The Modern Patterns Of Micro-incision Surgeries Of Lens Subluxation

Objective:Lens subluxation can lead to decreased vision, visual distortion, but also can cause secondary glaucoma, retinal detachment and other complications, the surgery for it is more complex and difficult, the traditional large incision surgery has a lot of defects, including no satisfactory visual acuity, too much surgical complications, much long recovery time. In recent years, with the ophthalmological surgery equipment improving and the continuous improvement of surgical techniques, while the introduction of new surgical technology and new tools, making the modern lens subluxation surgery towards to micro-incision, which make the postoperative visual acuity improved significantly, surgical complications reduced and recovery time shorten effectively, thus expanding the indication of the surgical treatment for lens subluxation. This research wants to investigate the surgical techniques in the different patterns of micro-incision surgeries of subluxated lens and to observe the clinical effects of the micro-incision surgeries.Methods:This retrospective study comprised 20 patients(21eyes)with micro-incision surgeries of subluxated lens, who were admitted into the ophthalmology department of the Second Affiliated Hospital of Dalian Medical University between August 2008 to October 2009. Dislocation range of all the eyes was in 1/3-2 quadrants. There was 9 eyes which dislocation ranges from 1 to 2 quadrant within which there were 5 eyes with superior dislocation,2 eyes with nasal dislocation,2 eyes with inferior dislocation; There was 12 eyes which dislocation ranges<1 quadrants. According to the range and location of lens subluxation, respectively, in the following two kinds of surgical methods:1. Lens dislocation range<1 quadrant and dislocation ranges from 1 to 2 quadrants with superior dislocation,14 eyes were treated with phacoemulsification with foldable posterior chamber intraocular lens implantation; 2. lens dislocation ranges from 1 to 2 quadrant within the remaining 7eyes were treated with phacoemulsification with capsular tension ring and foldable posterior chamber intraocular lens implantation (1 eye which has part defect of iris and larger range of dislocation was treated with iris retractor fixed capsule). The best corrected visual acuity(BCVA), intraocular pressure(IOP), intraocular lens(IOL) position and complications were evaluated.Results:All 21 eyes received surgery successfully, all the intraocular lens implanted into capsular in first time.3 months after operation, BCVA of all 21 eyes postoperatively improved much more significantly compared to that of preoperative (t=-10.45, P<0.01); the improvement of the BCVA between the two surgical methods was no statistically significant (t= 1.74, P> 0.05). IOP was significantly lower than that of preoperative, the difference has a statistically significant (t= 2.84, P<0.05); reduction of IOP between the two surgical methods was no statistically significant (t=-0.87, P> 0.05). The orthophoria rate of IOL between the two surgical methods was no statistically significant (Fisher exact test, P= 0.75> 0.05).There were no serious complications between the two surgical methods, the surgical response between the two surgical methods was no statistically significant (Fisher exact test, P orneal edema= 0.44, P inflammatory response=0.56,P introcular hypertension=0.25, P posterior capsule opacification=0.57, P> 0.05).Conclusion:In the modern surgical treatment of subluxated lens, according to different cases, selecting most suitable micro-incision surgeries combined with the new technologies and tools of modern ophthalmology, it would significantly improve patient visual acuity and decrease complications.