目的 探讨人工晶体脱位原因及手术方式.方法 依据34例(34眼)人工晶体脱位患者临床资料,对人工晶体脱位原因进行分析,采用玻璃体切除、人工晶体取出、人工晶体睫状沟缝线固定术并联合玻璃体视网膜等进行手术.结果 人工晶体脱位的主要原因是悬韧带断裂,且玻切术后患者易发生人工晶体脱位;28眼人工晶体稳定固定,2眼轻度偏位,4眼未植入人工晶体,视力均不同程度提高或保持不变.结论 人工晶体脱位的主要原因是悬韧带断裂,且玻切术后患者易发生人工晶体脱位,人工晶体脱位患者选择合理的手术方式或联合手术均取得满意疗效.

目的 观察白内障手术非正常情况下人工晶体植入的临床效果及并发症.方法 对19例(眼)小切口白内障术中非正常情况下人工晶体植入术后视力、人工晶体位置、并发症,随访6～18月.结果 术后3个月裸眼视力＜0.05者1例(眼),0.05 ～0.3者11例(眼),＞0.3者7例(眼)；1例(眼)人工晶体下沉移位呈日落征,18例(眼)位置稳定居中；无严重并发症发生.结论 白内障手术非正常条件下人工晶体植入亦能获得较好的临床效果.

Objective To evaluate the improvement of refractive status and the stability of the lens in the capsular pouch after carrying out Acrysof Toric intraocular lens implantation operation. Methods Twenty-eight eyes of 20 cataract patients from April 2012 to February 2014 were enrolled from the department of ophthalmology in our hospital. They are all regularity corneal astigmatism which was more than 1.00 diopter (D). All patients underwent similar phacoemulsification combined with Toric IOLs implantation and were followed up at 3 to 8 months. The uncorrected visual acuity (UCVA), best- corrected visual acuity (BCVA), preoperative reserved spherical power and postoperative residual spherical power, preoperative corneal astigmatism, anticipated residual astigmatism, postoperative residual astigmatism and intraocular lens (IOL) axis deflection were detected and measured. Results Three to eight months following surgery, a total of twenty eyes (71%) showed 0. 6 or better in UCVA. 7 eyes (21%) was 0. 8 or better in UCVA and twenty-five eyes (89%) achieved 0. 8 or better in BCVA. The spherical error of postoperative residual and IOL Master reserved ranges from -0.90 D to+0.85 D, and the deviation of spherical equivalent refraction is 0.46±0.23 D. The relations between the postoperative Spherical error and preoperative axial length is Y=11.908 x-231.65, R 2 =0.817, P P 0. 05) compared with postoperative residual astigmatism (0.18±0.11) D after the surgery of three to eight months. Compared with predetermined axis, intraocular lens axis has shift from zero to twelve degrees, and the deflection degrees of the mean axis is 3.96±3.46. Conclusions After the surgery of the Acrysof Toric intraocular lens implantation, the residual spherical powers and IOL Master reserved spherical powers has some error. And the error of the postoperative spherical equivalent was positively correlated with the preoperative axial length, which increases with the increasing axial length. As Acrysof Toric intraocular lens correction regularity corneal astigmatism error is small and has showed good rotational stability, it contributes to the correction of corneal astigmatism.

目的 评价Acrysof Toric人工晶状体植入术后屈光状态的改善以及晶状体在囊袋内的稳定性。 方法 选择2012-04至2014-02在我院眼科接受超声乳化白内障吸除联合Toric人工晶状体植入的白内障患者20例(28眼), 均为规则性角膜散光且散光>1.00 DC, 并完成3～8个月的随访。观察术眼术前眼轴、术前和术后裸眼视力、最佳矫正视力、术前预留球镜度和术后残余球镜度、术前角膜散光和预计残余散光、术后残余散光及人工晶状体偏转轴位。 结果 术后3～8个月, 20眼(71 %)裸眼视力≥0.6。7眼(21 %)裸眼视力≥0.8。25眼(89 %)最佳矫正视力≥0.8。术后3～8个月残余球镜度和IOL Master 预留球镜度的误差范围在(-0.90～+0.85)DS, 平均球镜度偏差为(0.46±0.23)DS。术后球镜度的误差与术前眼轴长度之间关系:Y=11.908x-231.65, R 2 =0.817, P 0.05。术前角膜散光平均为(1.84±0.55)DC, 术后3～8个月残余散光为(0.18±0.11)DC, 二者相比差异有统计学意义( P 0.05)。人工晶状体轴位与预定轴位相比偏移了0°～12°, 平均轴位发生偏转为(3.96±3.46)°。 结论 Acrysof Toric人工晶状体植入术后的残余球镜度和IOL Master 预留球镜度存在一定的误差;术后球镜度误差与术前眼轴长度呈正相关, 随眼轴的增加而增大;Acrysof Toric人工晶状体矫正规则性角膜散光误差小, 具有良好的旋转稳定性。

背景 睫状沟距离的直接测量对人工晶状体(I0L)植入术中IOL尺寸的选择具有重要意义.全景超声生物显微镜(UBM)的问世使在活体眼直接进行睫状沟距离的 测量成为可能.目的 探讨人眼前房直径和睫状沟距离之间的相关性及其在不同前房深度人群中的差别.方法 将疑似青光眼患者30例30只右眼作为浅前房组,而具有高度近视(-7 ～-18 D)的30例30只右眼作为深前房组.应用全景超声生物显微镜(UBM)进行图像采集,每眼获取焦点位于虹膜平面的眼球水平方向3:00 ～9:00处的全景截面图像共3张.由同一测量者对每一幅图像的前房直径和睫状沟距离进行测量.取3幅图像测量值的均值为最终测量结果,用独立样本t检验 和线性回归方程分析评估前房直径与睫状沟距离测量值的关系.结果 浅前房组的30眼中,全景UBM测得的前房直径为(11.49±0.75)mm,睫状沟距离为(10.97±0.86)mm,二者间的平均差值为 (-5.14±0.55)mm,差异有统计学意义(t=-5.092,P=0.000),线性回归分析显示二者之间呈线性相关 (R2=0.593,P=0.000),Pearson相关系数为0.767.深前房组的30眼中,全景UBM测得的前房直径均值为 (12.69±0.67)mm；睫状沟距离为(12.31±0.61)mm,二者之间平均差值为(-0.38±0.17)mm,差异有统计学意义 (t=-5.531,P=0.000)；线性回归分析显示二者之间具有显著相关性(R2=0.699,P=0.000),Pearson相关系数为 0.836.结论 全景UBM测得的睫状沟距离和前房直径呈明显正相关,深前房眼的相关性大于浅前房眼,该结果对于IOL植入术中IOL尺寸的选择具有重要意义.