有晶状体眼后房型人工晶状体植入矫正高度近视的临床观察

Observation of posterior or toric implantable collamer lens for the correction of high myopia

目的:通过超声生物显微镜(UBM)及光学相干断层扫描(OCT)评估有晶状体眼后房型人工晶状体矫正高度近视的疗效及安全性。方法:观察2015-01/04期间在我院行有晶状体眼后房型人工晶状体(implantable collamer lens,ICL)或散光型后房型人工晶状体(TICL)治疗的高度近视患者24例48眼,观察中央前房深度(ACD)、前房开放距离(AOD500)、术后拱高(ICL-vault)、术后最佳矫正视力(BCVA)、术后裸眼视力(UCVA)、角膜内皮细胞计数、眼压测量(IOP)、裂隙灯检查泪膜破裂时间(BUT)。结果:术前与术后1、3、6、12mo均采用UBM测量ACD与AOD500四个方位,术前与术后4个随访时间节点的值比较差异均存在统计学意义(P<0.05),术后测量值均较术前降低,OCT测量拱高术后各时间点比较,差异无统计学意义(P>0.05),术后BCVA、UCVA均较术前提高,与术前相比差异具有统计学意义(P<0.05),但术后各时间点相比,差异无统计学意义。术前患者平均眼压、角膜内皮细胞计数及BUT与术后4个随访节点相比较差异无统计学意义(P>0.05)。结论:ICL植入术矫正高度近视具有良好的疗效和安全性,术后泪膜稳定性变化不大,患者舒适度较好,满意度高。

AIM：To evaluate the efficacy and safety of posterior chamber phakic intraocular lens implantation for the correction of high myopia by ultrasound biomicroscopy（UBM） and optical coherence tomography（OCT）.METHODS：Twenty-four high myopia patients（48 eyes）who underwent the implantation of implantable collamer lens（ICL） or toric implantable collamer lens（TICL） in our hospital from Jan.2015 to Apr.2015 were observed.The various data included central anterior chamber depth（ACD）;angle opening distance 500（AOD500）;the distance between crystal lens and IOL（ICL-vault）;postoperative best corrected visual acuity（postoperativeBCVA）;postoperative uncorrected visual acuity（postoperative- UCVA）;counts of endothelial cells;intraocular pressure（IOP）;break-up time（BUT） by slit lamp were investigated during 1mo,3mo,6mo and 1y respectively on postoperative check while compared with the data of preoperation.The data were analyzed.RESULTS：UBM were used to investigate ACD and four directions of AOD500 in 1mo,3mo,6mo and 1y postoperative.The results were all reduced compared with preoperation.The differences were statistically significant（P〈0.05）.After the distances between crystal lens and IOL being examined by OCT after operation,we found that the four time nodes were not statistically different（P〈0.05）.However,all results including postoperative best corrected visual acuity（postoperativeBCVA）,postoperative uncorrected visual acuity（postoperative- UCVA） were improved compared with preoperation.There was significant difference between preoperation and postoperation（P〈0.05）.However,there was no significant difference in the various time points postoperative.Besides,there was no significant difference in mean IOP,mean counts of endothelial cells and the average BUT between preoperation and 4 times of postoperative following up studies（P〈0.05）.CONCLUSION：Several clinical data have proved curative effect and safety of ICL implantation for the correction of high myopia.The stability of tear film has no obvious change.The patients are highly satisfactory.