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目的探讨2种不同襻设计的人工晶状体应用于白内障超声乳化摘出联合玻璃体切割及人工晶状体植入术(简称“联合手术”)治疗玻璃体视网膜疾病合并白内障的临床疗效。方法回顾性分析联合手术治疗玻璃体视网膜疾病合并白内障患者52例54眼,AkreosAdapt组(4襻)26例28眼,C-flex组(双襻)26例26眼,术后定期随访,并观察视力、人工晶状体囊袋稳定性及手术并发症。结果术后随访10～18个月,平均(14.6±3.8)个月,术后最佳矫正视力:AkreosAdapt组提高22眼,C-flex组提高20眼,组间比较差异无统计学意义(Z=-0.13,P>0.05)。IOL偏心量:AkreosAdapt组:0级15眼,1级8眼,2级4眼,3级1眼;C-flex组:0级8眼,1级7眼,2级9眼,3级2眼,组间比较差异有统计学意义(Z=-2.00,P<0.05)。2组人工晶状体预防后发性白内障的组间比较差异无统计学意义(Z=-0.88,P>0.05)。手术主要并发症包括角膜水肿、前房纤维素性渗出、继发性青光眼等,组间比较差异均无统计学意义(P>0.05)。结论2种不同襻设计的人工晶状体应用于联合手术治疗玻璃体视网膜疾病合并白内障安全、可行。4襻AkerosAdapt人工晶状体的囊袋稳定性优于双襻C-flex人工晶状体,2种人工晶状体预防后发性白内障的作用有待于长期观察。
Objective To investigate the clinical effects of two different intraocular lenses (IOLs) designed for phacoemulsification and cataract surgery combined with vitrectomy and intraocular lens implantation (referred to as “combined surgery”) for the treatment of vitreoretinal diseases complicated with cataract. Methods A total of 52 eyes (54 eyes) with vitreo-retinal diseases complicated with cataract were retrospectively analyzed. Twenty-six eyes (26 eyes) were treated with AkreosAdapt (襻 襻) and 26 eyes (26 eyes) with C-flex. , Intraocular lens pocket stability and surgical complications. Results The patients were followed up for 10-18 months with an average of (14.6 ± 3.8) months. The best corrected visual acuity was 22 eyes in AkreosAdapt group and 20 eyes in C-flex group. There was no significant difference between the two groups (Z = -0.13, P> 0.05). IOL eccentricity: AkreosAdapt group: 0 grade 15 eyes, grade 1, 8 eyes, grade 2 4 eyes, grade 3 1 eyes; C-flex group: 0 grade 8 eyes, grade 1 7 eyes, grade 2 9 eyes, grade 2 Eye, the difference between the groups was statistically significant (Z = -2.00, P <0.05). There was no significant difference between the two groups in the prevention of posterior chamber intraocular lens (Z = -0.88, P> 0.05). The major complications of surgery included corneal edema, anterior chamber fibrin exudation and secondary glaucoma. There was no significant difference between the two groups (P> 0.05). Conclusions Two kinds of intraocular lenses with different diameters are suitable for the combined surgery for the treatment of vitreoretinal diseases complicated with cataract. 4 襻 AkerosAdapt intraocular lens bag superior stability than the double C-flex intraocular lens, two kinds of intraocular lens to prevent the role of cataract in the long-term observation.