超声乳化白内障吸除联合改良式囊袋张力环植入治疗悬韧带异常白内障

目的 探讨超声乳化白内障吸除联合人工晶状体（IOL）及改良式囊袋张力环（M-CTR）植入治疗悬韧带异常白内障病例的临床疗效.方法 前瞻性病例对照研究.2009年4月至2010年4月期间对合并晶状体悬韧带部分断裂的白内障患者12例（12眼,实验组）采取超声乳化白内障吸除联合改良式囊袋张力环及IOL植入术,于悬韧带断裂范围的中点行巩膜缝合固定;选取同期行标准白内障超声乳化联合IOL植入手术的患者12例（12眼）作为对照组.分别于术前,术后1个月、3个月和6个月随访两组裸眼视力、最佳矫正视力、IOL的偏心值与倾斜度、高阶像差和手术并发症.应用独立样本t检验对数据进行分析.结果 术后6个月,实验组的最佳矫正视力提高,所有术眼M-CTR、IOL都位于囊袋内.对照组、实验组的IOL偏心量差异无统计学意义,两组倾斜度分别为3.97°±1.40°和1.57°±0.92°,差异有统计学意义（t=3.058,P=O.010）.两组手术眼的球差差异无统计学意义,彗差分别为（0.32±0.11）μm和（0.17 ±O.13） μm,差异有统计学意义（t=2.335,P=0.047）.结论 对于晶状体悬韧带异常病例,采用超声乳化白内障吸除联合M-CTR及IOL植入具有良好的可预测性、安全性、有效性和稳定性.

Phacoemulsification and modified capasular tension ring implantation for zonular abnormal cataract eyes

Objective To evaluate the efficacy, predictability, stability, and safety of implantation with a modified capsular tension ring (M-CTR) and intraocular lens (IOL) in abnormal zonular eyes with cataracts.Methods A prospective case-control study was adopted to analyze 12 eyes of 12 patients who underwent IOL implantation and M-CTR insertion with a scleral suture fixation for the treatment of cataracts with zonular weakness.The study was conducted from April 2009 to April 2010.Twelve eyes of 12 patients who had undergone standard phacoemulsification and IOL implantation during the same period acted as the control group. Patients were examined preoperatively and were followed up at 1,3 and 6 months postoperation.The examinations included uncorrected visual acuity,best corrected visual acuity (BCVA),the tilt and decentration of the IOL,ocular aberrations, etc.An independent samples t test was used for statistical analysis.Results Successful implantation was achieved in all eyes.Postoperatively, BCVA improved in all eyes.No dislocation of the M-CTR or IOL was detected at 6 months postoperatively.There was no statistically significant difference in the decentration of the IOL or the spherical aberrations between the two groups.The tilt of the IOL was 3.97°±1.40°(1.81°～5.68°) in the experimental group and was 1.57° ±0.92°(0.70°～2.73°) in the control group.There was a statistically significant difference between the two groups (t=3.058,P=0.010).The coma in the experimental group was (0.32 ±0.11)μm and was (0.17±0.13)μm in the control group.There was a statistically significant difference,between the two groups (t=2.335,P=0.047).Conclusion Phacoemulsification with a M-CTR and IOL implantation provides efficacy and predictability,and is safe and reliable.