Phakic 6H_2前房型人工晶状体植入治疗高度近视的视觉质量

Clinical Observation of Vision Quality after Implantation of Phakic 6H_2

目的通过对植入Phakic 6H2前房型人工晶状体矫正高度近视的患者术前及术后视力、对比敏感度、波前像差变化的观察,评估Phakic 6H2前房型人工晶状体植入术后患者的视觉质量。方法选择高度近视患者39例(65眼),于术前2周以YAG激光行术眼虹膜周边根切术,预防术后瞳孔阻滞性青光眼的发生。分别于Phakic 6H2前房型人工晶状体植入术后1周、1月、3月及6月对患者进行随访,检查患者屈光状态、眼压、角膜内皮细胞及Phakic 6H2在前房内的位置,并测量对比敏感度及眩光敏感度;于术后1月、3月及6月对患者的波前像差进行测量。结果①术前所有患者的裸眼视力均<0.1,而术后6月时,所有患者裸眼视力均≥0.5,裸眼视力≥术前最佳矫正视力者占76.9%(50/65),最佳矫正视力≥0.8者占84.6%(55/65);②高阶像差均方根由术前的(0.44±0.06)μm升至(0.54±0.11)μm(P<0.05),其中3～6阶像差与术前相比差异具有统计学意义(P<0.01);③无眩光及眩光条件下各空间的对比敏感度于术后1周时均有不同程度下降,但没有统计学意义(P>0.05);术后1月时,明视眩光条件下,1.5cpd及3.0cpd两个空间频率下的对比敏感度较术前差异无统计学意义(均P>0.05);无眩光条件下明视时的1.5cpd空间频率下的对比敏感度较术前差异无统计学意义(P>0.05),余空间频率下的对比敏感度较术前差异均有统计学意义;术后6月时,所有条件下的对比敏感度及眩光敏感度较术前均有显著提高(均P<0.05)。结论 Phakic 6H2植入术后有效地提高了高度近视患者的远视力,视觉质量也得到了明显提高。

Objective To evaluate the vision quality of the eye before and after the insertion of Phakic 6H2 lens for the correction of high myopia with the examination of wavefront aberration,contrast sensitivity and glare sensitivity. Methods Sixty-five eyes of high myopia were chosen.The peripheral iridotomies were performed by YAG laser two weeks before the operation.After the operation,we visited the patients at 1st week,1st,3rd and 6th month,and checked the refractive condition,ocular tension,corneal endothelia count,contrast sensitivity and glare sensitivity;and checked the wavefront aberration at 1st,3rd and 6th month after operation. Results ①A postoperative uncorrected visual acuity（UCVA）of 0.5 or better was observed in all eyes at 6th month,and 76.9%（50/65）of UCVA ≥the preoperative best corrected visual acuity（BCVA）;a BCVA of 0.8 or better was observed in 84.6%（55/65）eyes;②The higher order aberration changed from（0.44±0.06）μm to（0.54±0.11）μm（P0.05）,among the total,3rd order to 6th order HOAs increased after implantation of Phakic 6H2 as compared with those before operation（P0.01）;③The contrast sensitivity and the glare sensitivity were decreased at 1st week after operation,but there was no statistically significant difference（P0.05）;at 1st month postoperation,under the condition of 85 cd/m2 without glare,the increase of the CS showed no statistically significant difference at the spatial frequency of 1.5 cpd and 3.0 cpd（P0.05）;under the condition of 3 cd/m2 and 85 cd/m2 with glare,the increase of the CS showed no statistically significant difference at the spatial frequency of 1.5 cpd（P0.05）.And the CS under the remnant spatial frequency all had statistically significant difference.At 6th month postoperation,all the CS and glare contrast sensitivity were increased statistically（all P0.05）. Conclusion The implantation of the Phakic 6H2 can effectively improve super visual acuity and the visual quality in patients with high myopia.