玻璃体手术后无晶状体眼的二期人工晶状体植入术

目的评价因复杂眼外伤或视网膜脱离行玻璃体手术和晶状体切除术后，二期手术植入人工晶状体(intraocular lens,IOL)的视力效果、手术技术及其安全性 。方法对在1996年11月至1999年12月之间在我院进行该手术的32例(32只眼，每例均为单眼)行回顾性分析。二期手术中应用经睫状体平部的眼内灌注，并根据晶状体囊膜完整性选择不同类型的IOL。结果本组包括复杂眼外伤30例(眼后节异物伤15例，穿通伤伴外伤性眼内炎及玻璃体积血各6例，钝挫伤伴晶状体脱位3例)；原发性视网膜脱离2例。均接受过玻璃体切割、晶状体切割，或眼内异物取出、角膜缝合等。2次手术的间隔为1～16个月，平均(6.8±3.7)个月。在25例晶状体囊环完整或存留2/3以上的眼植入后房型IOL于睫状沟内；5例作了IOL的透巩膜缝线固定术；植入前房型或带虹膜IOL各1例。5例同期放出硅油。手术后29例视力提高。主要并发症为角膜水肿及低眼压。结论在玻璃体手术后的二期手术中，应用眼内灌注和适当的IOL植入，可使经选择的无晶状体眼安全获得较好的视力恢复。(中华眼底病杂志,2001,17:96-98)

Secondary intraocular lens implantation in aphakic eyes following vitrectomy

ObjectiveTo evaluate the visual results,surgical tec hnique and safety of secondary intraocular lens (IOL) implantation in aphakic eyes following vitrectomy and lensectomy for complicated ocular trauma or retinal detachment．MethodsThe clinical records of 3 2 cases (32 eyes),received these surgeries during November 1996 and December 1999,were reviewed retrospectively.During the secondary operation，intraocular infu sion through the pars plana was performend and the type of IOL was chosen based on the integrity of lens capsule.ResultsThe study included 30 eyes suffering from trauma (foreign bodies in 15 eyes,penetrating injury with traumatic endophthalmitis and with vitreous hemorrhage in 6 eyes respectively, blunt trauma with lens dislocation in 3 eyes),and 2 eyes with primary retinal detachment.Those eyes all received vitrectomy,lensectomy,and/or remova l of foreign bodies and corneal suture.The interval of two operations ranged from 1 to 16 months with an average of 6.8±3.7 months.Posterior chamber IOL was implanted in the ciliary sulcus in 25 eyes with a whole or 2/3 of lens capsule,trans scleral suture fixation of IOL in 5 eyes,anterior chamber IOL and IOL with artificialiris in one eye respectively.Silicone oil was removed in 5 eyes duri ng the secondary operation.Post-operative visual improvement was achieved in 29 eyes.Main complications were corneal edema and low intraocular pressure after operation.ConclusionIntraocular infusion and proper IOL implantation during the secondary operation following vitrectomy can provide selected aphakic eyes with better visual recovery.(Chin J Ocul Fundus Dis, 2001,17:96-98)