目的：探讨自发性脱位于玻璃体腔的人工晶状体囊袋复合体经巩膜缝合固定的手术效果。

方法：回顾性病例对照研究。2017-04/2019-06对自发性脱位进入玻璃体腔内的人工晶状体囊袋复合体8例8眼(研究组)采取23G玻璃体切割术联合人工晶状体囊袋复合体巩膜缝合固定治疗。选取同期玻璃体晶状体切除术后行折叠人工晶状体悬吊手术10例10眼为对照组。术后7、30、60d随访两组裸眼视力、最佳矫正视力、眼压、角膜散光、IOL的偏心值与倾斜度和手术并发症。

结果：研究组8眼人工晶状体囊袋复合体顺利经巩膜缝合固定，对照组10眼成功植入并缝合固定人工晶状体。视力：两组内术后7、30、60d裸眼视力和术前比较，均提高(P<0.05)； 两组术后7、30、60d矫正视力较术前无差异(P>0.05)。术后两组裸眼视力无差异(P>0.05)，术后7d与术后30、60d裸眼视力有差异(P<0.001)； 术后7、30、60d两组矫正视力无差异(P>0.05)。术后7、30、60d两组患者眼压均正常(10～21mmHg)，组内及组间对比均无统计学意义(P>0.05)。角膜散光：组内比较：对照组术前与术后30、60d比较，研究组术前与术后30d比较，均有差异(P<0.05)，散光值较术前增大； 术后30、60d，对照组术后散光度均大于研究组(P<0.05)。IOL的偏心值与倾斜度：术后30、60d研究组均低于对照组(P<0.05)。

结论：对脱位于玻璃体腔内的人工晶状体囊袋复合体采取23G玻璃体切割术联合经巩膜缝合固定手术可以减少手术步骤，降低手术性创伤，较好恢复人工晶状体的位置和改善视觉质量。

METHODS: A retrospective case control study was adopted to analyze 8 eyes of 8 patients with spontaneous in-the-bag intraocular lens dislocated into the vitreous cavity. The study was conducted from April 2017 to June 2019. 8 eyes of 8 patients who had undergone standard 23G pars plana vitrectomy and in-the-bag intraocular lens were respositioned by ciliary sutures fixed act as research group.10 eyes of 10 patients with lens dislocated into vitreous cavity, which were performed with phacofragmentation and ciliary sutures fixed during the same period act as the control group. Patients were examined 7, 30 and 60d postoperatively. The examinations included uncorrected visual acuity, best corrected visual acuity, intraocular pressure, corneal astigmatism, the tilt and decentration of the IOL, complacations of surgeries etc.

RESULTS: Successful IOL implantations were achieved in all eyes. Visual acuity: At 7, 30, and 60d after surgery, the uncorrected visual acuity of the two groups was both improved compared with before surgery, and the difference was statistically significant(P<0.05). There was no difference between the best corrected visual at 7, 30, 60d after surgery and before(P>0.05). There was no difference in uncorrected visual acuity between the two groups, but there was statistically significant difference in uncorrected visual acuity between 7d and 30d, 7d and 60d after operation(P<0.001). There was no significant difference in corrected visual acuity between the two groups at 7d, 30d and 60d after operation(P>0.05). Intraocular pressure: Intraocular pressure in the two groups was within the normal range(10mmHg-21mmHg)at 7, 30 and 60d after surgery, and there was no statistically significant difference between the groups(P>0.05), while the difference between the groups was not statistically significant. Corneal astigmatism: At 30d after surgery, the corneal astigmatism of the two groups was both increased than before, at 60d after surgery, the corneal astigmatism of the control group was increased than before, and the differences were statistically significant(P<0.05). The corneal astigmatism of research group at 30 and 60d after surgery was significantly lower than control group(P<0.05). The tilt and decentration of the IOL: The tilt and decentration of the IOL of research group at 30 and 60d after surgery was significantly lower than control group(P<0.05).

CONCLUSION: Surgical respositioning of spontaneous in-the-bag intraocular lens dislocated into the vitreous cavity provides efficacy and predictability and is safe and reliable.