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目的:探讨白内障合并晶状体脱位范围>2个象限的患者,Ⅰ期行白内障囊内摘除术+前部玻璃体切割术,术后3mo矫正视力>0.3者,Ⅱ期行小切口两点固定人工晶状体悬吊术的临床疗效。方法:对2014-07/2016-12我院白内障科就诊的34例34眼白内障合并晶状体脱位范围>2个象限的患者,Ⅰ期行白内障囊内摘除术+前部玻璃体切割术,3mo后矫正视力>0.3者,Ⅱ期行小切口两点固定人工晶状体悬吊术,分别观察患者术后1wk,1、3mo裸眼视力、最佳矫正视力、眼压、角膜散光度、术后并发症情况。结果:随着术后恢复时间的延长,患者各期的裸眼视力和最佳矫正视力均较术前有明显提高。术后3mo最佳矫正视力0.1~<0.3者1眼,0.3~<0.5者8眼,0.5~<0.7者16眼,>0.7者9眼,达到或接近术前的最佳矫正视力。术后1wk,1、3mo眼压处于正常范围内。手术并没有明显增加角膜的散光度。结论:对于白内障合并晶状体脱位范围>2个象限的患者,Ⅰ期行白内障囊内摘除术+前部玻璃体切割术,3mo后矫正视力>0.3者,Ⅱ期行小切口两点固定人工晶状体悬吊术能有效确切地提高视力,稳定眼压,术后并发症少,是较为安全可靠的治疗方式。
Objective: To investigate the cataract patients with lens dislocation range> 2 quadrants, stage Ⅰ cataract extraction + anterior vitrectomy, corrected visual acuity> 0.3 after 3 months, stage II small incision with two fixed intraocular lens Crane surgery efficacy. Methods: 34 patients (34 eyes) with cataract who had lens dislocation> 2 quadrants in our hospital from July 2014 to December 2016 were enrolled in this study. The patients underwent primary cataract extraction and anterior vitrectomy in stage I, and corrected after 3 months Visual acuity> 0.3, Ⅱ small incision fixed intraocular lens suspension, were observed 1wk, 1,3mo postoperative uncorrected visual acuity, best corrected visual acuity, intraocular pressure, corneal astigmatism, postoperative complications. Results: With the extension of postoperative recovery time, the uncorrected visual acuity and the best corrected visual acuity were significantly increased in all stages. After 3 months, the best corrected visual acuity was 0.1 ~ <0.3 in 1 eye, 0.3 ~ <0.5 in 8 eyes, 0.5 ~ <0.7 in 16 eyes and> 0.7 in 9 eyes, and reached or approached the best corrected visual acuity before operation. Postoperative 1wk, 1,3mo IOP in the normal range. Surgery did not significantly increase the corneal astigmatism. CONCLUSIONS: For patients with cataract with dislocation of the lens> 2 quadrants, intracapsular cataract extraction + anterior vitrectomy in stage I and correction of visual acuity> 0.3 after 3 months. A two-point mini-incision intraocular lens (IOL) suspension Surgery can effectively improve vision, stable intraocular pressure, fewer postoperative complications, is a more safe and reliable treatment.