外伤性虹膜缺如眼植入虹膜隔人工晶状体的远期随访及植入技术改进

发布时间：2018-05-17 20:13

本文选题：虹膜缺如 + 虹膜隔人工晶状体　；参考：《青岛大学》2013年博士论文

【摘要】：目的眼球破裂伤常合并严重的虹膜、晶状体和玻璃体视网膜的损伤。通过手术治疗,大多数患者可以恢复一定的视功能,但是由于虹膜缺损带来的球面像差和色像差问题,给患者带来了严重的畏光和眩光症状。自从虹膜隔人工晶状体(black diaphragm intraocular lens, BDI)面世以来,国内外学者先后发表了多篇关于植入虹膜隔人工晶状体的临床病例报告。多数学者认为植入虹膜隔人工晶状体是治疗无虹膜无晶状体患者的有效方法。我们对在青岛眼科医院接受虹膜隔人工晶状体植入的患者进行了长期随访观察,发现部分患者有严重的继发性青光眼和角膜内皮功能失代偿发生。针对这个问题,我们将植入技术进行了改进,以避免虹膜隔人工晶状体植入术后远期并发症的发生。并对使用改进技术的患者进行随访,报告长期随访的结果。方法青岛眼科医院自1998年9月开始为虹膜缺损、缺如的患者植入虹膜隔人工晶状体,截止2012年12月共为78例患者的78只眼植入虹膜隔人工晶状体。1998年9月-2007年8月为第一阶段,在这个阶段我们为53例患者植入了虹膜隔人工晶状体。2008年11月至2012年12月为第二阶段,采用改进的植入技术为25例患者植入了虹膜隔人工晶状体。我们通过电话、网络和家访等多种途径联系患者,邀请其返院复诊,重点检查矫正视力,眼压,角膜内皮计数和超声生物显微镜检查(UBM)观察虹膜隔人工晶状体位置。结果第一阶段的53例患者中随访到30例,其中18例保持了良好的眼部情况,12例患者发生角膜内皮功能失代偿和继发性青光眼等并发症。接受技术改进的第二阶段的25例患者均保持良好的眼部情况,没有严重并发症发生。结论对于虹膜完全缺如的患者,虹膜隔人工晶状体植入时悬吊植入的位置适当偏后并要做到术中牢固固定,使之不与角膜内皮及房角接触,以避免该手术的远期并发症的发生。
[Abstract]:Purpose Rupture of the eyeball is often associated with severe iris, lens, and vitreoretinal injuries. Through surgical treatment most patients can recover certain visual function but the spherical aberration and color aberration caused by iris defect bring serious photophobia and glare to the patients. Since the appearance of black diaphragm intraocular lens, BDI) in iris septum intraocular lens (IOL), domestic and foreign scholars have published a number of clinical reports on the implantation of IOL in iris septum. Most scholars believe that the implantation of iris septum intraocular lens is an effective method for the treatment of aphakic patients. A long term follow-up study was carried out on patients receiving iris septum intraocular lens implantation in Qingdao Ophthalmology Hospital. Serious secondary glaucoma and corneal endothelial decompensation were found in some of the patients. To solve this problem, we improved the implantation technique to avoid long-term complications after IOL implantation. Patients using the improved technique were followed up and the results of long-term follow-up were reported. Method Since September 1998, Qingdao Ophthalmology Hospital has been responsible for iris defect. Iris septum IOL was implanted in 78 eyes of 78 patients by December 2012. The first stage was from September 1998 to August 2007, and Iris septum IOL was implanted in 78 eyes from September 1998 to August 2007 in Qingdao Ophthalmology Hospital. At this stage, we implanted iris septum intraocular lens in 53 patients, and in the second stage from November 2008 to December 2012, 25 patients were implanted with iris septum intraocular lens using improved implantation technique. We invite the patients to return to hospital through telephone, network and home visits, and focus on the examination of corrected visual acuity, intraocular pressure, corneal endothelium count and ultrasound biomicroscopy (UBMM) to observe the location of intraocular lens in the iris septum. Result Among the 53 patients in the first stage, 30 cases were followed up. Among them, 18 cases maintained good eye condition and 12 cases developed corneal endothelial decompensation and secondary glaucoma complications. All of the 25 patients undergoing the second stage of the technical improvement maintained a good eye condition without serious complications. Conclusion For the patients with complete iris absence, the position of suspended implantation of iris septum intraocular lens implantation should be properly deviated and fixed firmly during operation so as to avoid the long-term complications of the operation in order to avoid contact with corneal endothelium and angle of atrium.
【学位授予单位】：青岛大学
【学位级别】：博士
【学位授予年份】：2013
【分类号】：R779.6

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