虹膜夹持型前房人工晶状体植入矫正超高度近视

Iris-claw phakic anterior chamber intraocular lens implantation for ultra-high myopia correction

目的探讨虹膜夹持型前房人工晶状体植入矫正超高度近视的临床效果。方法对10例(19眼)超高度近视(-15.50D^-30.00D)进行虹膜夹持型前房人工晶状体(AMO)植入术,观察手术前后屈光状态、裸眼视力、眼压、瞳孔形态、角膜内皮细胞计数及人工晶状体位置。结果19眼超高度近视通过植入虹膜夹持型前房晶状体,全部达到术前最佳矫正视力,其中18眼超过术前最佳矫正视力1~3行。术前裸眼视力0.02~0.1,术后裸眼视力0.3~1.0。1眼因虹膜弹性差,术后发生瞳孔轻度变形人工晶状体前倾,手术后复位,其余患者均无特殊。结论作为屈光性手术的虹膜夹持型前房人工晶状体植入术,用于矫正超高度近视,可获得满意的临床效果。由于其具有术后视力恢复迅速、屈光度稳定、并发症较少并且具有良好的可预测性的特点,所以是目前不宜行准分子角膜屈光手术的超高度近视的一种有效的手术矫正方法。

Objective To evaluate the clinical efficacy and safety of the Iris-claw phakic anterior chamber intraocular lens implantation for ultra-high myopia. Methods To implant the Verisyse iris pinch-type phakic anterior chamber intraocular lens into 19 eyes of 10 patients with ultra-high myopia （with-15. 50 -30.00 diopters）, then to analyze pre and post operation eye refractive status, uncorrected visual acuity, corrected visual acuity, intraocular pressure, pupil speciation, corneal endothelial cell counts and intraocular lens location. Results 19 eyes got the best corrected vision when they were implanted. And most of the patients＇s best corrected acuity surpass the pre operation about 1-3 rows. （ Pre operation the uncorrected visual acuity is 0.02-0.1 ;post operation the uncorrected visual acuity is 0.3-1.0） But the poor of the iris elasticity lead to 1 eye pupil＇s deformation and in- traocular lens＇s anteversion,, then reducted after an other operation. Conclusions As refractive surgery, the iris pinch-type phakic anterior chamber intraocular lens implantation were used to cure ultra-high myopia, and showed its satisfactory clinical effects and some advantages： operative visual acuity recovered rapidly; stable diopter; few complications and good predictability, became the effective correct way to cure ultra-high myopia patients who is not suitable to receive a excimer laser corneal refractive surgery.