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目的 探讨玻璃体切割术后人工晶体 (intraocularlens,IOL)植入术的效果及硅油填充眼IOL度数的测算方法。方法 1 硅油填充眼IOL度数测算。 2 建立玻璃体腔液体灌注系统维持术中和术后眼压分别为 2 7 2cmH2 .O (相当于 2 0mmHg)和 4. 0 8cmH2 O ( 30mmHg)。 3 硅油填充眼先行眼内硅油取出术 ,然后行后房型IOL植入术。 4 植入后房型IOL :若后囊完整 ,植入囊袋内IOL ;前囊完整植入睫状沟固定IOL ;前后囊缺损植入睫状沟缝合固定IOL ;虹膜缺损或瞳孔极度散大 ,植入带虹膜IOL。 5 术后随访 2 . 5～ 39个月 ,平均 1 4 5个月。结果 38例 ( 38只眼 )成功地进行了后房型IOL植入术 ,其中囊袋内植入IOL 6例 ,睫状沟固定IOL 1 9例 ,睫状沟缝合固定IOL 9例 ,植入带虹膜IOL- 4例。硅油取出联合IOL植入术 1 0例。术后视力≥ 0 .1 32例 ( 84 . 2 % ) ,≥ 0 32 2例( 57 .9% )。硅油填充眼术后屈光度 ( - 1 . 58± 0 . 6 1 )D ,与术前预见的屈光度相比 ,差别无统计学意义 (P >0 0 5)。术中并发症有视网膜损伤 ( 2例 )及睫状体出血 ( 2例 ) ,术后并发症有玻璃体出血( 3例 )、视网膜脱离 ( 2例 )及眼球萎缩 ( 1例 )。结论 玻璃体切割术后IOL植入术的效果满意 ,术中术后眼压维持对于减少术中术后并发症至关重要 ,
Objective To investigate the effect of intraocular lens implantation (IOL) after vitrectomy and the estimation of IOL in silicone oil filled eyes. Method 1 Silicone filled eyes IOL degree calculation. 2 to establish vitreous cavity liquid perfusion system to maintain intraoperative and postoperative intraocular pressure were 272cmH2. O (equivalent to 20mmHg) and 4. 0 8cmH2O (30mmHg). 3 silicone oil filled eyes first intraocular silicone oil removal surgery, and then line IOL implantation. 4 IOL implantation after posterior chamber: if the posterior capsule is intact, implanted in the bag IOL; anterior capsule completely implanted ciliary sulcus IOL; anterior and posterior capsule defects implanted ciliary sulcus suture IOL; iris defect or pupil extremely scattered, Iris implanted with iris. 5 postoperative follow-up 2.5 to 39 months, an average of 14.5 months. Results 38 cases (38 eyes) successfully performed posterior chamber IOL implantation. There were 6 cases of IOL in capsular bag, 19 cases of IOL in ciliary sulcus, 9 cases of IOL in ciliary sulcus and 9 cases of IOL in ciliary sulcus. Iris iris - 4 cases. Silicone oil removal combined with IOL implantation in 10 cases. Postoperative visual acuity ≥0.1 32 cases (84.2%), ≥ 0322 cases (57.9%). There was no significant difference (P> 0.05) between the refractive power of the silicone oil-filled eyes and the preoperative visual acuity (-1.58 ± 0.661) D. Intraoperative complications included retinal damage (2 cases) and ciliary body hemorrhage (2 cases). Postoperative complications included vitreous hemorrhage (3 cases), retinal detachment (2 cases), and atrophy of the eyeball (1 case). Conclusion The results of IOL implantation after vitrectomy are satisfactory. Intraoperative and postoperative IOP maintenance is very important for reducing intraoperative and postoperative complications.