高度近视囊袋内植入不同人工晶状体囊袋稳定性研究

Stability of different intraocular lens implanted in sac of high myopia

目的:观察高度近视并发性白内障患者行超声乳化吸除联合Bigbag,Sensar以及PMMA人工晶状体(intraocular lens,IOL)植入术后的早期临床效果。方法:患者159例202眼接受白内障超声乳化吸除联合IOL植入术,其中植入Bigbag,Sensar以及PMMAIOL分别为55眼、71眼和76眼。观察三组患者术后第1mo的最佳矫正视力(best-corrected visua lacuity,BCVA)、术后第1mo与术前中轴区晶状体后囊膜到视网膜间距离的差值、术后并发症等指标。结果:术后1mo时,BCVA≥0.6的眼数和百分比分别为Bigbag组9眼(16.4%)、Sensar组17眼(23.9%)和PMMA组11眼(14.5%),三组间两两比较差异无统计学意义(P>0.05);Bigbag组术后第1mo与术前中轴区晶状体后囊膜到视网膜间距离的差值为(1.52±0.11)mm,显著小于Sensar组和PMMA组,组间比较差异均有统计学意义(P<0.05);三组术后眼压比较差异无统计学意义(P>0.05)。三组术后均未见严重并发症。结论:Bigbag人工晶状体较其它人工晶状体对于提高术后视力没有明显优越性,但由于其设计上的特殊性,对术后后囊膜能起到稳定的支撑作用,可以减弱玻璃体前涌,减轻超声乳化联合IOL植入对眼后段的影响。

AIM：To observe the early clinical efficacy of phacoemulsification combined with Bigbag,Sensar and PMMA intraocular lens（IOL） implantation in patients of high myopia complicated with cataract.METHODS：Totally 159 cases（202 eyes） patients received phacoemulsification combined with IOL implantation,in which implanted Bigbag,Sensar and PMMA IOL were 55,71 and 76 eyes respectively.The best-corrected visual acuity（BCVA） 1 month after surgery,the difference of distance between posterior capsule with retina 1 month after surgery and preoperative,the postoperative complications of three groups were observed.RESULTS：In 1 month postoperation,the number and percentage of eyes with BCVA≥0.6 were 9 eyes（16.4%） in Bigbag group,17 eyes（23.9%） in Sensar group and 11 eyes（14.5%） in PMMA group,the difference between any two groups was not statistically significant（P0.05）;the difference of distance between posterior capsule with retina 1 month after surgery and preoperative in Bigbag group was（1.52±0.11） mm,which was significantly smaller than Sensar group and PMMA group,the difference was statistically significant（P0.05）;the postoperative intraocular pressure（IOP） had no statistically difference among the three groups（P0.05）.No serious postoperative complications occurred in three groups.CONCLUSION：Bigbag IOL has no obvious superiority to increase visual acuity than other IOL,but because of its special design,it can play a stabilizing role of supporting the postoperative posterior capsule and weaken the vitreous rush forth so as to reduce the influence of phacoemulsification combined with IOL implantation for posterior segment of eyeball.