Objective To compare the clinical effects of one-stage modified capsular tension ring (MCTR) scleral fixation and second-stage capsular tension ring (CTR) capsular bag complex scleral fixation in the treatment of moderate and severe subluxation of lens.Methods Retrospective study.Thirty cases (43 eyes) of patients with moderate and severe subluxation of lens from January 2012 to December 2015 were collected.Those patients were treated with phacoemulsification cataract extraction and MCTR or CTR and IOL intracapsular implantation under local anesthesia.23 eyes in group A were treated with MCTR combined with IOL implantation and one-stage scleral fixation.20 eyes in group B were treated with one-phase CTR combined with IOL implantation and second-stage of CTR-capsular bag complex scleral fixation after 3 to 6 months.The best corrected visual acuity,location of the postoperative capsular bag complex and complication were observed at 6 months after surgery.Results Postoperative 6-month,the best corrected visual acuity ≥0.6 were in 87％,95％ of the patients m group B,and there was no statistical significance difference (P ＞ 0.05).All CTR and IOL were located in the capsular bag after surgery.Two eyes in group A and 1 eye in group B were observed with moderate contraction and off-center of capsular bag,there was no significant difference (P ＞ 0.05).All groups achieved response after YAG laser anterior capsule relaxing incisions.Early complications of postoperative (1 month):3 eyes in group A and 1 eye in group B were observed with exudative membrane in anterior chamber;5 eyes in group A and 2 eyes in group B were with transient high intraocular pressure,and there was no significant difference (all P ＞ 0.05).Long-term complications of postoperative (6 months):3 eyes in group A and 1 eye in group B were observed with after cataract,and there was no significant difference (P ＞ 0.05).All groups conducted YAG laser posterior capsulotomy.Conclusion The location stability of the capsular complex after one-stage MCTR scleral fixation or secondstage CTR capsular bag sclera fixation is good.And the treatment is effective for moderate and severe lens dislocation.%目的 比较一期改良式囊袋张力环(modified capsular tension ring,MCTR)巩膜固定或二期囊袋张力环(capsular tension ring,CTR)-囊袋复合体巩膜固定治疗中重度晶状体不全脱位的临床效果.方法 回顾性研究.收集我院2012年1月至2015年12月中重度(120°～270°)晶状体不全脱位患者30例43眼,均在局部麻醉下行超声乳化白内障吸出及MCTR或CTR和IOL囊袋内植入术,A组23眼均采用MCTR联合IOL植入术,一期巩膜固定;B组20眼均采用一期CTR联合IOL植入术,3～6个月后行二期CTR-囊袋复合体巩膜固定术.观察两组术后6个月最佳矫正视力、术后囊袋复合体的位置及并发症等情况.结果 术后6个月,A组87％患眼最佳矫正视力≥0.6,B组95％患眼最佳矫正视力≥0.6,两组相比差异无统计学意义(P＞0.05).术后所有CTR、IOL均位于囊袋内,囊袋中度收缩偏中心A组2眼,B组1眼,两组发生率相比差异无统计学意义(P＞0.05),均行YAG激光前囊膜松解后缓解.术后早期(1个月)并发症:前房渗出膜A组3眼,B组1眼;一过性高眼压A组5眼,B组2眼,两组两种并发症发生率相比差异均无统计学意义(均为P＞0.05).术后远期(6个月)并发症:后发性白内障A组3眼,B组1眼,两组相比差异无统计学意义(P＞0.05),均行YAG后囊切开术.结论 一期MCTR巩膜固定或二期CTR-囊袋复合体巩膜固定术后囊袋复合体的位置和稳定性均良好,对中重度晶状体脱位治疗均有效.
展开▼
