有晶状体眼后房人工晶状体植入矫正超高度近视临床观察

Clinical observation of implantation of phakic anterior chamber lens for treat super-high myopia

目的观察有晶状体眼后房人工晶状体（ICL）植入超高度近视眼对视功能、眼结构的影响。方法回顾性临床系列研究。对2010年4月至2014年9月通过对-12DS至-23DS（17．25±4．23）DS超高度近视眼植入后房型人工晶状体的临床随访观察（3—27）月、平均（15．8±3．8）月，随访项目包括：术前、术后1天、末次裸眼视力、矫正视力、眼压、屈光度、晶状体透明度、人工晶状体位置、角膜内皮计数、前房深度、眼轴、调节近点。结果术后末次随访裸眼视力0．62±0．15、最好矫正视力0．91±0．16，与术前矫正视力比较，前者差异无统计学意义（t=-0．45、P=0．55）、后者差异有统计学意义（t=-3．16、P=0．006），术后末次随访屈光度（-1．28±0．96）DS；术后末次随访眼压：（17．96±3．57）mmHg，与术前比较差异无统计学意义（t=-0．54、P=0．59）；术后末次随访角膜内皮计数、前房深度、眼轴、调节近点分别为（2686±361）个／mm^2、（3．52±0．39）mm、（30．98±1．36）mm，（19．00±3．87）cm，与术前比较分别为（t=0．89、P=0．38）、（t=2．48、P=0．03）、（t=-0．23、P：0．81）、（t=-0．21、P=0．90）。UBM示ICL与晶状体无接触、房角大于30度，未见晶状体混浊。结论有晶状体眼后房人工晶状体（ICL）植入超高度近视能有效提高视力，未对眼结构和调节产生明显影响。

Objective To observe the influence on visual function and eye structure before and after the implantation of posterior chamber phakic intraocular lens for the correction of super-high myopia. Methods Ten cases （17 eyes） with 12 diapers--27diapers（D） （17.25±4.23DS） of super-high myopia were implanted with posterior chamber phakic intraocular lens and were followed-up for 3-27 months （mean 15.8±3.8months）. Patients were examined preoperatively and followed at 1 day and the last postoperatively. The examination content included the uncorrected visual acuity, best corrected visual acuity （BCVA）, intraocular pressure, refractive power, lens transparency, IOL position, corneal endothelial count, anterior chamber depth, axial length, and near point of accommodation. Results The uncorrected visual acuity of after operation （0.62±0.15） was not significantly different from pre-operation （t =-0.45, P =0.55）. The BCVA after operation （0.91±0.16） was significantly different from pre-operation （t =-3.16, P =0.006）. The last follow-up refractive power was （-1.28±0.96） DS. The last follow-up intraocular pressure was （17.96 ± 3.57） mmHg, which was not significantly different from pre-operation （t =-0.54, P =0.59）. The postoperative corneal endothelial count, anterior chamber depth, axial length, near point of accommodation were 2686±361/mm^2, 3.52±0.39mm, （30.98±1.36） mm, （19.00± 3.87） cm, compared with pre-operative ones （t =0.89, P =0.38） （t =2.48, P =0.03） （t =-0.23, P =0.81） （t =-0.21, P =0.90）. UBM showed that ICL was not contact to the lens, and angle was greater than 30 degrees. The lens remained transparent. Conclusions Phakic posterior chamber intraocular lens （ICL） implantation for super-high myopia can effectively improve the vision, and does not have negative effect on eye structure and accommodation