晶状体悬韧带的研究进展
Research Progress of Suspensory Ligaments of Lens
摘要: 晶状体悬韧带是连接着睫状体和晶状体的带状纤维组织,凭借纤维组织间共同张力,将晶状体悬挂于视轴解剖位置。晶状体悬韧带是一个复杂的细胞外纤维系统,在生理状态下是透明的,难以观测。临床医生经常通过裂隙灯显微镜检查间接观察悬韧带异常,如虹膜震颤和周边浅前房,当悬韧带出现部分或全部断裂时,通常会伴随晶状体不全脱位或全脱位。然而,一些临床症状可能是隐匿性或轻微的,在临床上很容易被忽视。因此对于接受眼科手术的患者,术前仔细评估晶状体悬韧带情况是十分必要的。本文就晶状体悬韧带解剖结构、功能及悬韧带异常的机制及治疗综述如下。
Abstract: The suspensory ligaments of lens are a banded fibrous tissue connecting the ciliary body and the lens. By virtue of the common tension between the fibrous tissues, the lens is suspended in the an-atomical position of the optic axis. The suspensory ligaments of lens are a complex extracellular fi-ber system, which is transparent and difficult to observe under physiological conditions. Clinicians often observe zonule abnormalities indirectly through slit-lamp microscopy, such as iris tremor and peripheral superficial anterior chamber. When the suspensory ligaments of lens are partially or completely broken, it is usually accompanied by incomplete dislocation or total dislocation of the lens. However, some clinical symptoms may be insidious or mild and can be easily overlooked clini-cally. Therefore, it is necessary to carefully evaluate the suspensory ligaments of lens before surgery for patients undergoing eye surgery. In this paper, the anatomical structure, function, mechanism and treatment of zonule abnormalities are summarized as follows.
文章引用:刘若武, 张晗. 晶状体悬韧带的研究进展[J]. 临床医学进展, 2023, 13(5): 8634-8639. https://doi.org/10.12677/ACM.2023.1351207

参考文献

[1] Bassnett, S. (2021) Zinn’s Zonule. Progress in Retinal and Eye Research, 82, Article ID: 100902. [Google Scholar] [CrossRef] [PubMed]
[2] Goldfischer, S., Coltoff-Schiller, B. and Goldfischer, M. (1985) Microfibrils, Elastic Anchoring Components of the Extracellular Matrix, Are Associated with Fibronectin in the Zonule of Zinn and Aorta. Tissue and Cell, 17, 441-450. [Google Scholar] [CrossRef] [PubMed]
[3] Godwin, A.R., Starborg, T., Smith, D.J., Sherratt, M.J., Roseman, A.M. and Baldock, C. (2018) Multiscale Imaging Reveals the Hierarchical Organization of Fibrillin Microfi-brils. Journal of Molecular Biology, 430, 4142-4155. [Google Scholar] [CrossRef] [PubMed]
[4] Canals, M., Costa-Vila, J., Potau, J., et al. (1996) Scanning Electron Microscopy of the Human Zonule of the Lens (Zonula ciliaris). Cells Tissues Organs, 157, 309-314. [Google Scholar] [CrossRef] [PubMed]
[5] Lütjen-Drecoll, E., Kaufman, P.L., Wasielewski, R., et al. (2010) Mor-phology and Accommodative Function of the Vitreous Zonule in Human and Monkey Eyes. Investigative Ophthalmology & Visual Science, 51, 1554-1564. [Google Scholar] [CrossRef] [PubMed]
[6] Goldberg, D.B. (2011) Computer-Animated Model of Accommodation and Theory of Reciprocal Zonular Action. Clinical Ophthalmology, 5, 1559-1566. [Google Scholar] [CrossRef
[7] de Maria, A., Wilmarth, P.A., David, L.L. and Bassnett, S. (2017) Proteomic Analysis of the Bovine and Human Ciliary Zonule. Investigative Ophthalmology & Visual Science, 58, 573-585. [Google Scholar] [CrossRef] [PubMed]
[8] Hubmacher, D., Reinhardt, D.P., Plesec, T., Schenke-Layland, K. and Apte, S.S. (2014) Human Eye Development Is Characterized by Coordinated Expression of Fibrillin Isoforms. Investigative Ophthalmology & Visual Science, 55, 7934-7944. [Google Scholar] [CrossRef] [PubMed]
[9] 王适宜, 任珏. 超声生物显微镜及其在眼科临床中的应用[J]. 国际眼科杂志, 2012, 12(10): 1915-1918.
[10] 董红颜, 王秀娟, 董丽, 等. 超声生物显微镜对晶状体悬韧带异常的观察[J]. 国际眼科杂志, 2009, 9(1): 175-176.
[11] Pavlin, C.J., Buys, Y.M. and Pathmanathan, T. (1998) Imaging Zonular Abnormalities Using Ultrasound Biomicroscopy. Ar-chives of Ophthalmology, 116, 854-857. [Google Scholar] [CrossRef] [PubMed]
[12] Square, T. and London, W.C.H. (2021) European Glaucoma Society Terminology and Guidelines for Glaucoma, 5th Edition. British Journal of Ophthalmology, 105, 1-169.
[13] 中华医学会眼科学分会青光眼学组. 中国原发性闭角型青光眼诊治方案专家共识(2019年) [J]. 中华眼科杂志, 2019, 55(5): 325-328.
[14] Salimi, A., Fanous, A., Watt, H., et al. (2021) Prevalence of Zonulopathy in Primary Angle Closure Disease. Clinical & Experimental Ophthalmology, 49, 1018-1026. [Google Scholar] [CrossRef] [PubMed]
[15] 崔冬梅, 吴小宏, 贺严. UBM对白内障合并原发性闭角型青光眼术前晶状体悬韧带及术后房角形态的观察[J]. 河北医学, 2020, 26(6): 980-983.
[16] Ma, J., Jiang, N., Jiang, Z., Lin, J., Li, C. and Zhao, G. (2022) Ultrasound Biomicroscopy Observation of Suspicious Primary Angle Closure Combined with the Relaxation of Zonule. Journal of Ophthalmology, 2022, Article ID: 1614678. [Google Scholar] [CrossRef] [PubMed]
[17] Lee, B.W., Lau, F.S., Wong, E.L., et al. (2021) Lessons from Man-agement: Perioperative Phacoemulsification Planning Following Resolution of Acute Angle Closure. Cureus, 13, e14331. [Google Scholar] [CrossRef] [PubMed]
[18] Pascolini, D. and Mariotti, S.P. (2012) Global Estimates of Visual Im-pairment: 2010. British Journal of Ophthalmology, 96, 614-618. [Google Scholar] [CrossRef] [PubMed]
[19] Jehan, F.S., Mamalis, N. and Crandall, A.S. (2001) Spon-taneous Late Dislocation of Intraocular Lens within the Capsular Bag in Pseudoexfoliation Patients. Ophthalmology, 108, 1727-1731. [Google Scholar] [CrossRef
[20] Shingleton, B.J., Neo, Y.N., Cvintal, V., et al. (2017) Out-come of Phacoemulsification and Intraocular Lens Implantion in Eyes with Pseudoexfoliation and Weak Zonules. Acta Ophthalmologica, 95, 182-187. [Google Scholar] [CrossRef] [PubMed]
[21] Dureau, P. (2008) Pathophysiology of Zonular Diseases. Current Opinion in Ophthalmology, 19, 27-30. [Google Scholar] [CrossRef
[22] Yasuda, A., Ohkoshi, K., Orihara, Y., Kusano, Y., Sakuma, A. and Yamaguchi, T. (2000) Spontaneous Luxation of Encapsulated Intraocular Lens onto the Retina after a Triple Pro-cedure of Vitrectomy, Phacoemulsification and Intraocular Lens Implantation. American Journal of Ophthalmology, 130, 836-837. [Google Scholar] [CrossRef
[23] Meng, B., Li, H., Yang, T., et al. (2011) Identification of a Novel FBN1 Gene Mutation in a Chinese Family with Marfan Syndrome. Molecular Vision, 17, 2421-2427.
[24] Xiao, Y., Liu, X., Guo, X., et al. (2017) A Novel FBN1 Mutation Causes Autosomal Dominant Marfan Syndrome. Molecular Medicine Reports, 16, 7321-7328. [Google Scholar] [CrossRef] [PubMed]
[25] Beene, L.C., Wang, L.W., Hub-macher, D., et al. (2013) Nonselective Assembly of fiBrillin 1 and Fibrillin 2 in the Rodent Ocular Zonule and in Cul-tured Cells: Implications for Marfan Syndrome. Investigative Ophthalmology & Visual Science, 54, 8337-8344. [Google Scholar] [CrossRef] [PubMed]
[26] Wirtz, M., Samples, J., Kramer, P., et al. (1996) Weill-Marchesani Syndrome-Possible Linkage of the Autosomal Dominant form to 15q21.1. American Journal of Medical Genetics, 65, 68-75. [Google Scholar] [CrossRef
[27] Crandall, A.S. (2018) Exfoliation Syndrome and Cataract Surgery. Journal of Glaucoma, 27, S102-S104. [Google Scholar] [CrossRef
[28] Teshigawara, T., Meguro, A., Sanjo, S., et al. (2019) The Advantages of Femtosecond Laser-Assisted Cataract Surgery for Zonulopathy. International Medical Case Reports Journal, 12, 109-116. [Google Scholar] [CrossRef
[29] Dryjski, O., Awidi, A. and Daoud, Y.J. (2019) Femtosecond Laser-Assisted Cataract Surgery in Patients with Zonular Weakness. American Journal of Ophthalmology Case Reports, 15, Article ID: 100483. [Google Scholar] [CrossRef] [PubMed]
[30] Lee, D.H., Lee, H.-Y., Lee, K.H., et al. (2001) Effect of a Capsular Tension Ring on the Shape of the Capsular Bag and Opening and the Intraocular Lens. Journal of Cataract & Refractive Surgery, 27, 452-456. [Google Scholar] [CrossRef
[31] Alió, J.L., Elkady, B., Ortiz, D., et al. (2008) Microincision Multifocal Intraocular Lens with and without a Capsular Tension Ring: Optical Quality and Clinical Outcomes. Journal of Cataract & Refractive Surgery, 34, 1468-1475. [Google Scholar] [CrossRef] [PubMed]
[32] Yang, J., Lu, Y., Luo, Y. and Wang, L. (2007) Clinical Efficacy of Management of Zonular Abnormalities with Capsular Tension Ring: A Two-Year Follow-Up Study. Chinese Journal of Ophthalmology, 43, 519-524.