有晶状体眼前房型人工晶状体植入治疗高度近视

Implantation of Phakic Anterior Chamber Lens for High Myopia

目的观察有晶状体眼前房型人工晶状体植入矫正高度近视的临床效果。方法 12例(17眼)-6.25～-18.75D 之间的高度近视患者表面麻醉下在前房内植入 phakic6H120型人工晶状体,随访半年以上,进行临床总结。结果术后半年,12例(17眼)术后裸眼视力(平均4.75±0.15)与术前矫正视力(平均4.72±0.21)的差异无统计学意义(P>0.05)。术后平均矫正视力为4.83±0.14,高于术前的4.72±0.21,差异有统计学意义(P<0.05)。手术后平均散光度数为-0.82±0.64,低于术前的-1.49±0.81,差异有统计学意义(P<0.05),平均眼内压无明显变化。术前平均角膜内皮细胞计数为(3078.35±363.71)个/mm^2,高于术后的(2745.88±373.95)个/mm^2,差异有统计学意义(P<0.05)。1例单眼术后眼压高、前房反应较重,术后1年查角膜内皮计数较术前损失50%;1例(双眼)瞳孔略呈椭圆形;1例(双眼)人工晶状体轻微旋转,人工晶状体上襻缘端滑入虹膜根切孔,所有患者未发生晶状体混浊及眼底并发症。结论有晶状体眼前房型人工晶状体植入治疗高度近视有一定优势,不适宜做准分子激光的高度近视者可谨慎选择该手术,但其远期疗效尚不明确,仍需大样本病例进一步观察。(中国眼耳鼻喉科杂志,2007,7:366-368)

Purpose To evaluate the clinical effect of the implantation of phakic anterior chamber lens（PACLs） for high myopia. Methods Seventeen eyes of 12 patients with - 6. 25 to - 18.75 diopter （ D ） accepted PACLs （phakie6H120） implantation under topical anaesthesia. They were followed up for more than 6 months. Results In 6 months after the operation ,there was no significant difference between the uncorrected visual acuity after operation（4.75± 0. 15 ） and the best corrected visual acuity before operation （4.72 ± 0.21 ） for all 12 patients （ 17 eyes ） （ P 〉 0.05 ）. After the operation,the best corrected visual acuity significantly improved from 4.83 ±0. 14 to 4.72 ±0. 21 （P 〈0.05） and the average astigmatism significantly decreased from - 1.49 s 0. 81 to - 0. 82 s 0.64 （ P 〈 0.05 ）. The average intraoeular pressure（IOP） had no significant difference between pre - and postoperative,while the corneal endothelial cell number significantly decreased from （3 078.35 ± 363.71 ）/mm^2 to （2 745.88 ± 373.95 ）/mm^2 （ P 〈 0. 05 ）. High IOP and iridoeyclitis appeared in one eye whose corneal endothelial cells lost about 50% one year after operation. Elliptical pupils were observed in one case （binocular）. In one patient （binocular） ,the upper loops of the PACLs were rotated and moved into the hole of peripheral iridectomy. There were no turbid lens or fundus changes in all cases. Conclusions The implantation of PACLs is an effective way to treat high myopia for whom laser in situ keratmoleusis （LASIK） are not indicated, and more investigation is needed for its long-term effect.