探讨一种规范化的高度近视白内障超声乳化方式

Exploration of a standardized approach of phacoemulsification in high myopia

目的探讨一种规范化的的高度近视白内障超声乳化方式,总结手术注意点。方法选取高度近视白内障患者91例(91眼)均予以超声乳化联合人工晶体植入术治疗并总结。结果所有病例的术后裸眼视力均优于术前裸眼视力。术后第1天裸眼视力≥0.2共72眼(79.12%),≥0.5共37只眼(40.66%);术后3月裸眼视力≥0.2共85只眼(93.41%),≥0.5共42只眼(46.15%)。最佳矫正视力≥0.2共89只眼(97.80%),最佳矫正视力≥0.5共72只眼(79.12%)。术前散光度平均1.10D±0.78D,术后3月散光度平均1.25D±0.72D。术后散光度与术前散光度比较,差异无显著性(t=1.166,P=0.261)。无瞳孔严重变形、视网膜脱离、囊样黄斑水肿、瞳孔夹持、青光眼以及顽固性葡萄膜炎等并发症。结论低能量,高负压,低灌注,连续环形撕囊,双手劈核技术对于高度近视白内障患者更加安全有效。

Objective To explore a standardized approach of phacoemulsification in high myopia and sum up the attention point of surgery. Methods 91 patients （91 eyes） with high myopia were selected and treated by phacoemulsification combined with intraocular lens implantation. Results 1 day after the surgery, the visual acuities reached 0.2 or better in 72 eyes （79.12%） and 0.5 or better in 37 eyes （40.66%）; During 3 months of follow up, the visual acuities reached 0.2 or better in 85 eyes （93.41%） and 0.5 Or better in 42 eyes （46.15%）, The best corrected visual acuity reached 0.2 or better in 89 eyes （97.80%） and 0.5 or better in 72 eyes （79.12%）. Preoperative astigmatism averaged 1.10D ± 0.78D and postoperative astigmatism after 3 months average 1.25D ± 0.72D. There was no significant difference between postoperative radiography and preoperative astigmatism （t =1.166, P= 0.261）. No eye had posterior capsule rupture and retinal or choroid detachment. Conclusion Low energy, high negative pressure, low perfusion, continuous annular capsulorhexis and two - hand cleavage technique are safe and effective for patients with high myopia cataract.