摘要
目的评价有晶状体眼后房型人工晶状体植入术治疗高度近视的安全性和有效性。方法高度近视患者18例（34只眼）接受有晶状体眼后房型人工晶状体植入，每只眼术前及术后进行眼部检查，包括：裸眼视力、矫正视力、睫状肌麻痹验光、角膜曲率、裂隙灯检查、眼压测量、角膜地形图、角膜厚度、角膜内皮细胞计数、UBM、B超、角膜水平直径散瞳眼底检查。手术在表面麻醉下进行，作透明角膜隧道式切口，可植入式接触镜（implantable contactlens，ICL）置于透明晶状体与虹膜之间，术中1点位作虹膜周切口。结果34只眼术前裸眼视力和最好矫正视力分别为0．08±0．06，0．5±0．3；术后分别提高为0．5±0．2，0．7±0．2，术后裸眼和矫正视力均明显好于术前（P〈0．05）。术前平均屈光度为（-19．9±5．4）D，术后1个月平均屈光度为（-1．5±1．5）D。术前角膜内皮细胞数（3249．6±337．1）／mm^2术后1个月角膜内皮细胞为（3103．4±305．5）／mm^2，丢失率为4．5％。术前平均眼压为（15．5±2．7）mmHg，术后第一天眼压为（19.4±7．3）mmHg，增高率25．2％。通过UBM观察术前前房深度（3．20±0．30）mm，而术后1月明显减少到（2．99±0．19）mm，两者相比较差异具有统计学意义（P〈0．05），而以后随访中前房深度没有明显差异。结论有晶状体眼后房型人工晶状体植入术对高度近视的治疗是一种有效的方法，具有矫正效果好、预测性好、可逆性和简单等优点，但要谨慎看待这种手术长期的安全性，更长时间的随访是必需的。
Objective To evaluate the efficacy and safety of the surgical correction of high myopia using a phakic posterior chamber intraocular lens （PCPIOL）.Methotls Thirty-four eyes of 18 patients with high myopia who accepted surgery treatment.Each eye was examined before and after surgery.The examination included visual acuity, refraction, tonometry, kerameter, pachometer, anterior chamber depth, horizontal corneal diameter （white to white）, and posterior segment evaluation after indirect ophthalmolscope examination.All surgeries were performed using topical anesthesia and clear corneal incision.The posterior chamber phakic intraocular lens manufactured with STAAR collamer was implanted between transparent lens and iris. Results All eyes of preoperative uncorrected visual acuity （UCVA） and best-corrected visual acuity （BCVA） were 0.08 ± 0.06, 0.5 ± 0.3 respectively and postoperative were 0.5 ± 0.2, 0.7 ± 0.2 respectively.The mean preoperative SE was -19.9± 5.4D and postoperative SE was -1.5-± 1.5D.The mean preoperative ECD was 3249.6± 337.1/mm^2 and postoperative ECD was 3103.4± 305.5/mm^2 and the percentage of loss was 4.5%.The mean preoperative IOP was 15.5± 2.7 mmHg and postoperative 10P at first day was 19.4± 7.3 mmHg.UBM showed that preoperative ACD was 3.20± 0.30 mrn and postoperative ACD reduced 2.99± 0.19 mm.Conelusions The phakic IOLs were an effective treatment for the correction of high myopia and have significant advantages such as reversibility, immediate correction, stability, and relative simplicity.However, long-term studies are necessary to assess the potential risks.
出处
《中国实用眼科杂志》
CSCD
北大核心
2010年第4期385-389,共5页
Chinese Journal of Practical Ophthalmology
