囊袋张力环植入治疗外伤性晶状体脱位_临床医学论文.docVIP

囊袋张力环植入治疗外伤性晶状体脱位_临床医学论文 囊袋张力环植入治疗外伤性晶状体脱位_临床医学论文 【摘要】 　　目的 探讨囊袋张力环(CTR) 在外伤性晶状体悬韧带断裂的白内障手术中的植入时机。方法 对24例(25眼)外伤性晶状体悬韧带部分断裂的患者行白内障手术,术中连续环形撕囊，行白内障超声乳化吸除后，囊袋内植入CTR及后房型人工晶状体。术后随访6个月～4年。结果 术中无悬韧带断裂范围扩大，白内障皮质注吸干净。术后1个月矫正视力≤0.4者6眼，0.5～0.9者16眼，≥1.0者3眼。术后6个月散瞳检查，25眼的人工晶状体均处于正位,无倾斜及明显偏位。未见CTR 引起的并发症。结论 CTR应用于外伤性晶状体悬韧带断裂的白内障患者,利于人工晶状体囊袋内植入，有效防止术后人工晶状体偏位的发生。白内障超声乳化吸除后植入CTR利于术中操作，更安全可靠。 【关键词】 白内障吸除术；晶状体脱位；人工晶状体；囊袋张力环 　　【Abstract】 Objective To determine the safety,efficacy and appropriate timing of capsular tension ring (CTR) implantation in eyes with zonular dialysis of traumatic cataract having phacoemulsification.Methods This prospective study comprised 25 eyes of 24 patients with traumatized zonular dialysis.After performing continuous curvilinear capsulorhexis and phacoemulsification,25 eyes had CTR implantation.The followup was 6 months to 4 years.Results Intraoperative extension of the zonular dialysis did not occur in any eye.Six eyes had a final best corrected visual acuity of worse than 0.4 because of coexisting fundus pathology.Sixteen eyes had a final visual acuity of 0.5 to 0.9.Three eyes had a final visual acuity of 1.0 or better.A dilated pupil examination at 6 months showed a wellcentered IOL(intraocular lens) in the bag in all the eyes.No complication of CTR was occurred.Conclusion CTR implantation in eyes with zonular dialysis facilitates IOL insertion in the bag and prevent the postoperative IOL decentration.In terms of minimizing further zonular stress and damage and capsular destabilization,the ideal timing for CTR placement is after phacoemulsification cataract surgery. 　　【Key words】aspiration of cataract;zonular dialysis;intraocular lens;capsular tension ring 　　由于白内障超声乳化吸除过程中易造成晶状体悬韧带断裂范围扩大及玻璃体脱出，导致后房型人工晶状体植入困难及偏位，因此，伴有晶状体悬韧带断裂的外伤性白内障手术治疗很棘手。近年来，随着囊袋张力环(capsular tension ring,CTR) 的应用,这一问题得到了较好的解决［1-2］。目前国内外临床医生多选择在环形撕囊后即刻植入CTR［1-3］，我们在2004年12月～2009年6月对24例（25眼）外伤性晶状体悬韧带断裂的患者行白内障超声乳化及后房型人工晶状体植入手术,选择在超声乳化后植入CTR，取得满意疗效，现将结果报告如下。　　临床资料 　　1 一般资料 　　收集20