不同眼内填充物对晶状体后脱位于玻璃体腔手术疗效的影响比较

摘要

目的 对比分析眼内填充物气体(C3F8)、硅油(SO)对晶状体全脱位于玻璃体腔行玻璃体切除联合晶状体切除术疗效的影响.方法 选取2013年1月至2014年12月于郑州大学第一附属医院确诊为晶状体全脱位且脱位于玻璃体腔的患者40例42眼,术前完善相关检查,明确术中填充物的种类,行晶状体切除、玻璃体切除、眼内填充联合人工晶状体植入,根据填充物种类分为两组(C3F8组23眼、SO组19眼),随访12~24个月,对比分析手术前后logMAR最佳矫正视力、视神经功能及并发症发生情况.结果 两组术后logMAR最佳矫正视力与术前比较,差异均有统计学意义(P<0.05);术前和术后,两组logMAR最佳矫正视力比较,差异均有统计学意义(P<0.05).SO组视神经功能改善较C3F8差(P<0.05).C3F8组术后并发症明显较SO组高.结论 晶状体全脱位于玻璃体腔行晶状体切除、玻璃体切除联合眼内容物填充术能明显提高患者最佳矫正视力,是一种安全有效的手术方式,但不同种类的眼内填充物因患者病情及自身性质的不同,效果仍有一定的差异.%Objective To compare the influence of perfluoropropane(C3F8) and silicon oil(SO) on the effect of vitrectomy for crystalline lens dislocate into vitreous.Methods Forty two eyes of 40 patients who underwent lensectomy, vitrectomy, intraocular filling combined with intraocular lens (IOL) implantation surgery with crystalline lens dislocate and fully dislocate into vitreous were analyzed retrospectively in the First Affiliated Hospital of Zhengzhou University from January of 2013 to December of 2014.Based on related examines and the vitrectomy tamponades were chosen.The patients were divided into C3F8 group(23 eyes) and SO group(19 eye) depending on different tamponades.The best corrected visual acuity, the function of optic nerve and complications were compared between two groups.The patients had been followed up from 12 to 24 months.Results The best corrected visual acuity of C3F8 group and SO group were both promoted postoperation(P<0.05).The function of optic nerve of C3F8 group was promoted to a level higher than SO group postoperation(P<0.05).The occurence rate of complications of C3F8 group was higher than SO group(P<0.05).Conclusion Lensectomy, vitrectomy, intraocular filling combined with IOL implantation surgery is safe and effective, and can promote the best corrected visual acuity of patients with crystalline lens dislocate and fully dislocate into vitreous.But because of the physicochenical and different conditions, the effective is still different.