人工晶状体置换原因临床分析

发布时间：2019-01-01 19:42

【摘要】：目的分析人工晶状体(IOL)置换的原因及预防对策。设计回顾性病例系列。研究对象2012年4月至2013年5月在北京大学第三医院眼科因各种原因行IOL置换者28例(28眼)。方法对患者的既往病史、IOL置换原因、IOL及囊袋情况进行描述性归纳分析,计算IOL置换原因构成比。针对不同原因研究预防对策。主要指标患者的既往病史、IOL置换原因、IOL及囊袋情况。结果 IOL置换原因包括:前房型IOL致大泡性角膜病变10眼(35.70%)。IOL脱位14眼(50.00%),其中IOL脱位于玻璃体10眼(35.70%),高度近视囊袋半脱位2眼(7.14%),脱位于玻璃体伴有缺血性视神经病变2眼(7.14%)。屈光异常2眼(7.14%),包括儿童IOL植入术后高度近视1眼(3.57%),高度近视IOL测量错误1眼(3.57%)。激光导致IOL损伤2眼(7.14%)。预防措施包括提高手术技巧,减少术中瞬间高眼压,较少悬韧带损伤,减少后囊破裂几率,掌握后囊破裂后IOL植入指征,正确计算IOL度数,提高儿童白内障术后近视控制技术,避免植入房角固定型前房IOL等。结论 IOL置换原因以前房型IOL导致大泡性角膜病变和IOL脱位为多。提高手术技巧,避免植入房角固定型前房IOL等可有助于减少IOL置换的发生。
[Abstract]:Objective to analyze the causes and preventive measures of intraocular lens (IOL) replacement. Design retrospective case series. Participants 28 patients (28 eyes) underwent IOL replacement for various reasons in the third Hospital of Peking University from April 2012 to May 2013. Methods the history of the patients, the causes of IOL replacement, IOL and sac were analyzed, and the ratio of IOL replacement causes was calculated. To study the preventive measures for different reasons. Main outcome measures previous history of patients, causes of IOL replacement, IOL and pouch. Results the causes of IOL replacement were as follows: 10 eyes (35.70%) had vesicular keratopathy caused by anterior chamber IOL (50.00%), and 10 eyes (35.70%) had IOL dislocated in vitreous body. There were 2 eyes (7.14%) with high myopia and 2 eyes (7.14%) with ischemic optic neuropathy. There were 2 eyes (7.14%) with ametropia, including 1 eye (3.57%) with high myopia after IOL implantation, and 1 eye (3.57%) with high myopia mismeasured by IOL. Laser induced IOL injury in 2 eyes (7.14%). The preventive measures include improving surgical skills, reducing intraoperative high intraocular pressure, reducing injury of ligament suspension, reducing the probability of posterior capsule rupture, mastering the indication of IOL implantation after posterior capsule rupture, correctly calculating the degree of IOL, and improving myopia control technology after cataract surgery in children. Avoid implantation of fixed anterior chamber IOL. Conclusion the reason of IOL replacement is that anterior chamber IOL leads to more vesicular keratopathy and IOL dislocation. Improving surgical skills and avoiding the implantation of fixed anterior chamber IOL can help to reduce the occurrence of IOL replacement.
【作者单位】：北京大学第三医院眼科中心
【分类号】：R779.66

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