高度近视合并白内障后房型PIOL植入对眼轴测量、内轴向结构稳定的影响

Effect of Posterior Phakic Intraocular Lens on Axis Oculi Measurement and Structure Stabilization of Inner Axial Direction in High Myopia Patients with Cataract

目的观察高度近视合并白内障植入不同后房型有晶状体眼人工晶状体(phakic intraocular lens,PIOL)对眼轴测量及内轴向空间结构稳定性的影响。方法 2012年7月—2015年7月对106例(168只眼)行白内障超声乳化吸出术联合PIOL植入术,根据患者植入PIOL类型分为有晶状体眼屈光镜(phakic refractive lens,PRL)组81只眼和可植入式接触镜(implantable collamer lens,ICL)组87只眼。测量两组手术前、后眼轴长度并分析其相关性,观察手术前、后前房深度的变化。结果两组术后眼轴长度和最佳矫正视力均较术前提高,PRL组术后眼轴长度长于ICL组,但术后最佳矫正视力低于ICL组(P<0.05)。手术前、后眼轴长度差值PRL组随着眼轴的延长而逐渐缩小,ICL组随着眼轴的延长而逐渐增大,但波动范围较小。两组术后前房深度小于术前,但PRL组大于ICL组(P<0.05)。结论后房型PIOL植入对高度近视合并白内障患者的眼轴测量影响较小,有利于眼内轴向空间结构的稳定,但不同材质的PIOL对内轴向结构的稳定性不同。

Objective To observe the effect of different posterior phakic intraocular lens（ PIOL） on axis oculi measurement and structure stability of inner axial space in high myopia patients with cataract. Methods A total of 106patients（ 168 eyes） underwent cataract phacoemulsification combined with PIOL implantation during July 2012 and July2015,and were divided into phakic refractive lens group（ PRL group,n = 81） and implantable contact lens group（ ICL group,n = 87） according to implanted PIOL types. The axis oculi length were measured before and after the operation,and the correlation was analyzed in the two groups,and the changes of anterior chamber depth before and after the operation was observed. Results The axis oculi length and best corrected visual acuity were improved after the operation compared with those before the operation in the two groups; in PRL group,axis oculi length was longer,but the best corrected visual acuity was lower than those in ICL group（ P〈0. 05）. The axis oculi differences before and after the operation showed that the value was reduced in PRL group and increased in ICL group with the extensing length with little fluctuation range. The values of anterior chamber depth were lower after the operation than those before the operation in the two groups,but the value in PRL group was higher than that of ICL group（ P〈0. 05）. Conclusion The posterior phakic intraocular lens for high myopia patients with cataract has little effect on axis oculi measurement,and is helpful for structure stability of inner axial space,but different PIOL materials have different levels of stability.