Bigbag人工晶状体在高度近视并发白内障中的应用研究

Phacoemulsification with Bigbag intraocular lens implantation for high myopia with cataract

目的探讨超声乳化白内障吸出联合Bigbag人工晶状体植入在高度近视合并白内障中的临床应用效果。方法选择因高度近视合并白内障行超声乳化吸出术患者63例(94眼),根据患者意愿,植入Bigbag人工晶状体作为观察组,32例(48眼),植入Acrysof后房型人工晶状体作为对照组,31例(46眼),观察并比较两组术前、术后1周、术后1、3个月患者裸眼视力、最佳矫正视力、屈光状态、眼压及术后并发症。结果观察组术后1周、术后1、3个月裸眼视力均较术前提高(t=-5.270、-5.873、-16.738,均P<0.05),屈光度较术前降低(t=-2.415、-2.386、-16.053,P<0.05),眼压较术前无明显变化(t=1.195、-1.131、1.036,均P>0.05);对照组术后1周、术后1、3个月裸眼视力均较术前提高(t=-14.738、-14.365、-13.954,均P<0.05),屈光度较术前降低(t=-13.666、-13.627、-12.820,均P<0.05),眼压较术前差异无统计学意义(t=-1.101、-0.745、-0.786,均P>0.05);术后1周、术后1、3个月裸眼视力两组差异均无统计学意义(t=1.478、1.740、2.844,均P>0.05),术后1周、1个月最佳矫正视力观察组优于对照组(t=2.640、2.642,均P<0.05)。观察组术后后囊膜皱褶、后发性白内障及眩光现象的发生率较对照组降低(χ~2=41.17、5.452、2.352,均P<0.05)。结论对高度近视合并白内障患者行超声乳化白内障吸出联合Bigbag人工晶状体植入术可达到较理想的术后视力,是一种安全有效的治疗方法。Bigbag人工晶状体对后囊膜有稳定的支撑作用,可明显减少术后并发症的发生,特别是后囊膜皱褶和后发性白内障及眩光现象。

Objective To assess the clinical application of phacoemulsification with Bigbag intraocular lens implantation for high myopia with cataract.Methods Sixty cases（94 eyes） of high myopia with cataract underwent phacoemulsification combined with intraocular lens implantation,including 32 cases（48 eyes） receiving Bigbag intraocular lens（study group） and 31cases（46 eyes） receiving Acrysof lens（control group）.The visual acuity,best corrected visual acuity,refraction,intraocular pressure（IOP） and complications of operation were observed at 1 week,1 month and 3 months after operation.Results Compared those before operation,the visual acuity was increased,diopter was decreased（all P〈0.05） and the IOP was not changed at 1 week,1 month and 3 months after operation in both groups.There was no significant difference in visual acuity between two groups after operation.The best corrected visual acuity in study group was better than that in control group at 1week and 1 month after operation（t=2.640,2.642,P〈0.05）.The occurrence of posterior capsular wrinkle,capsular opacification and glare in study group was less than that in control group（χ^2=41.17,5.452,2.352,P〈0.05）.Conclusion Bigbag intraocular lens implantation is a safe and effective method for high myopia with cataract after phacoemulsification.