有晶状体眼后房型人工晶状体矫治超高度近视临床观察

Clinical observation of phakic intraocular lens implantation for patients with extreme highly myopia

目的：观察有晶状体眼后房型人工晶状体植入术矫正超高度近视的临床疗效及安全性。 方法：我院于2010-07/2013-07开展后房型人工晶状体植入术矫治超高度近视患者18例32眼,屈光度-10.5-19.0D,散光-0.5-4.5DC,术后1d,1wk,1mo,3mo及1a密切观察术后眼压、屈光改变、视力及角膜内皮、前房深度、虹膜、拱高、晶状体情况,随访1a。 结果：术前裸眼视力0.01-0.05,最佳矫正视力0.4-1.0,术后裸眼视力0.5-1.2,1mo 时平均拱高547±222μm （95%CI 442-672）,1a 时平均拱高528±268μm （95%CI 354-635）,差异无统计学意义（P=0.81）。术后视力恢复快,并发症少,1眼晶状体前囊膜下混浊,3眼一过性眼压升高,2眼虹膜少许脱色素,未见严重并发症。 结论：有晶状体眼后房型人工晶状体植入术矫正超高度近视,术后视力效果好,屈光度稳定,可预测性强,安全性高。

AIM： To evaluate the clinical effects and security of posterior chamber implantable Collamer lens （ ICL ） implantation in patients with extreme highly myopia. METHODS：ln this study, 18 patients （ 32 eyes ） with extreme highly myopic patients who had undergone posterior chamber ICLs implantation from July 2010 to July 2013 were evaluated. Diopter -10. 5 - 19. 0D, and astigmia -0. 5 -4. 5DC. Changes in intraocular pressure （ IOP ） , refraction, visual acuity and corneal endothelium, anterior chamber depth, iris, high arch, lens were noted at 1d, 1wk, 1, 3mo and 1a after surgery respectively, and follow-up was of 1a. RESULTS： Before surgery, the uncorrected visual acuity （UCVA） were 0. 01-0. 05, and the best spectacle-corrected visual acuity （ BSCVA） were 0. 4 - 1. 0. One month after surgery, the UCVA were 0. 5-1. 2. The mean vault were 547±222 μm （95%CI 442-672μm） and 528±268μm （95%CI 354 -635μm） for 1mo and 1a, respectively （P = 0. 81）, and there was no significant difference. Anterior subcapsular opacities in 1 eye, mild and transient increase in IOP in 3 eyes, and chronic pigment dispersion in 2 eyes were observed. There was no serious complication. CONCLUSION： Posterior chamber phakic intraocular lens implantation is an effective and safe method for correcting patients with extreme highly myopia.