前段玻璃体切除术联合人工晶体悬吊治疗晶状体脱位对眼压及角膜内皮的影响

Effect of anterior vitrectomy combined with intraocular lens suspension on intraocular pressure and corneal endothelium in treatment of lens dislocation

摘要:

目的 探讨前段玻璃体切除术联合人工晶体悬吊治疗晶状体脱位对眼压及角膜内皮的影响。方法 回顾性分析2019年1月至2022年12月漯河市第三人民医院（漯河市妇幼保健院）诊治的晶体脱位92例患者，行前段玻璃体切除术联合人工晶体悬吊治疗，对比观察手术前后最佳矫正视力、眼压、眼角膜内皮计数以及术后并发症。结果 术后92例患者眼压较术前降低，差异有统计学意义（P<0.05）；术后92例患者角膜内皮计数较术前无明显变化，差异无统计学意义（P>0.05）；术后92例患者视力均有不同程度提高，其中矫正视力≥0.3者有67例，与术前相比，差异有统计学意义（P<0.05）；术后92例患者出现葡萄膜炎反应8眼，早期角膜轻度水肿6眼，玻璃体积血1眼，高眼压1眼，给予相应保守处理后均恢复正常。结论 前段玻璃体切除术联合人工晶体悬吊治疗能够有效控制晶状体脱位患者的眼压，对角膜内皮造成的损伤较小，为人工晶状体悬吊创造有利条件，从而有效改善患者的视力，能够加快患者的恢复，虽术后会出现较少的并发症，但经过相应的保守处理均恢复正常，不影响研究结果。

Abstract:

Objective To investigate the effects of anterior vitrectomy combined with intraocular lens suspension on intraocular pressure and corneal endothelium in the treatment of lens dislocation.Methods Totally 92 cases of lens dislocation diagnosed and treated in Luohe Third People's Hospital (Luohe Maternal and Child Health Hospital) from January 2019 to December 2022 were retrospectively analyzed and treated with anterior vitrectomy combined with intraocular lens suspension. The optimal corrected visual acuity, intraocular pressure, corneal endothelial count and postoperative complications were compared before and after surgery.Results The intraocular pressure of 92 patients decreased after operation, a statistically significant difference was observed (P<0.05). Postoperative corneal endothelial count of 92 patients had no significant change compared with that before surgery, with no statistical significance (P>0.05). Postoperative visual acuity of 92 patients improved to varying degrees, of which 67 patients had corrected visual acuity ≥0.3, and the difference was statistically significant compared with that before surgery (P<0.05). Postoperative uveitis reaction occurred in 8 eyes of 92 patients, early mild cornea in 6 eyes, vitreous hematoma in 1 eye, and intraocular hypertension in 1 eye, all of which returned to normal after conservative treatment.Conclusion Anterior vitrectomy combined with intraocular lens suspension treatment can effectively control the intraocular pressure of patients with lens dislocation, causing less damage to the corneal endothelium, creating favorable conditions for intraocular lens suspension, thereby effectively improving the vision of patients and speed up the recovery of patients. Although there will be few postoperative complications, they all return to normal after appropriate conservative treatment, which does not affect the study results.