超声乳化术治疗高度近视合并白内障12例

Phacoemulsification for treatment of high myopia combined with cataract in 12 cases

目的观察高度近视合并白内障患者行超声乳化吸出联合折叠式人工晶状体植入术的临床手术效果。方法对12例(18眼)高度近视合并白内障的患者行透明角膜切口的超声乳化术,术前人工晶状体的计算公式根据眼轴的长度的不同选用不同的计算公式:眼轴长度<26.00mm者,人工晶状体计算公式采用SRK-Ⅱ,眼轴长度>26.00mm者,采用SRK-T公式(为保证手术后的裸眼视力效果,眼轴长度>26.00mm的患者实际植入人工晶状体度数采用SRK-T公式的计算结果,与SRK-Ⅱ公式仅作术前理论预测对照),同期植入疏水性丙烯酸酯折叠式人工晶状体。结果18眼术后最佳矫正视力>0.25者占94.4%,SRK-Ⅱ和SRK-T公式预测屈光度和术后实际屈光度的误差值分别为(1.48±0.67)D和(0.78±0.56)D,二者比较差异有统计学意义(P<0.05),术中无一例患者发生后囊膜破裂,术后第1天8眼患者眼压轻度升高,经降眼压后1～2d恢复正常,术后无一例患者发生角膜内皮失代偿,随访期内(6～12个月)未发现影响视力的后囊增生及视网膜脱离的发生。结论超声乳化联合折叠式人工晶状体植入术是治疗高度近视合并白内障安全而有效的方法,对于眼轴长度>26.00mm的高度近视患者的人工晶状体的计算公式选择SRK-T对保证手术效果是有益的。

Objective To investigate the clinical effects of phacoemulsification and foldable IOL implantation for patients with high myopia combined with cataract. Methods Twelve cases（ 18 eyes） with high myopia combined with cataract received clear corneal incision phacoemulsification. Before the treatment, the selection of IOL degree calculation formula depended on different axial length. When axial length was less than 26.00 ram, IOL degree calculation formula SRK-Ⅱ was adopted;When axial length was more than 26.00 mm, SRK-T should be selected. To ensure naked vision after the treatment, IOL degree was calculated with SRK-T calculation formula in patients, whose axial lengths were more than 26.00 ram, which was only for theoretically predictive con- trast with that with SRK-Ⅱ calculation formula. Hydrophobic acrylic foldable IOL were implanted at the same time. Results In a total of 18 eyes,postoperative best correc- ted visual acuity more than 0.25 accounted for 94.4%. The differences between predic- tive diopter and actual diopter with SRK-Ⅱ and SRK-T formula were （ 1.48 ± 0.67 ） D and （0.78 ± 0.56 ） D （ P 〈 0. 05 ）. No posterior capsular rupture occurred during the treatment. IOP of 8 eyes slightly increased at 1 day postoperatively, and returned to nor- real at t day to 2 days after lowering IOP. No decompensation of corneal endothelium was found after treatment. During the follow up time with 6 months to 12 months,no after-cataract or retinal detachment was found. Conclusions Phacoemulsification and foldable IOL implantation is an effective and safe method for the treatment of high myopia combined with cataract. It is an effective way to ensure a satisfactory treatment when the SRK-T calculation formula is adopted for those whose axial lengths are more than 26.00 mm.