高度近视白内障超声乳化摘除的探讨

Investigation of phacoemulsification for high myopia

目的:探讨高度近视白内障超声乳化摘除及后房型人工晶状体植入术的方法及疗效。方法:对125例142眼有高度近视的老年性、并发性及先天性白内障施行巩膜隧道切口超声乳化吸除,通过3.2mm切口植入折叠式人工晶状体,通过5.5mm切口植入PMMA硬性人工晶状体。年龄61(平均22～78)岁,眼轴长26.00～34.10(平均28.5±1.20)mm,角膜曲率42.00～46.54(平均43.38±1.36)D,人工晶状体屈光度+1.00～+15.00(平均+9.58±3.65)D。结果:术后裸眼或矫正视力≥0.5者为86.4%;视力≥1.0者为57.1%,未见明显严重并发症。结论:高度近视白内障超声乳化及后房型人工晶状体植入术,具有术后视力恢复快、手术并发症较ECCE少,但眼轴极长者(>30mm),视力恢复较差。

AIM. To investigate the therapeutic effect and method of phacoemulsification and posterior chamber intraocular lens （IOL） implantation in high myopia. METHODS： Phacoemulsification with implantation of a foldable IOL or a PMMA rigid IOL was performed on 142 eyes of 125 patients with senile,complicated or congenital cataracts through a 3. 2ram scleral tunnel incision or through a 5.5mm incision respectively. The average age of the patients was 61 years （22 -78 years）. The mean axial length was 29.40 ± 1.23 （26.00 - 34.10 ） mm. The mean keratometry was 43.38 ± 1.36 （42.00 - 46.54 ） D. The mean diopter of IOL was （ ＋9.58 ±3.65） D （ ＋ 1.00 - ＋15.00）D. RESULTS ： Postoperatively, the uncorrected or corrected visual acuity ≥0.5 or better was in 86.4%. The patients achieved the best visual acuity of 1.0 or better accounted for 57. 1% respectively, no severe complications were recorded. CONCLUSION： Phacoemulsification and the posterior chamber IOL implantation offer the advantages of rapid and better rehabilitation of visual acuity and more stabilization of postoperative astigmatism in patients with high myopia, For eyes with the axial lengths over 30mm, the recovery of the visual acuity was less satisfactory.