高度近视合并白内障患者植入不同人工晶状体术后黄斑区视网膜厚度的变化

Effects of different intraocular lens on macula area of high myopia associated with cataract

目的研究高度近视合并白内障植入不同后房型人工晶状体对眼底黄斑结构的影响。方法对高度近视合并白内障患者68例(78眼)施行白内障超声乳化吸出联合人工晶状体植入术,根据植入的人工晶状体不同分为三组:Bigbag组28眼、MA60MA组26眼和PMMA组24眼。观察患者术后1周、1个月、3个月的最佳矫正视力,术后第1周、1个月、3个月黄斑厚度的变化及术后并发症等指标。结果所有手术眼术后矫正视力(best-corrected visual acuity,BCVA)均有不同程度提高,Bigbag组术后1周、1个月黄斑厚度显著小于M A60M A组和PM M A组,组间比较差异均有统计学意义(P<0.05),术后3个月时三组黄斑厚度与术前比较没有明显差异(P>0.05),术后均未见严重并发症。结论超声乳化吸出联合针对近视眼设计的人工晶状体植入术可以有效改善高度近视白内障患者的视力,对后囊膜起到稳定的支撑作用,有利于眼内轴向空间结构的稳定,减轻手术对眼后段的影响。

Objective To observe and analyze the effects of different intraocular lens（IOL）on macular thickness of high myopia associated with cataract in order to provide a clinical supporting of acquiring a best IOL for these patients. Methods Totally 68 patients （78 eyes）with high myopia were performed on phacoemulsification in combination with IOL implantation,including three kinds of IOL：Bigbag,MA60MA and PMMA which were 28,26 and 24 eyes respec-tively.The post-operative 1 week,1 and 3months best-corrected visual acuity（BCVA）,pre-operative and post-opera-tive macular thickness at different stages were observed and measured by optical coherence tomography.Results BCVA increased in different degree in the three groups.The difference of macular thickness at 1 week and 1 month after surgery in the Bigbag group was significantly smaller than that of the MA60MA and PMMA groups（P〈0.05）.Com-pared with the pre-operative macular thickness,there were no significantly changes in the three groups （P〉0.05）.No serious post-operative complications occurred in three groups.Conclusion Phacoemulsification in combination with Bigbag IOL implantation could improve the visual acuity of patients with cataract and high myopia,play a stabilizing role of supporting the post-operative posterior capsule so as to provide a beneficial effect on maintaining the stability of the axial apace structure in eye and reduce the influence of the posterior segment of the eyeball.