有晶状体眼后房型人工晶状体植入术矫治高度近视临床研究

Posterior chamber phakic intraocular lens for high myopia

目的研究有晶状体眼后房型人工晶状体植入术矫治高度近视的安全性、有效性及稳定性。方法774例（883眼），年龄18—40岁的高度近视患者行有晶状体眼人工晶状体植人，术后观察两组视力、眼压、屈光度、角膜内皮细胞计数、人工晶状体位置、手术并发症及视觉不良症状。结果术后2个月裸眼视力〉0．5者占74．6％；术后30～36个月时占83．5％，二者差异无统计学意义（P〉0．05）。术后3～6个月屈光度改变均在±1．00D之内，眼压、角膜内皮细胞计数与术前比较差异均无统计学意义（P〉0．05）。并发症：术后24h内高眼压16眼，3月后发生眼底黄斑出血4眼。主诉夜间眩光症状者5例。结论有晶状体眼后房型人工晶状体植入术矫治高度及超高度近视眼具有良好的安全性，有效性和可预测性。

Objective To evaluate the safety, efficacy and stability of posterior chamber phakic in- traocular lens （pIOL） in the management of high myopia. Methods 774 cases （883 eyes） with high myo-pia underwent pIOL implantation. We assessed postoperative visual acuity, intraocular pressure, refraction, corneal endothelia, pIOL position, surgical complications and other visual complaints. Results Uncorrect-ed visual acuity at 〉0.5 accounted for 74.6% at 2 months postoperatively and 83.5% at 30 - 36 months postoperatively. Refractive changes were within - 1～＋ 1 D at 3 - 6 months postoperatively. There were no statistical differences between the preoperative level and the postoperative level in intraocular pressure and corneal endothelia （P 〉 0.05）. 16 eyes had high intraocular pressure within 24 hours postoperatively. 4 eyes had macular hemorrhage at 3 months after the operation. 5 patients complained about night flare. Con-clusion Implantation of pIOL to correct high myopia is effective, safe and predictable.