方法：本研究收集缺少囊膜支撑的无晶状体患者70例进行回顾性对比分析，患者根据手术方式的不同分为A、B两组，A组35眼行后房植入虹膜夹IOL，B组35眼行后房睫状沟巩膜缝合固定IOL。比较两组患者术前及术后3d，1、3、6mo，1a的裸眼视力(UCVA)、最佳矫正视力(BCVA)、眼压(IOP)、角膜内皮细胞密度(CECD)，并且观察两组IOL的稳定性，记录术中及术后并发症。

结果：随访12～14mo。术后3d，A组的UCVA较术前明显改善(P<0.01)，而BCVA较术前无差异(P=0.073)； B组的UCVA较术前无差异(P=0.097)，而BCVA较术前差(P=0.002)； 两组患者术后1mo UCVA、BCVA均较术前显著改善(P<0.05)，分别于术后6、3mo保持稳定。两组患者随访期间的IOP均维持于正常水平。A组、B组患者术后1a的CECD分别较术前平均降低0.7%、2.3%(均P<0.05)。两组患者随访期间各时间点IOP及CECD的均无差异(P>0.05)。两组患者术后1、3mo的全眼散光较角膜散光无明显差异(均P>0.05)。术后两组各有1眼IOL脱位，均经手术复位，其余患者术后随访期间IOL无显著倾斜和偏位； 其他术后并发症较轻微，组间并发症发生率无差异(P>0.05)。

结论：对于缺少囊膜支持的无晶状体眼患者，后房植入虹膜夹IOL与后房睫状沟巩膜缝合固定IOL均是安全有效的手术方式。后房植入虹膜夹IOL的操作相对简单，对眼球内组织损伤较小，手术时间较短，术后视力恢复较快，是有效的治疗方法之一。

METHODS: The present retrospective study included 70 aphakic eyes without capsular support. According to the different surgical methods, the patients were divided into two groups, including group A(35 eyes)with treatment of retropupillary iris claw IOL implantation, group B(35 eyes)with treatment of posterior chamber ciliary scleral suture fixed IOL. The uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), intraocular pressure(IOP)and corneal endothelial cell density(CECD)of the two groups were documented and compared before operation and 3d, 1, 3, 6mo and 1a after operation. Furthermore, the stability of IOL in both groups, as well as the intraoperative and postoperative complications were recorded.

RESULTS: The patients in the present study were followed up for 12 to 14mo. 3d after surgery, UCVA in group A was significantly improved compared with that before surgery(P<0.01), while BCVA had no difference compared with that before surgery(P=0.073).UCVA in group B showed no difference(P=0.097), while BCVA was worse(P=0.002). UCVA and BCVA in both groups were significantly elevated 1mo after surgery(P<0.05), and remained stable 6, 3mo later,respectively. Furthermore, IOP in both groups remained in normal level during the follow up period, 0.7% and 2.3% reduction of CECD in A group and B gruop was observed at 1a after operation respectively(P<0.05). Both IOP and CECD between the two groups have no significant differenc at each time point during the follow up period(P>0.05).There was no significant difference between whole eye astigmatism and corneal astigmatism in A group and B gruop at 1 and 6mo after operation(P>0.05). Additionally, There was 1 case of IOL dislocation in each group after operation, which was further recovered by operation. Significant tilt and deviation of IOL were not observed in the rest of the patients during the follow up period. The other postoperative complications were mild with no difference in complications between the two groups(P>0.05).

CONCLUSION: For aphakic eyes without capsular support, both retropupillary iris claw IOL implantation and posterior chamber ciliary scleral suture fixed IOL are safe and effective surgical methods. Retropupillary iris claw IOL implantation has relatively simple operation, lower damage to the eyeball tissue, the shorter operation time, and the quicker recovery of postoperative visual acuity, which is one of the effective clinical treatments.