虹膜固定型有晶体眼人工晶体种植矫正高度近视临床疗效观察

Clinical Effective Research of the Implantation of Phakic Iris-fixated Intraocular Lens for High Myopia

目的回顾性分析我院虹膜固定型有晶体眼人工晶体种植矫正高度近视的临床效果,以评价虹膜固定型有晶体眼人工晶体种植矫正超高度近视的有效性及安全性。方法12例(18眼)术前平均等效球面屈光度数为-15.12±5.23D的高度近视患者,术后随访3～6个月(平均5.1个月),观察术前及术后6个月时视力、眼压、对比敏感度、眩光敏感度、角膜内皮计数及人工晶体的稳定性和晶体的混浊程度,调查患者的满意度。结果18眼术后6个月时裸眼视力0.73±0.21,与术前矫正视力0.52±0.17比较差别有显著性意义(P<0.05);术后散光明显减轻,与术前比较差别有显著性意义(P<0.05);术后6个月时裸眼对比敏感度及眩光敏感度值较术前在全频明显提高,两者比较差别有显著性意义(P<005);术后6个月与术前角膜内皮细胞数及眼压比较无显著性意义(P<0.05);随访6个月未出现严重并发症;患者满意度较高。结论短期观察虹膜固定型有晶体眼前房人工晶体种植矫正高度近视有较好的预测性及稳定性,可获得满意的术后视力及对比敏感度,术后并发症较少且安全性高,是一种颇具前途的高度近视治疗方法。

Objective To evaluate the effeciency and safety of the implantation of phakic iris - fixated intraocular lens for high myopia. Methods 12 cases（ 18 eyes） with the mean spherieal equivalent refraction was （ - 15.12 ± 5.23） diopters of myopia, following up 3 - 6 months after surgery（ averaging 5.1 months） were enrolled. Visual acuity,intraocular pressure, contrast sensitivity, glare sensitivity, corneal endothelium and the stable of intraocular lens and the turbid level of lens were observed. Results A postoperation uncorrected visual acuity of （0.73 ± 0.21 ） was observed in 18 eyes at 6 months. There was significant difference as compared with preoperation corrected visual acuity of （0.52 ± 0.17 ） （ P 〈 0.05 ）. Astigmatism relieved obviously. There was significant difference as compared with preoperation （P 〈 0.05 ）. Naked eye＇ s contrast sensitivity and glare sensitivity improved obviously at muhichannel at 6months after operation. There was significant difference （P 〈 0.05 ）. There was no significant difference between preoperation and postoperation in mean corneal endothelium and intraocular pressure（P 〈 0.05）. No severe complications were observed following up 6 months. The patients were santisfid with the results. Conclusion Preliminary observation shows that the implantation of phakic iris - fixated intraocular lens for high myopia is predictable and stable. Postoperation visual acuity and contrast sensitivity were satisfying. There was high safety and few complications. This operation to correct high myopia is promising.