一体式水凝胶折叠人工晶体植入术300例临床分析

Observation on one-piece hydroview foldable IOL implantation

目的 :观察分析一体式水凝胶折叠人工晶体 (hydroview)植入的临床效果、稳定性 (stabili ty)、中心定位性 (centration)及袢的位置。方法 :对超声乳化植入水凝胶晶体 30 0只眼术后进行常规检查 ,记录资料输入计算机。分析术后视力、角膜散光、晶体偏移及对激光耐受性。手术性角膜散光值用正余弦定律计算 ,晶体位置用屈光法、直接观测法和超声生物显微镜 (UBM)检查。随机抽取三体式硅酮晶体、一体式PMMA晶体各 1 50只眼对比。结果 :术后矫正视力≥ 0 5的为 92 9% ,≥ 1 0为75 0 % ;无眼病组术后 6个月最佳矫正视力≥ 0 5的为 97 0 % ,≥ 1 0为 76 9% ,优于PMMA组。术后手术性角膜散光与硅酮组相近 ,<0 1 5D ;且明显低于PMMA组 (P <0 0 5)。 94 1 %的水凝胶晶体偏移<0 5mm ,晶体散光和PMMA组相近 ,72 %以上 <0 5D。 86 7%的双袢位置完全对称囊袋内 ,距睫状突0 6～ 0 8mm。激光后囊切开率 9 33% ,晶体位置未受影响。结论 :一体式水凝胶晶体植入术后效果好 ,几乎不引起角膜散光 ,眼内稳定性及中心定位性好 ,对激光抵抗力强。

Objective:To observe and analyse the clinical results,stability and centration of hydroview IOL.Methods:300 eyes were implanted with hydroview lenses through a 3 2～3 8mm incision and with the same phaco manipulation in a single horizontal groove.The data and records were analysed for visual acuity,induced corneal astigmatism,decentration and tiltation of the lenses and toleration in YAG laser capsulotomies.The induced corneal astigmatism was calculated with sin and cos law.The centration was examined with refraction and modified Linnolas method.All results were compared with three-piece silicone foldable IOL (150 eyes) and one-piece PMMA IOL (150 eyes).Results:The acuity of all patients was 20/40 or better in 92 9%, (20/20) or better in 75 0%.The corrected acuity of best case was 20/40 or better in 97 0%,20/20 or better in 76 9%.They were better than that of PMMA lenses.Postoperative induced corneal astigmatism of hydroview lenses was nearly the same as that of silicone lenses (<0 15D),much less than that of PMMA lenses (P<0 05).The decentration of hydroview lenses was less than 0 5mm in 94 1%.The lenses induced astigmatism was nearly equal to that of PMMA lenses (<0 5D in more than 72 0%).There were 86 7% of IOLs with two loops completely symmetry in bag and keeping a 0 6-0 8mm of distance between the equator of loop and ciliary process.The rate of YAG laser capsulotomies was 9 33%,and no lens subluxation was found.Conclusions:One-piece hydroview foldable IOL implantation had satisfactory clinical results,nearly no induced corneal astigmatism occurred had good stability and centration of lenses,and was very tolerable to YAG laser damage.