小切口非超声乳化白内障摘除人工晶状体植入治疗高度近视白内障疗效观察

The efficacy of small incision non-phacoemulsification cataract intraocular lens implantation treatment of cataract with high myopia

目的回顾性分析小切口非超声乳化白内障摘除联合人工晶状体植入治疗高度近视白内障的临床疗效。方法对于2007年1月至2012年6月在衢化医院眼科中心收治的62例（74只眼）高度近视白内障患者行小切口白内障摘除联合人工晶状体植入，术后随访3个月，观察术后视力、屈光度变化，并对相关并发症进行分析。结果（1）术后视力：最好视力0．6，最低视力眼前手动，术后3个月65只眼（87．8％）视力优于术前，眼轴〈30mm组（25．87～29．41mm）51只眼；眼轴≥30mm组（30．02～31．47mm）14只眼；其它9只眼视力与术前相比无变化。其中6只眼黄斑区脉络膜萎缩，2只眼视神经萎缩，1只眼视网膜色素变性。（2）术前及术后1天、1周、3个月测得角膜平均散光度分别为：（2．43±0．72）D，（0．75±0．21）D，（0．52±0．33）D，（0．50±0．31）D。术前术后散光度比较有统计学意义（P〈0．05）。术后各时间段角膜散光之间差异无统计学意义（P〉0．05）。（3）术中、术后并发症：后囊破裂6只眼（8．1％），行前段玻璃体切除后，4只眼后囊中央破口直径小于5mm者植入后房型人工晶状体，2只眼破口超过2个象限者植入前房型人工晶状体。一过性角膜水肿38只眼（51．4％），1周后消退。暂时性高眼压8只眼（10．8％），1天后恢复正常眼压。结论小切口非超声乳化白内障摘除人工晶状体植入治疗高度近视白内障术后视功能恢复良好，可以在无超声乳化设备的基层医院开展。

Objective To analyze the efficacy of small incision non-phacoemulsification cataract intraocular lens implantation treatment of cataract with high myopia retrospectively. Methods A total of 62 cases （74 eyes） of high myopia with cataract received small incision cataract extraction and in- traocular lens implantation and were followed up for 1 month to 3 months. One day, 1 week, and three months were observed postoperatively. Visual acuity, refractive changes and related complications were analyzed. Results （1） Visual acuity： 65 eyes （87.8%） corrected visual acuity better than preoper- ative. After three months, in the axial length less than 30mm group （51 eyes）, corrected visual acuity was greater than or equal to 0.3, 18 （35.3%） less than 0.02-0.3, 20 （39.2%） less than or equal to 30ram group （14 eyes）. The above vision standards, the number of eyes were 3（21.4%）, 9（64.3%）, 2 （14.3%）. （2） Postoperative complications： 6 eyes （8.2%） had poster capsule rupture, 38 （58.4%） dis- played corneal edema, 8（12.3%） temporary high intraocular pressure. Postoperative astigmatism： From 74 eyes, preoperative and postoperative one day in January, March, measured mean corneal astigma- tism were （2.43±0.72）D, （0.75±0.21）D, （0.52±0.33）D, （0.50±0.31）D. Preoperative and postoperative astigmatism was statistically significant （P 〈0.05）, had no significant difference in the postoperative pe- riod corneal astigmatism between （P 〉0.05）. Conclusions Small incision non-phacoemulsification cata- ract intraocular lens implantation treatment of cataract with high myopia has good postoperative recov- ery of visual function, can be used as phacoemulsification routine supplementation technique.