人工晶状体前脱位的手术策略
Surgical strategies for intraocular lens anterior dislocation
徐雯 1许哲1
作者信息
- 1. 浙江大学医学院附属第二医院眼科 杭州 310009
- 折叠
摘要
后房型人工晶状体(IOL)前脱位是白内障手术后的并发症之一,主要由于IOL固定不良或囊袋支持力不足等原因引起.虽然这一并发症的发生率并不高,但脱位的IOL可能导致角膜内皮损伤、瞳孔变形、视觉障碍等严重问题,因此依然值得临床医师重点关注.在遇到相关情况时,应及时进行全面评估和及时处理.本述评通过回顾既往研究,分析了IOL前脱位的发生率、风险因素及临床表现,详细阐述了术前评估要点、手术时机选择及具体手术处理策略,提出了针对不同脱位情况的手术方案,包括无缝线或使用缝线的IOL复位、IOL-囊袋复合物复位,以及必要情况下的IOL置换等,并对瞳孔、玻璃体、视网膜等其他眼内组织的术中处理给出了建议.
Abstract
Anterior dislocation of posterior intraocular lens(IOL)is one of the complications after cataract surgery,mainly caused by poor fixation of the IOL or insufficient support from the capsular bag.Although the incidence of this complication is not high,the dislocated IOL can lead to serious problems such as corneal endothelial damage,pupil deformation,and visual impairment.Therefore,it still deserves the attention of ophthalmologists,who should promptly conduct comprehensive evaluations and proper management when encountering relevant situations.This commentary analyzes the incidence,risk factors,and clinical manifestations of anterior dislocation of IOL through a review of previous studies.It elaborates on the key points of preoperative assessment,selection of surgical timing,and specific surgical treatment strategies.Various surgical options are proposed for different dislocation scenarios,including IOL repositioning with or without sutures,repositioning of IOL-capsular bag complex,and IOL replacement when necessary.Recommendations are also provided for the intraoperative management of other intraocular tissues such as the pupil,vitreous,and retina.
关键词
人工晶状体/前脱位/手术策略/并发症处理/白内障Key words
Intraocular lens/Anterior dislocation/Surgical strategy/Complication management/Cataract引用本文复制引用
基金项目
国家自然科学基金(82271042)
浙江省重点研发计划(2023C03090)
浙江省自然科学基金(LTGY24H120004)
出版年
2024
NETL
NSTL
万方数据