高度近视可植入接触镜植入术的效果观察

Posterior chamber phakic intraocular lens implantation for high myopia

目的观察高度近视可植入接触镜(ICL)的安全性和有效性。方法对77例(140眼)高度近视施行Staar Col-lamer单片式ICL植入。并在术前2周行激光周边虹膜切除术(少数病例在术中施行周边虹膜切除术)。平均年龄28岁(20~37岁),角膜厚度0.463~0.582 mm,平均0.511 mm,屈光度-20.50D^-8.50D,平均-15.50D。随诊观察0.5~2.5年,查视力,测眼压,验光。结果术后裸眼远视力全部较术前提高,70眼(50.00%)裸眼视力好于术前最佳矫正视力,60眼(42.86%)裸眼视力等于术前最佳矫正视力,10眼(7.14%)因高度散光(-3.00D)较术前矫正视力低。1眼(0.714%)术后出现前房纤维素样渗出,12眼(8.57%)出现一过性高眼压,用药后均正常,随诊观察0.5~2.5年,视力无回退,眼压,晶状体及角膜内皮情况较术前均无变化。结论 ICL治疗-8.00D^-20.00D高度近视效果好,损伤小,恢复快,具有良好的安全性、有效性和可预测性。

Objective To avaluate the safety and efficacy of posterior chamber phakic intraocular lens（PIOLs） implantation for the correction of high myopia. Methods 140 eyes of 77 patients with high myopia（between -20.5D--8.5D） had a posterior chamber PIOL（staar ICL） implanted and peripheral iridectomy.The average age was 28 years （range,20 to 37 years）.During 6-30 months＇ follow-up,visual acuity,refraction,intraocular pressure（IOP）,corneal refraction were teated. Results Successful implantation was achieved,postoperative visual acuity without correction greater than preoperative in all patients,postoperative visual acuity without correction of 70 eyes（50.00%） greater than preoperative correction visual acuity.postoperative visual acuity without correction of 60 eyes（42.86 %） is equal preoperative correction visual acuity and visual acuity without correction of 10 eyes（7.14 %） decreased from 0.7 to 0.4 because of high astigmatism.Fibrose exudation in anterior chamber aqueouse was found at 1 eye and intraocular pressure（IOP） increase was found at 12 eye and IOP returned to normal range following the antiglaucoma medicine therapy.During 6-30 months＇ follow-up,refraction was stable and no cornea edema and lens opacity and glaucoma was found. Conclusion Posterior chamber PIOL（Staar ICL） implantation is an effective and safety and predictable refractive technique for the correction of high myopia（between-20.00D--8.00D）.Its surgical complications about glaucoma and cataract and cornea endothelium decrease should be long-term studied.