张晓山，崔迎春，张业婉



开放囊袋-IOL单襻睫状沟固定术治疗先天性晶状体半脱位

张晓山，崔迎春，张业婉

Aier Eye Hospital (Heze), Heze 274000, Shandong Province, China

Correspondence to:Xiao-Shan Zhang.Aier Eye Hospital (Heze), Heze 274000, Shandong Province, China. 360985049@qq.com

Abstract

•AIM: To evaluate the safety and efficiency of the open capsule-single loop intraocular lens (IOL) ciliary sulcus fixation for the treatment of congenital subluxation lens.

•METHODS: Ten patients (13 eyes) with congenital subluxation lens were included. After conventional tunnel incision and continuous curvilinear capsulorhexis, iris hooks were used to fix the luxation lens helped the phacoemulsification (phaco) procedure and IOL implantation into capsular bag. The inferior capsular bag was opened. The IOL prolapsed from the bag and was half packaged. The lower loop was fixed to the ciliary sulcus by suturing to avoid the possible dislocation.

•RESULTS: The best corrected visual acuity (BCVA) was increased in all of the patients without any serious complication. The IOL kept stable in 12mo.

•CONCLUSION: The iris hooks can fix subluxation lens and facilitate the phaco. Open capsular bag makes IOL half-free and single suture the lower IOL loop in ciliary sulcus. It can avoid dislocation of the IOL due to progressive weakening of the zonular fibers.

目的：探讨开放囊袋-人工晶状体(IOL)单襻睫状沟固定术治疗先天性晶状体半脱位的安全性和有效性。

方法：收集2011-03-01/2013-12-31影响视力的先天性晶状体半脱位患者10例13眼，做角巩膜缘隧道切口，环形撕囊后，使用虹膜拉钩，固定脱位晶状体，完成超声乳化手术。植入IOL，剪开晶状体脱位一侧囊袋，翻转前囊，上襻位于囊袋内，下襻单针经缝合固定于睫状沟。

结果：所有患者最佳矫正视力均不同程度提高，IOL稳定，没有进展性偏位。

结论：虹膜拉钩可以稳定脱位的晶状体，使超声乳化手术顺利完成。开放下方囊袋，IOL呈半游离状态，下襻睫状沟缝合固定可维持IOL的长期稳定，避免囊袋进行性偏移，造成IOL偏位。

晶状体半脱位；人工晶状体；晶状体囊

引用：张晓山，崔迎春，张业婉.开放囊袋-IOL单襻睫状沟固定术治疗先天性晶状体半脱位.国际眼科杂志2016;16(9):1729-1731

0引言

先天性晶状体半脱位，常见于马凡氏综合征、Marchesani氏综合征、先天性白内障、高胱氨酸尿症等。此类患者，悬韧带缺陷以进行性发展为主，常可致严重屈光异常及不同程度弱视，发展严重时需手术干预。传统的手术方法主要有晶状体摘除联合双针后房型人工晶状体(IOL)睫状沟固定术、IOL囊袋植入联合囊袋张力环(capsular tension ring，CTR)缝合固定术等。本文介绍一种新的手术方式：开放囊袋-IOL单襻睫状沟固定术，并初步探讨该新术式在先天性晶状体半脱位治疗中的有效性、安全性和便捷性。……