ICL植入术治疗高度近视的临床效果观察

Clinical observation after implantation of implantable contact lens in high myopia

目的探讨胶原性可植入性接触镜(ICL)植入术矫正高度近视的临床效果。方法收集接受ICL植入术的高度近视患者142例,共269眼,根据术前等效球镜度(MRSE)将患者分为A(-6.00^-12.00D)、B(≥-12.00D)两组,平均MRSE为(-11.48±3.70)D。手术前后检查屈光度、裸眼视力(UCVA)、最佳矫正视力(BCVA)、眼压、角膜内皮密度并进行对比分析。所有患者随访12~36个月。结果术后UCVA显著提高,术前BCVA≥0.5和≥1.0的比例分别为87.36%和25.28%;术后UCVA≥0.5和≥1.0的分别为95.91%和68.77%。B组的有效性指数、安全性指数均高于A组,差异有统计学意义(P<0.05);术后MRSE与预期屈光度的差值在±0.50D内的为83.08%,在±1.00D内的为96.41%。手术前后的平均角膜内皮密度、眼压差异均无统计学意义。术后1眼ICL取出,无其他严重并发症发生。最后1次随访,93.05%的患者对手术效果满意,B组满意度高于A组。结论 ICL植入术治疗高度近视临床效果确切,特别适于无法选择角膜屈光手术者,其远期并发症有待进一步观察。

Objective To observe and analyze the collamer implantable contact lens（ICL）in the clinical effect of correction of high myopia.Methods There were 142 cases of patients with high myopia 269 eyes who had acceptted the ICL implantation.According to degree of preoperative spherical equivalent,all patients were divided into two groups,group A-6.00 ^-12.00D,group B≥-12.00D,the average refraction was（-11.48 ± 3.70）D.Before and after refractive surgery,diopter uncorrected visual acuity（UCVA）,best corrected visual acuity（BCVA）,intraocular pressure,corneal endothelial density were compared and analyzed.All cases were followed up for 12 to 36 months.Results UCVA was significantly improved postoperatively.Preoperative UCVA ≥ 0.5 ratio was 87.36%,≥ 1.0 ratio was 25.28%.Postoperative UCVA≥ 0.5 ratio was 95.91%,≥ 1.0 ratio was 68.77%.The mean efficacy index and the mean safety index in the group B were both higher than that in the group A,and the difference was statistically significant.83.08% of the postoperative refraction was within ±0.50D,96.41% of the postoperative refraction was within ±1.00D.Before and after surgery,the mean corneal endothelial density and intraocular pressure have no statistically significant difference.Postoperative complications were as follows：an ICL removal,in addition to the above complications,no other serious complications had happened.93.05% of patients were satisfied with the surgery in the last follow-up.Group B were more satisfied with the surgery than group A.Conclusion ICL implantation have an exact effect for high myopia.ICL implantation is especially suitable for those who can not choose corneal refractive surgery,but its long-term complications needs further observation.