双眼人工晶状体脱位1例
A case of bilateral intraocular lens dislocation
宁利 1洪莹莹 1季樱红1
作者信息
- 1. 复旦大学附属眼耳鼻喉科医院眼科 上海 200031
- 折叠
摘要
36 岁女性,因双眼白内障术后视力下降 2 年,右眼为甚就诊.患者因双眼白内障分别于 32 岁、34岁时先后在外院行左眼及右眼白内障超声乳化吸出联合人工晶状体(IOL)植入术.双眼最佳矫正视力:右眼1.0(+12.25/-2.00×165°),左眼 0.8(+1.25/-1.25×20°).裂隙灯检查:双眼角膜直径偏大,瞳孔欠圆、直径约 3 mm×3 mm、扩瞳药物扩不大,虹膜点片状萎缩伴虹膜震颤,IOL向下移位.超声生物显微镜(UBM)检查:双眼虹膜略后凹,虹膜根部附着点偏后位,睫状体瘦小,巩膜突不明显.诊断为双眼IOL脱位,双眼眼前段发育不良(前部巨眼).追溯既往资料,患者右眼曾植入散光矫正型IOL,遂行"右眼前部玻璃体切除术+原脱位Toric IOL巩膜缝线固定术",手术顺利.术后3周术眼裸眼视力:1.0.讨论体会:对于IOL脱位的患者,首先要分析导致IOL脱位的原因,同时不忘屈光白内障理念,根据患者眼部状况,做好术前规划.
Abstract
A 36-year-old woman presented with decreased vision in both eyes for 2 years after cataract surgery,and the vision loss was more obvious in the right eye.The patient underwent phacoemulsification combined with intraocular lens(IOL)implantation in the left eye and right eye at the age of 32 and 34 years,respectively.The best corrected visual acuity was 1.0(+12.25/-2.00×165°)for the right eye and 0.8(+1.25/-1.25×20°)for the left.Slit lamp examination showed:the diameter of both corneas was rather large;the pupils were slightly irregular and insensitive to mydriatic drugs;there is patchy atrophy of the iris with iridodonesis,and the intraocular lens was displaced downward.Ultrasound biomicroscopy(UBM)examination:the iris of both eyes is slightly posteriorly concave,the attachment point of the iris root is located posteriorly,the ciliary body is thin and small,and the scleral spur is not obvious.The patient was diagnosed with bilateral IOL dislocation and anterior segment dysgenesis(anterior macrophthalmia).Based on the patient's surgical history,the patient had had a Toric IOL implanted in her right eye,so she underwent anterior segment vitrectomy and scleral suture fixation of the original IOL successfully.Three weeks after the surgery,her uncorrected visual acuity was 1.0 in the right eye.For patients with IOL dislocation,we should first analyze the causes of IOL dislocation.At the same time,keep the concept of refractive cataracts in mind and make preoperative plan according to patients'eye condition.
关键词
人工晶状体脱位/人工晶状体巩膜缝线固定术/眼前段发育不良/前部巨眼Key words
Intraocular lens dislocation/Intraocular lens scleral suture fixation/Anterior segment dysgenesis/Anterior megalophthalmos引用本文复制引用
出版年
2024
NETL
NSTL
万方数据