有晶状体眼后房型人工晶状体植入术治疗高度近视术后早期临床疗效

Preliminary clinical efficacy of posterior chamber phakic intraocular lens implantation for high myopia

目的观察有晶状体眼后房型人工晶状体(implantable contact lens,ICL)植入术治疗高度近视的早期临床效果。方法按照拟定的入选标准选取行ICL植入术治疗的高度近视患者48例90眼,术后随访6个月。记录术前、术后各随访时间点的裸眼视力、等效球镜度、低对比度视力、眼压及角膜内皮细胞密度。使用SPSS 19.0软件描述术前术后各指标的分布特征,采用非参数检验对裸眼视力进行手术前后的差异性比较,采用配对t检验对其余各指标进行手术前后的差异性比较。结果 90眼均成功植入ICL。全部患者在随访期中,裸眼视力均达到术前最佳矫正视力,52.2%的眼数超出一行及以上;等效球镜度维持在±1.0 D;低对比度视力术后1个月、3个月、6个月分别为-0.43±0.20、-0.47±0.21、-0.45±0.18,较术前矫正屈光不正后测得值有所提高(P<0.05),眼压无明显变化(P>0.05),角膜内皮细胞密度较术前减少(P<0.05)。对于术后有统计学意义的指标,除低对比度视力在术后3个月达稳定水平外,其余指标均在术后1个月时即达到稳定状态。91.7%的患者对ICL植入术早期效果表示满意,全部患者术后均未出现严重并发症。结论有晶状体眼后房型人工晶状体植入术矫正高度近视在术后早期随访中取得了满意的临床效果。

Objective To observe the preliminary clinical efficacy of posterior chamber phakic intraocular lens implantation for high myopia. Methods According to the proposed inclusion criteria,90 eyes（48 patients） with high myopia underwent poste- rior chamber phakic intraocular lens implantation were selected. The mean follow-up was 6 months. The preoperative and postoperative uncorrected visual acuity （ UCVA）, spherical equivalent （ SE ）, low comparative visual acuity （ LCVA）, intraocular pressure （IOP） and endothelial cell density（ECD） at different follow-up time points were recor- ded. SPSS 19.0 statistical software was used to describe the indexes distribution at dif- ferent time points. The changes of UCVA between pre-operation and post-operation were compared by nonparametric test, others by matching t test. Results ALL of 90 eyes were implanted with posterior chamber phakic intraocular lens successfully. During the follow-up of all the patients, the postoperative UCVA reached the preoperative BC- VA,52.2% of the patients exceed preoperative BCVA one line or above;SE maintained within - 1.0 D to ＋ 1.0 D; LCVA increased compared with pre-operation when refractive eiTom were corrected（P 〈 0.05 ）. No change appeared in IOP（P 〉 0.05 ）. The postoperative ECD was less than post-operation（P 〈 0.05 ）. For the indexes with statistically significant difference, they achieved stable state in postoperative 1 month but LCVA in postoperative 3 months. 91.7% of patients were satisfied with the operation,and no serious complications occurred in all after the operation. Con- clusion Posterior chamber intraocular leus implantation in phakic eye for high myopia achieves the preliminary satisfac- tory clinical effects in the early follow-up.