有晶状体眼后房型人工晶状体植入治疗高度近视临床观察

Clinical study for the implantation of posterior chamber phakic implantable contact lens in high myopia

目的评价有晶状体眼后房型人工晶状体(ICL)植入术矫治高度近视的临床效果。方法自2009年2月至2011年2月接受ICL植入的高度近视患者82例(160只眼),术前平均屈光度球镜(-13.65±4.25)D,柱镜(-2.65±0.75)D。观察术后裸眼视力、最佳矫正视力、屈光度、内皮细胞计数等情况,分析并发症的发生情况。结果术后裸眼视力:0.5～1.0,平均0.78±0.32。术前最佳矫正视力:0.3～1.0,平均0.59±0.36,术后最佳矫正视力0.79±0.30。达到术前矫正视力92只眼(57.5%),超过术前最佳矫正视力68只眼(42.5%),随访6个月至2年,无明显变化。术后屈光度数平均球镜(-0.75±0.65)D,柱镜(-0.55±0.25)D。角膜内皮细胞计数术前(3126±260)个/mm2,术后6个月为(3069±308)个/mm2,差异无统计学意义。结论有晶状体眼后房型人工晶状体(ICL)植入矫治高度近视及超高度近视安全有效,是高度近视患者的理想治疗方法。

Objective To assess the clinical outcome of phakic posterior chamber intraocullar lens （ICL） implantation for high myopia. Methods One hundred sixty-two eyes Of 82 patients with high myopia were treated with ICL implantation from Feb 2009 to Feb 2011. The preoperative mean spherical equivalent was 13.65±4.25 D, the mean cylindri- cal equivalent was 2.65 ±0. 75 D. All subjects were followed for 6 months up to 2 years. Uncorrected and best corrected visual acuity, refraction, intraccular pressure, endothelial cell morphometry, and adverse complications were analyzed. Results The range of uncorrected visual acuity after operation was 0.5 ± 1.0, with mean of 0.78 ± 0.32. The range of preoperative best corrected visual acuity was 0.3±1.0, with mean of 0.59± 0.36. The mean best corrected visual acuity after operation was 0.79 ± 0.30. The uncorrected visual acuity was better than preoperative best corrected visual acuity in 68 out of 160 eyes. The mean spherical equivalent after operation was -0.75± 0.65 D, the mean cylindrical equivalent was 0.55± 0.25 D. Corneal endothelium counting had no significant changes after the surgery. No serious complications have been reported during the follow-up period. Conclusion The implantation of phakic posterior chamber ICL for high myopia is safe and effective. It is an appropriate treaaent for high myopia.