中央孔型ICL植入术中的改良技巧及2a临床应用观察

Modified technique and clinical application of central hole ICL implantation for 2a

目的:探讨改良技巧在中央孔型ICL V4c植入术中的应用及其临床效果。方法:对2015-09/2016-08在我院行ICL V4c植入术的近视患者72例141眼采用改良手术技巧,包括2.8mm透明角膜单切口、ICL植入前免前房黏弹剂等。监测术后6h内眼内压,术后随访2a观察视力、屈光度、眼内压、角膜内皮细胞情况。结果:所有患者均成功通过透明角膜2.8mm单切口植入中央孔型ICL V4c,取得良好的效果,但术后6h内有一定的高眼压发生率,尤其是术后2h眼内压最高,95.7%的术眼眼内压能够在术后6h恢复到正常范围,且术后2a内眼内压平稳。术后6mo,1、2a本组患者累积角膜内皮细胞丢失率分别为4.70%、7.59%、9.63%。术后2a随访期间无晶状体混浊等并发症发生。结论:中央孔型ICL V4c植入术中采用的改良方法安全可行。

AIM: To explore the application of improved skills in central hole ICL V4c implantation and its clinical efficacy. METHODS: This study included 141 eyes of 72 patients with myopia from September 2015 to August 2016. An implantable contact lens with a central hole (ICL V4c) was inserted by improved surgical skills including single 2.8mm clear corneal incision,no anterior chamber viscoelastics before ICL implantation. The intraocular pressure (IOP) was measured at the early stage within 6h after operation. The visual acuity,diopter,intraocular pressure and corneal endothelial cell density were observed after operation and follow up 2a. RESULTS: ICL V4c was implanted successfully in all patients by this improved skills and fine clinical results were achieved. Elevated IOP is possible at early stage post-operation,especially within 2h after operation. 95.7% had normal IOP 6h after operation. The postoperative IOP was stable within 2a follow-up period. The cumulative corneal endothelial loss rates of 6mo,1a and 2a were 4.70%,7.59% and 9.63% respectively. There was no complications such as subcapsular cataract during the 2a follow-up period. CONCLUSION: The improved skills used in our study is safe and feasible.