【摘要】 目的：评价囊袋张力环(capsular tension ring, CTR)在晶状体半脱位的白内障手术中的应用。方法：对15例15眼合并白内障的晶状体半脱位患者连续环形撕囊(continues curvilinear capsulorhexis,CCC)后植入CTR,然后行白内障超声乳化，及人工晶状体植入术。结果：所有15眼IOL正位，无倾斜及偏位，术后10～12mo观察矫正视力满意，未发现CTR引起的并发症。结论：CTR植入是治疗合并晶状体半脱位的白内障超声乳化的一种安全、有效的方法，可以防止人工晶状体偏位，减少手术并发症。
【关键词】 晶状体半脱位;人工晶状体;超声乳化术;囊袋张力环
Capsular tension ring in phacoemulsification and intraocular lens implantation for the treatment of subluxated lens with cataractJing LiDepartment of Ophthalmology, the Central Hospital of Baotou, Baotou 014040, Inner Mongolia Autonomous Region, ChinaAbstractAIM: To evaluated the application of capsular tension ring (CTR) implantation during phacoemulsification for sublusated lens with cataract.METHODS: Fifteen eyes of lens subluxation with cataract was implanted CTR after continues curvillinear capsulorhexis (CCC), phacoemulsification and posterior chamber intraocular lens (IOL) implantation.RESULTS: The IOLs in fifteen eyes were in the normal position without tilting or decentration. Ten to twelve months postoperatively, the corrected visual acuity was satisfaction. There were no special complications.CONCLUSION: The CTR implantation during phacoemulsification is a safe and effective method for subluxated lens with cataract. It can prevent the IOL decentration and decrease the complications.
KEYWORDS: lens subluxation; intraocular lens; phacoemulsification; capsular tension ring0引言
长期以来伴有晶状体半脱位的白内障如何安全有效地行晶状体摘除及人工晶状体植入，一直被关注。自晶状体囊袋张力环问世以来，许多医疗单位应用于临床，并给予了充分的肯定，临床上得到了广泛应用，它使晶状体半脱位的白内障手术的繁琐操作简化并减少对术眼的损伤，有效地解决了人工晶状体植入的困难及偏位等问题。自200406/200612间对15例15眼晶状体半脱位的白内障患者应用CTR施行白内障超声乳化术取得了满意的临床效果，现报告如下。
1对象和方法
1.1对象
共观察晶状体半脱位的白内障患者15例15眼，男11例，女4例，年龄42～74岁，术前视力：手动/眼前～0.1，术前发现晶状体半脱位的白内障患者13眼，其中外伤引起的晶状体半脱位的白内障10眼，不明原因引起的晶状体半脱位3眼，另2眼白内障在手术CCC时发现晶状体悬韧带断裂，脱离范围在90°～270°晶状体核硬度为1～3级，术前眼压：14～32mmHg。
1.2方法
对15眼均行白内障晶状体超声乳化吸出术，植入CTR及折叠式人工晶状体。术前均用4g/L倍诺喜眼液表面麻醉，眼压偏高者术前0.5h静脉点滴甘露醇，手术所用CTR为法国IOLTECH公司生产的。手术行角膜隧道切口，约2∶00位辅助切口前房注入足量黏弹剂，CCC，直径约5～6mm，水分离后，注入足量黏弹剂，撑开囊袋，用镊子夹住CTR一端沿囊袋穹窿轻轻推入囊袋，当外端到达角膜缘隧道口时，用晶状体镊夹住末端，推压入囊袋，在囊袋张力环完全松开前旋转将CTR开口转到晶状体悬韧带断裂对侧，使囊袋充分扩张，超声乳化晶状体核，皮质，清除残留皮质，囊袋内植入折叠型人工晶状体。
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