双眼超高度近视合并白内障手术患者人工晶状体的选择

Selection of intraocluar lens in patients undergoing phacoemulsification surgery for extreme myopia combined with cataract

目的探讨双眼超高度近视合并白内障手术时人工晶状体(晶体)参数选择。方法回顾性分析35例(70眼)超高度近视合并白内障行白内障超声乳化+人工晶体植入术患者的临床资料。依据术前视力检查、主导眼检查、人工晶体度数及光学区范围、术后视力、屈光度以及相关并发症发生情况,提出人工晶体参数选择的建议。结果随访1个月。术后最佳矫正视力≥0.3者56只眼(80.0%),最佳矫正视力<0.3的14眼(20.0%)。术后屈光度(含等效球镜):-1.0^-2.0D的52眼(74.3%),≥-2.0D的13眼(18.6%),<-1.0D的5眼(7.1%)。术前术后主导眼的屈光度无明显变化。术后角膜水肿17眼,眼压增高12眼,均在3d内恢复正常。结论双眼超高度近视合并白内障手术宜采用光学区直径大的人工晶体,保留近视度数,并保持术前术后主导眼的参数不变。

Objective To investigate the selection of intraocluar lens in the patients undergoing phacoemulsification surgery for extreme myopia combined with cataract.Methods Data of 35patients（70eyes）with extreme myopia combined with cataract underwent phacoemulsification and intraocluar lens implantation were retrospectively analyzed.On the basis of preoperative visual acuity,dominant eye examination,intraocluar lens parameter and postoperative visual acuity,refractive error,and complications,the parameters for the selection of intraocluar lens were suggested.Results The patients were followed up for one month.The best corrected visual acuity achieved 0.3or better in 56eyes（80.0%）and below 0.3in 14eyes（20.0%）.The values of postoperative diopter（including equivalent spherical lens）were-1.0--2.0Din 52eyes（74.3%）,≥-2.0Din 13eyes（18.6%）,〈-1.0Din 5eyes（7.1%）,which were not significantly changed in dominant eyes after surgery.The corneal edema ocuurred in 17 eyes and increased intraocular pressure was seen in 12 eyes,which were all improved and returned to the normal in 3days after operation.Conclusion It is better to select the intraocluar lens with large optical zone in diameter,keep the myopia degrees and parameters of dominant eyes unchanged in the patients undergoing phacoemulsification surgery for extreme myopia combined with cataract.