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目的探讨不同手术方法治疗外伤性晶状体脱位的疗效。方法回顾性分析2006年1月—2009年1月在郑州市第二人民医院住院手术治疗的36例外伤性晶状体脱位患者的临床资料。所有患者根据晶状体脱位的不同类型和程度采取不同的手术方式如:包括晶状体囊内摘除、超声乳化吸除、经睫状体平坦部切口晶状体切除,同时视不同的病情联合相应的手术方式如:玻璃体视网膜手术,抗青光眼手术(小梁切除或青光眼减压阀植入),人工晶体Ⅰ期或Ⅱ期植入(植入后房型人工晶体或睫状沟缝合固定)等。结果所有患者均成功完成手术并Ⅰ期或Ⅱ期植入人工晶体,其中Ⅰ期植入26例,包括后房型人工晶体20例和睫状沟缝合固定6例;Ⅱ期植入10例(睫状沟缝线固定)。高眼压患者术后眼压均获得控制,10例视网膜脱离者完全复位。患者术后视力有不同程度的提高,16例(44.4%)视力≥0.3。结论外伤性晶状体脱位应根据晶状体脱位的不同类型和程度以及有无并发症,合理的选择手术方式或联合手术是获得手术成功的关键。
Objective To investigate the curative effect of different surgical methods in the treatment of traumatic lens dislocation. Methods The clinical data of 36 patients with traumatic lens dislocation who underwent surgery in the Second People’s Hospital of Zhengzhou from January 2006 to January 2009 were retrospectively analyzed. All patients according to the different types and degrees of lens dislocation to take different surgical methods such as: Including the lens capsule removal, phacoemulsification, transection of the ciliary body by the lensectomy, while depending on the condition associated with the corresponding surgical methods such as: Vitreoretinal surgery, anti-glaucoma surgery (trabeculectomy or glaucoma valve implantation), intraocular lens implantation of stage I or II (implantation of posterior chamber intraocular lens or ciliary sulcus fixation) and so on. Results All the patients were successfully operated and had intraocular lens implantation in stage Ⅰ or Ⅱ, of which 26 cases were implanted in stage Ⅰ, including 20 cases of posterior chamber intraocular lens implantation and 6 cases of ciliary sulcus fixation. In stage Ⅱ, 10 cases were implanted Shaped groove suture fixation). Intraocular pressure in patients with ocular hypertension were controlled, and 10 cases of retinal detachment were completely reset. The postoperative visual acuity of the patients improved to some extent, 16 cases (44.4%) visual acuity ≥0.3. Conclusion The dislocation of traumatic lens should be based on the different types and degrees of dislocation of the lens and the presence or absence of complications. Reasonable choice of surgical approach or combined surgery is the key to successful operation.