Artisan虹膜固定型人工晶状体在无晶状体眼患者中的应用

摘要

目的 观察Artisan虹膜固定型人工晶状体(IOL)在无晶状体眼患者中的应用.方法 回顾性病例系列研究.2008年1月到2010年5月间行Artisan IOL植入术且临床资料完整的无晶状体眼患者46例(46眼),年龄为21～56岁,平均(32.8±5.2)岁,其中男28例,女18例.所有患者均在神经阻滞麻醉下行Artisan前房虹膜固定型IOL植入,术后随访3～10个月.对手术所需时长、患者裸眼视力、最佳矫正视力、手术源性散光、瞳孔散大直径、角膜内皮计数和术后并发症等指标进行分析,对手术的疗效和安全性进行评估.手术前后裸眼视力、最佳矫正视力和眼压的比较采用配对t检验.结果 植入Artisan IOL所需手术时间平均为(19.8±6.6)min.患者裸眼视力均较术前有明显提高(0.49±0.23 vs1.21±0.22),与目标屈光状态的差值平均为0.27 D;最佳矫正视力与术前相比无明显差异,手术源性散光为1.45 D.植入IOL后瞳孔直径最大可散至6.77 mm;角膜内皮细胞丢失率为3.6%.术后出现一过性高眼压的有4眼(8.7%);虹膜萎缩有3眼(6.5%);IOL脱位1眼(2.2%).结论 Artisan虹膜固定型IOL在无晶状体眼治疗中具有较好的疗效和较高的安全性,是无晶状体眼患者理想的IOL选择之一.%Objective To study the clinical results of using iris-fixated Artisan intraocular lenses (IOL) in aphakic eyes. Methods This was a retrospective case series study. Forty-six patients who received Artisan IOL implants at the Third People's Hospital of Changzhou from Jan 2008 to May 2010 and had been followed up were included in the study. Their clinical data were collected and analyzed. Of the 46 patients, there were 28 males (28 eyes) and 18 females (18 eyes), aged 25to 49 years, average (32.8±5.2)years. All the surgeries were performed under nerve block anesthesia.Data on the patients' visual acuity, best corrected visual acuity, corneal endothelium density, dilated pupil size, surgically induced astigmatism and complications were collected and the safety as well as the clinical results of the Artisan IOL were analyzed. Data were analyzed with paired t test. Results The average time for Artisan IOL implantation was (19.8±6.6)min. During the follow-up period,transient high intraocular pressure was found in 4 cases (8.7%), focal iris atrophy at the claw was found in 3 cases (6.5%), dislocation of the lens was found in 1 case (2.2%), and the average loss of corneal endothelium was 3.6%. In all, the patient's uncorrected visual acuity was greatly improved;the postoperative best corrected visual acuity was similar to that before the surgery, surgically induced astigmatism was 1.45 D, and after implantation the mean diameter of the dilated pupil was 6.77 mm. Conclusion In an aphakic eye, the iris-fixated Artisan IOL is a safe and efficient option for refractive error correction.