有晶状体眼后房型人工晶状体植入术治疗高度近视临床观察

Clinical Observation of Posterior Chamber Phakic Intraocular Lens Implantation for High Myopia

目的:评价有晶状体眼后房型人工晶状体(ICL)植入术治疗高度近视的有效性和安全性。方法:对7例(14只眼)高度近视患者行有晶状体眼ICL植入术。术后随访3-9个月,观察手术前后裸眼视力、最佳矫正视力、屈光度、眼压、内皮细胞计数等。结果:所有患者成功植入ICL,14只眼手术前后平均屈光度分别为(-14.52±-6.43)D,(-0.01±0.28)D;裸眼视力分别为0.08±0.06,0.6±0.3;最佳矫正视力分别为0.5±0.2,0.7±0.2;术后裸眼视力和最佳矫正视力均明显好于术前(P<0.05)。术前平均眼压为(16.21±2.84)mmHg,术后平均眼压为(17.03±1.95)mmHg;内皮细胞计数术前为(3 028±289)个/mm2,术后为(2 912±251)个/mm2;前房深度术前平均为(3.69±0.31)mm,术后为(3.57±0.29)mm,差异均无统计学意义(P>0.05)。结论:ICL矫正高度近视近期临床效果有效、可靠,临床观察未发现手术并发症,远期效果需进一步观察。

Objective： To evaluate the efficacy and safety of the surgical correction of high myopia using an implantation of posterior chamber intraocular lens.Methods： Posterior chamber phakic intraocular lens（ICL） implantation was performed in 14 eyes of 7 patients with high myopia.After follow-up for 3 to 9 months,the clinical ocular examinations were performed including uncorrected visual acuity（UCVA）,best corrected visual acuity（BCVA） retraction,intraocular pressure（IOP）,slit-lamp findings,cornea topography and cornea endothelial cell density before and after surgery.Results： Posterior chamber phakic intraocular lens were implanted successfully in all the operative eyes.The mean preoperative diopter was-14.52±6.43 D,and postoperative diopter was-0.01±0.28 D.The UCVA and BCVA were 0.08±0.06 and 0.5±0.2 respectively before operation versus 0.6±0.3 and 0.7±0.2 respectively after operation.It is obvious that postoperative UCVA and BCVA were better than the preoperative ones（P0.05）.The mean preoperative IOP was（16.21±2.84） mmHg and postoperative IOP was 17.03±1.95 mmHg.The cornea endothelial cell density was（3 028±289）/mm2 before operation and（2 912±251）/mm2 after operation,and average preoperative anterior chamber depth was 3.69±0.31 mm and the postoperative was 3.57±0.29 mm,showing no significant difference（P0.05）.Conclusion： Phakic ICL is an effective treatment for the correction of high myopia and has significant advantages such as reversibility,immediate correction,stability,and no postoperative complications.However,a long-term evaluation of effectiveness and safety for this phakic ICL should be performed.