超声乳化摘除透明晶状体治疗高度近视的疗效观察

The phacoemulsification extraction of transparent lens with implantation of artificial lens to correct high myopia

目的探讨超声乳化透明晶状体吸除联合人工晶体植入术治疗高度近视的有效性和安全性。方法对59例103只眼高度近视患者行巩膜隧道切口超声乳化透明晶状体吸除联合人工晶体植入术。术中将切口选在陡子午线上可以矫正术前存在的部分散光.平均年龄35.37±4.32岁,术前矫正视力0.15～1.0,平均近视度数-13.10±3.15D,平均散光度数-1.36±0.83D,平均眼轴长度27.82±2.13mm,平均植入人工晶状体屈光度数＋7.22±3.71D。结果术后88只眼裸眼视力≥0.5,其中19只眼视力≥0.8;14只眼视力〈0.5,但较术前最佳矫正视力有所提高;1只眼术后视力无提高,查眼底见黄斑变性。术后平均近视度数-2.13±0.31D;平均散光度数-1.21±0.26D。术后发生晶状体后囊膜混浊3只眼,视网膜脱离1只眼,黄斑囊样水肿1只眼。结论超声乳化透明晶状体吸除联合人工晶状体植入术是矫治高度近视安全、有效的方法,具有术后视力好、并发症少,预测屈光状态准确性高及稳定性好,可通过切口的选择减少散光等优点。可用于高度近视眼的屈光手术治疗,特别是对于准分子激光无法治疗的超高度近视尤为适用。

Objective To investigate the efficacy and safety of the phacoemulsification （Phaco） extraction of transparent lens with implantation of artificial lens to correct high myopia. Methods Phacoemulsification extraction of transparent lens with imphqntation of artificial lens through scleral tunnel incision was performed on 103 eyes of 59 high myopic patients. In order to correct partial astigmatism we select the incision on the sharp meridian. The average age of patients was 35.37 ± 4.32 years old. The preoperative corrected visual acuity was 0.15-1.0. The mean preoperative spherical equivalent and astigmatism was （-13.10 ± 3.15）D and （-1.36 ± 0.83） D respectively. The mean length of eye＇s axis was 27.82 ± 2.13mm. The mean diopter of IOL was （＋7.22 ± 3.71） D. Results After surgery, the visual acuity of 88 eyes achieve 〈0.5 （ 19 eyes achieve ≥0.8 ）. Although the visual acuity of 14 eyes was ￡±0.5, but it was better than the best corrected visual acuity （BCVA）. 1 eye＇s visual acuity don＇t improved, it was degeneration of macula by chest. The mean postoperative spherical equivalent and astigmatism was （-2.13 ± 0.31）D and （-1.21 ± 0.26）D. 3 eyes appeared after cataract, 1 eye was retinal detachment and leye was cystoid macular edema. Conclusions the phacoemulsification extraction of transparent lens with implantation of artificial lens to correct high myopia is a safe, effective procedure serving as a refractive surgery. It is worth to spread due to good outcome of visual acuity, low incidence of complication, high predictability and stability, decrease astigmatism by selecting incision. It is better method to cure high myopia, specially apply to those who can not adopt LASIK.