摘要目的 通过对人工晶状体取出病例的原因分析,探讨人工晶状体植人手术的适应证及并发症的防治.方法 回顾在西安市第四医院眼科自2013年1月至2015年1月行人工晶状体取出术共65例68只眼进行临床分析.结果 导致人工晶状体取出的常见原因依次为人工晶状体脱位或半脱位、视网膜脱离、人工晶状体度数误差、眼内炎等.人工晶状体植入至取出间隔时间最短1d,最长为15年,人工晶状体植入多在术后1月内和2～5年发生严重并发症导致人工晶状体取出.取出的人工晶状体:后房型64只眼,ICL3只眼,前房型1只眼.术后视力:53只眼(77.9％)有不同程度的提高,14只眼(20.6％)无明显变化,1只眼因并发眼内炎,术后视力由光感变为无光感.结论 人工晶状体植入术后的严重并发症是导致人工晶状体取出的直接原因.术前严格掌握人工晶状体植入的适应证,有效控制术中、术后的并发症,是避免术后人工晶状体取出的重要保证,及时准确地取出人工晶状体,同时酌情植入适当的人工晶状体,可有效提高患者视力和生活质量.

abstractsObjective To analyze the causes of explantation of intraocular lens (IOL) postoperation,and explore surgery accommodation and prevent surgery complications.Methods The causes for 65 cases (68 eyes) of lens explantation from January 2013 to January 2015 were retrospectively analyzed.Results The most common causes of IOL explantation were IOL decentration and dislocation,retinal detachment,postoperative refractive error and endophthalmitis.The shortest interval of IOL implantation to explantation was one day,while the longest interval was 15 years.Intraocular lens implantation surgery in one month and 2 ～ 5 years was more prone to occur serious complications leading to IOL explantation.IOL types of explantation including:posterior chamber IOL in 64 eyes,ICL (implantable collamer lens) in 3 eyes,and anterior chamber IOL in one eye.Postoperative visual acuity outcome:The visual acuity of 53 eyes (77.9％) was improved significantly compared with preoperation,14 eyes (20.6％) was not obviously changed.And one patient's visual acuity changed from light perception to no light perception due to complicated by endophthalmitis.Conclusions Serious complication of IOL implantation is the direct cause of IOL explantation.Strictly controlled indications of intraocular lens implantation and effective treatment of postoperative complications are important guarantee to prevent postoperative IOL explantation.Timely and accurate IOL explantation and implanting new IOL can effectively improve the vision and quality of patient's life.