高度近视有晶状体眼人工晶状体植入对调节功能影响

The effect on accommodation of phakic intraocular lens implantation for high myopia

目的 分析有晶状体眼人工晶状体植入术对高度近视患者调节功能的影响.方法 收集2008年8月至2009年3月在行有晶状体眼人工晶状体植入的高度近视患者16例（32只眼）,年龄（27.56±4.50）岁（19～35）岁,其中10例接受后房型有晶状体眼人工晶状体植入手术（Visian ICL）,6例行虹膜夹型有晶体眼人工晶状体植入手术（Verisyse）.分别于术前和术后1周及术后3个月测量屈光状态、最佳矫正远视力、调节近点、正负相对调节（PRA/NRA）、调节灵活度.数据采用SPSS15.0统计软件包行单因素方差分析.结果 术前、术后1周及术后3个月的最佳矫正远视力分别为4.84±0.12、4.91±0.11、4.92±0.11：调节近点分别为（10.02±1.92）cm、（14.38±3.59）cm、（13.19±2.91）cm.术后1周和3个月时较术前明显远移（F=19.45,P〈0.05）;PRA/NRA、单眼调节灵活度术前分别为（-2.29±0.48）D、（2.06±0.29）D、（9.50±2.00）cpm,术后1周分别为（-2.05±0.33）D、（2.09±0.27）D、（9.34±1.70）cpm,术后3个月分别为（-2.19±0.35）D、（2.14±0.27）D、（9.63±1.76）cpm,正负相对调节和调节灵活度手术前后差异均无统计学意义（P〉0.05）.结论 高度近视有晶状体眼人工晶状体植入术后调节近点明显远移,正负相对调节和单眼调节灵活度手术前后无明显变化.

Objective To study the effect on accommodation of phakic intraocular lens implantation for high myopia. Methods In this prospective study, 32 eyes of 16 patients with high myopia received phakic intraocular lenses implantation in our hospital from August 2008 to March 2009 were collected. Age 19 to 35 years （mean age 27.56±4.50 years）. Among them 10 patients received posterior chamber intraocular lens implantation surgery （PRL）, 6 patients received the Verisyse iris-fixated phakic IOL surgery. The refractive diopter, best corrected visual acuity （BCVA）, near point accommodation, positive/negative relation accommodation （PRA/NRA）, monocular accommodation facility were measured preoperation, 1 week and 3 months postoperation, respectively. The data were analyzed with one-way ANOVA by SPSS15.0. Results The best corrected visual acuity （BCVA）of preoperation, 1 week 3 months and postoperation was 4.84±0.12, 4.91±0.11,4.92±0.11, respectively. The near point accommodationwas （ 10.02±1.92） cm, （14.38±3.59） cm,（13.19±2.91） cm, respectively. The near point accommodation of 1 week and 3 months postoperation was significant far migration compared with preoperation （F=19.45, P 〈0.05 ）. The positive/negative relation accommodation （PRA/NRA）, monocular accommodation facility ofpreoperation was （-2.29±0.48）D, （2.06±0.29）D, （9.50±2.00）cpm; and 1 week postoperation was （-2.05±0.33）D, （2.09±0.27）D, （9.34±1.70） cpm; and 3 months postoperation was （-2.19±0.35）D, （2.14±0.27）D, （9.63±1.76）cpm, respectively.There was no siguifieant difference of positive/negative relative accommodation and monocular accommodation facility between preoperation and postoperation （P 〉0.05 ）. Conclusions The near point accommodation of postoperation has significant far migration. There is no significant difference of positive/negative relation accommodation, and monocular accommodation facility between preoperation and postoperation.