高度近视超声乳化人工晶状体植入术临床观察

Phacoemulsification and intraocular lens implantation for correction of high myopia

目的:探讨超声乳化人工晶状体植入术治疗高度近视的临床疗效。方法:对89例(169眼)高度近视患者行超声乳化人工晶状体植入,年龄26~75(平均49.4±10.4)岁,术前裸眼视力<0.1,0.1~0.3的分别为159眼(94.1%),10眼(5.9%),矫正视力<0.1,0.1~0.3,0.3~0.5,0.5~1.0的分别为24眼(14.2%),59眼(34.9%),50眼(29.6%),36眼(21.3%),等效球镜度数-7.63^-31.00D,平均为(-16.48±7·87)D。术前预防性视网膜光凝术26眼。术后随访0.5~2a。结果:术后裸眼视力<0.1,0.1~0.3,0.3~0.5,0.5~1.0分别为11眼(6.5%),62眼(36.7%),48眼(28.4%),48眼(28.4%),矫正视力<0.1,0.1~0.3,0.3~0.5,0.5~1.0分别为4眼(2.4%),31眼(18.3%),28眼(16.6%),106眼(62.7%)。等效球镜度数+0.50^-5.00D,平均为(-2.89±1.23)D。术中后囊膜破裂4眼,一过性角膜水肿13眼,随访期间视网膜脱离2眼,对术后屈光状态不满意4例7眼。结论:高度近视超声乳化人工晶状体植入治疗安全、有效,但要注意避免视网膜脱离等并发症的发生和术后屈光状态的选择。

AIM： To evaluate the clinical effects of phacoemulsification and intraocular lens （IOL） implantation for correction of high myopia. METHODS： Phacoemulsification and intraocular lens implantation was performed on 89 patients （169 eyes） with high myopia. The age of patients ranged from 26 to 75 years with a mean of 49.43 ± 10.40 years. 159 eyes （94.1%） with an uncorrected visual acuity of 〈 0.1, and 10 eyes（5.9% ） with an uncorrected visual acuity of 0.1.0.3. The best corrected visual acuity of 〈 0.1,0.1-0. 3,0. 3.0. 5, 0.5-1.0 were in 24 eyes（14.2%）, 59 eyes（34.9%）, 50 eyes （29. 6%）, 36 eyes （ 21. 3%） respectively. The spherical equivalent （SE） degrees ranged from -7. 63 to -31. 00D with a mean of （-16.48 ± 7. 87） D. 26 eyes underwent preventive photocoagulation before the surgery. The patients had been followed up for 0.5 years to 2 years. RESULTS： After the surgery, the uncorrected visual acuity of 〈 0.1,0.1.0. 3,0. 3.0. 5,0. 5-1. 0 were in 11 eyes （6.5%）,62 eyes（36. 7%）,48 eyes（28. 4%）,48 eyes （28.4%）, while the best corrected visual acuity of 〈 0.1, 0.1.0.3,0. 3.0. 5,0. 5-1. 0 were in 4 eyes （ 2.4% ）, 31 eyes （18. 3%）, 28 eyes（16. 6%）, 106 eyes（62. 7%）. The spherical equivalent （SE） degrees after the surgery ranged from ＋0.50 to -5.00D with a mean of （-2.89± 1.23） D. During the surgery, there were 4 eyes with posterior capsule rupture. Thirteen eyes were found to have transient corneal edema after the surgery. During the follow-up period, two eyes were found to have retinal detachment and 4 patients were （7 eyes, 4.1%） dissatisfied with the postoperative refractive state. CONCLUSION： Phacoemulsification and intraocular lens implantation is a safe and effective surgery in high myopia. But attentions should be paid to complications like retinal detachment, and the choice of the reserved diopters.