角膜屈光矫正手术后白内障手术

Cataract surgery after corneal laser refrac-tive surgery

目的:探讨角膜屈光矫正手术后白内障手术的诊疗特点。方法:对2005/2008年间于我院就诊的4例角膜屈光矫正手术后白内障患者行白内障超声乳化吸出术+人工晶状体植入术。依据患者提供的角膜屈光手术资料,分别采用临床病史法或角膜后表面曲率法计算矫正角膜曲率及人工晶状体度数。术后随访观察角膜情况、手术并发症、裸眼视力、最佳矫正视力、术后屈光状态等。结果:术后最佳矫正视力较术前明显提高。术后稳定屈光度与手术前预留屈光状态比较误差范围为-1.00～+1.25D。结论:对角膜屈光手术后的白内障患者施行白内障超声乳化吸出术+人工晶状体植入术是可行的。然而只有了解这类患者病情特点,掌握手术前后诊疗方法,准确计算人工晶状体度数,才能达到满意的疗效。

AIM： To discuss the characteristic of cataract surgery with intraocular lens（IOL） implantation after corneal laser refractive surgery. METHODS： This retrospective study included 4 eyes of 4 cases who had previously undergone myopic corneal laser refractive surgery and subsequently phacoemulsifi-cation with implantation of IOL. Based on the data cases provided, clinical history method（CHM） or adjusted keratometry method were used to calculate the kerato-metry and IOL power. Corneal conditions, surgical com-plications, uncorrected visual acuity, best corrected visual acuity, postoperative refractive status, etc were observed during the follow-up. RESULTS： The best corrected visual acuity postopera-tively increased obviously. The error between postopera-tive refraction and predicted refraction preoperatively ranged from -1.00D to ＋1.25D. CONCLUSION： Cataract surgery with IOL implantation after corneal laser refractive surgery is feasible. The characteristics and calculation methods of IOL must be mastered.