreous hemorrhage in the control group, 1 case in the test group and 2 cases in the control group. Conclusion UBM assisted single loop suspension of foldable intraocular lens can significantly improve visual quality and is safe and stable. UBM provides an alternative method for calculating the eccentricity and inclination of intraocular lens.
【作者单位】：承德医学院附属医院眼科;
【分类号】：R779.66

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