有晶状体眼后房型人工晶状体植入治疗高度近视的临床观察

Clinical research of the implantation of ICL/TICL for the correction of extreme myopia

目的探讨有晶状体眼后房型人工晶状体(ICL/TICL)植入术矫正高度近视的有效性和安全性。方法选择高度近视8例(15只眼),平均年龄(25.56±3.2)岁,经术前检查后符合入选标准,屈光状态稳定1年以上。14只眼矫正视力≥0.8,1只眼0.6。11只眼行ICL植入,4只眼行TICL植入。结果 15只眼中14只眼术后裸眼远视力等于或大于术前最佳矫正视力(93.33%),术后1 d裸眼远视力≥1.0者10只眼(66.7%),0.5～0.8者4只眼(26.7%),0.4者1只眼(6.67%);随访6个月时矫正视力,12只眼≥1.0,2只眼为0.8,1只眼为0.6。4只眼TICL经随访6个月,散光轴偏差均<10°。本组病例未发现前囊下晶状体局限性混浊。术后角膜内皮细胞计数及前房深度未见明显变化。结论有晶状体眼后房型人工晶状体植入预测性好,视力恢复迅速,无回退,无严重并发症,适用屈光度范围广,特别适用于不适合准分子激光手术的高度近视患者。

Objective To investigate the efficacy and safety of the implantation of implantable contact lens （ICL） /toric implantable contact lens （TICL） for the correction of extreme myopia. Methods This study included 15 eyes of 8 pa- tients with -8.5 - 15.5 diopters of myopia,in which 11 eyes were treated with ICL implantation,and 4 with TICL. Result After operation,naked vision of 14 eyes（93.33% ） was the same or better than the pre-operative best vision. At the first day after operation, there were 10 eyes （ 66.7% ） got naked vision increased to l. 0 or even better, with 4 eyes （ 26.7% ） to 0. 5 - 0.8,1 eye （ 6.67% ） to 0.4. After 6 month , there were 12 eyes got naked vision increased to 1.0 or even better, 2 eyes to 0.8,1 eye to 0.6. There were 4 eyes happened increased intraocular pressure in early days after operation,the in- traocular pressure became normal soon after positive treatment. The astigmatism axis deviations of the 4 eyes which were treated with TICL implantation were all less than 10% After operation, there was no limited lens opacities of anterior subeap- sular , and the anterior chamber depth intraocular pressure and corneal endothelium counting before and after the operation had no significant difference. Conclusion The implantation of phakic posterior chamber ICL/TICL to correct high myopia was a predictable method which can increase vision rapidly , with no regression and serious complication . It is a suitable treatment method for high myopia ,especially for patients who was not suitable for LASIK,with a wide range of diopters.