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目的探讨后房型人工晶体脱位至玻璃体腔的原因和处理方法。方法对8例人工晶体全脱位的原因进行分类、分析;行前部玻璃体切割后直接取出人工晶体及重新固定6例、前部玻璃体切割后俯卧位下取出人工晶体2例。结果 8例患者人工晶体全脱位有垂直下沉、上襻翻转下沉、直接向后沉于玻璃体腔等3种情况,均顺利取出;3例行人工晶体睫状沟固定术,4例行巩膜瓣下缝线固定术,1例未重新植入。术前视力均为手动至0.06。术后随访半年以上,7例重新植入人工晶体患者视力均大于0.25,最佳1.0,平均0.56;1例未植入人工晶体者矫正视力0.5+2。术后无严重并发症。结论人工晶体全脱位的原因与晶体后囊破裂、悬韧带断裂、玻璃体脱出、人工晶体植入位置不当及虹膜因素有关;前部玻璃体切割后直接取出,或俯卧位下取出全脱位的人工晶体,并重新固定,是手术处理人工晶体脱位至玻璃体腔简单、有效的方法。
Objective To investigate the causes and treatment of posterior chamber intraocular lens (IOL) dislocation into vitreous cavity. Methods Eight cases of total dislocation of intraocular lens were classified and analyzed. Six cases of intraocular lens were removed directly after anterior vitrectomy and two cases of intraocular lens were removed under prone position after anterior vitrectomy. Results The total dislocation of intraocular lens in 8 patients was successfully taken out in 3 cases, including vertical subsidence, upper subsidence subsidence, and direct subsidence in the vitreous cavity. 3 cases were treated by intraocular lens ciliary sulcus fixation and 4 cases received scleral buckling Under the flap suture, 1 patient did not re-implant. Preoperative visual acuity was manually to 0.06. The patients were followed up for more than six months. The visual acuity of 7 patients who were re-implanted intraocular lens was greater than 0.25, the best was 1.0, with an average of 0.56. One patient without intraocular lens correction had a visual acuity of 0.5 + 2. No serious complications after surgery. Conclusions The causes of total dislocation of intraocular lens are related to the rupture of posterior capsule, fracture of suspensory ligament, vitreous prolapse, improper placement of intraocular lens and iris factors. The anterior vitreous body is directly removed after being cut, or the dislocated intraocular lens is removed under prone position. And re-fixed, is the surgical treatment of intraocular lens dislocation into the vitreous cavity simple and effective method.