超声乳化透明晶状体联合人工晶状体植入治疗高度近视

Phacoemulsification of clear lens and intraocular lens implantation in high myopia

目的:探讨超声乳化透明晶状体联合人工晶状体植入治疗高度近视的有效性和安全性。方法:对我院自2004/2006年25例43眼的高度近视患者施行透明晶状体超声乳化联合人工晶状体植入术。平均年龄48.6岁,术前患者裸眼视力0.01～0.25,屈光度数平均-13.75±0.26D,平均散光度数1.07±0.86D,矫正视力0.1～0.6,平均眼轴长度28.13±2.32mm。结果:所有患者裸眼视力均比术前提高,其中术后1d4眼(9%)0.1～0.12者9眼(21%)0.15～0.4者30眼(70%)≥0.5;术后3mo18例主导眼裸眼视力均≥0.5,40眼(93%)矫正视力≥0.5,其中3眼(7%)因后巩膜葡萄肿及黄斑病变矫正视力较差0.12～0.3;所有患者术中术后无严重并发症,术后屈光状态稳定,未见回退的现象。结论:超声乳化透明晶状体联合人工晶状体植入术可治疗其他屈光手术难以解决的高度近视,是这一部分患者获得正视的安全、有效、准确和稳定的可靠途径。

AIM： To evaluate the efficacy and safety of phacoemulsification of clear lens in combination with intraocular lens （IOL） implantation for the correction of high myopia. METHODS： Phacoemulsification of clear lens in combination with IOL implantation was performed in a total of 25 patients （43 eyes） with high myopia with an average age of 48.6 in the period from 2004 to 2006. The mean of preoperative uncorrected visual acuity was 0.01-0.25, refraction 13.75±4.26D, astigmatism 1.07±0.86D, corrected visual acuity 0.1-0.6 and axial length 28.13±2.32mm. RESULTS： The naked Visual acuity was improved after surgery. At 1 day postoperatively, uncorrected visual acuity greater than 0.5 was found in 30 eyes （93%）, 0.1-0.12 in 4 eyes （9%） and 0.15-0.4 in 9 eyes （21%）. During the 3 months＇ follow-up, uncorrected visual acuity was greater than 0.5 in 18 cases of dominant eyes and the corrected visual acuity was greater than 0.5 in 40 eyes （93%）. The corrected visual acuity was not satisfactorily developed （0.12-0.3） in 3 eyes （7%） because of posterior staphyloma and maculopathy. No postoperative complications were observed. Refraction was stable with no retrogradation. CONCLUSION： Phacoemulsification of clear lens in combination with IOL implantation has satisfactory results which cannot be achieved by other refractive surgeries. It is safe, effective and stable for the correction of high myopia.