有晶状体眼后房型人工晶状体植入术治疗高度近视3年随访分析

A three-year follow-up of posterior chamber phakic intraocular lens implantation in patients with high myopia

目的:探讨有晶状体眼后房型人工晶状体植入术矫正高度近视的安全性、有效性和可预测性。方法:对屈光度为-8.50^-16.5D的20例(32眼)高度近视患者行有晶状体眼ICL人工晶状体植入术。术前、术后观察患者的视力、屈光度、眼压、角膜内皮细胞计数、人工晶状体的稳定性及晶状体的混浊情况,术后随访3年。结果:32眼均成功植入ICL人工晶状体。术后3年,全部患者裸眼视力均>0.4,最佳矫正视力>0.8占53.13%(17/32),裸眼视力较术前明显提高,且差异有统计学意义(P<0.05)。术后3年,50.0%(16/32)患者的屈光度在预期屈光度±1.0D之内;眼压、角膜内皮细胞计数与术前相比,差异均无统计学意义(P>0.05)。术后无严重并发症发生。结论:有晶状体眼后房型人工晶状体植入术矫正高度近视具有较好的安全性、有效性和可预测性,未见继发性青光眼、并发性白内障、视网膜脱离等并发症发生。

Objective. To evaluate the safety, efficacy and predictability of posterior chamber phakic intraocular lens implantation in the correction of high myopia. Methods. Phakic intraocular lens implantations were performed in 20 patients （32 eyes） with high myopia whose diopters were -8.5 to -16.5D. Visual acuity（VA）, refraction, intraocular pressure （IOP）, endothelial cell density （ECD）, stability and turbidity of intraocular lens were observed before and after operation. The patients were followed up for three years. Results.. Implantations were successfully performed in all 32 eyes. Three years after operation, naked VA of all patients were 〉0.4 which were increased significantly than before（P〈0.05）, and the best corrected VA were 〉0.8 which were accounted for 53.13% （16/32） ,refractions of 50% patients （16/32） were within predicted value ±1.0 D, but IOP and ECD were the same compared with before （P〉0.05）. No severe complications were observed. Conclusion： It is safe, efficient and predictable to correct high myopia by posterior chamber phakic intraocular lens implantation, and no severe complications such as secondary glaucoma, complicated cataract and retinal detachment occur.