PC-PRL植入术治疗高度近视的疗效及对患者并发症的影响

Efficacy of PC-PRL implantation in the treatment of high myopia and its complications

目的研究可植入式后房型人工晶状体(PC-PRL)植入术治疗高度近视的疗效及对患者裸眼视力、视网膜并发症的影响。方法选择本院收治的高度近视患者110例(220只眼)为研究对象,均接受PC-PRL植入术治疗,观察比较治疗前后裸眼视力(UCVA)、最佳矫正视力(BCVA)、眼压、角膜内皮细胞计数及人工晶状体位置(前房深度、拱高),分析视网膜并发症发生情况。结果治疗后6个月,68.18%患者0.6≤UCVA≤0.9,31.81%患者UCVA≥1.0,100.00%患者BCVA≥1.0;患者术后1周及1、3、6个月的BCVA、UCVA值明显大于术前(P<0.05);术后1周及1、3、6个月BCVA、UCVA值组间比较差异无统计学意义(P>0.05);患者术后1周眼压明显大于术前(P<0.05),术后1、3、6个月的眼压与术前比较,差异无统计学意义(P>0.05);治疗前后角膜内皮细胞计数、拱高比较,差异无统计学意义(P>0.05);术后3、6个月前房深度明显小于术前,差异具有统计学意义(P<0.05),术后3、6个月前房深度组间比较,差异无统计学意义(P>0.05);术后1周内出现角膜水肿7例,高压眼4例,6个月内出现屈光回退2例,视近困难1例,总并发症发生率为12.73%。结论PC-PRL植入术治疗高度近视疗效确切,有助于提高患者裸眼及矫正视力,同时视网膜并发症发生率较低,可临床推广应用。

Objective To investigate the efficacy of posterior chamber phakic refractive lens(PC-PRL)implantation in the treatment of high myopia and its effect on naked vision and retinal complications.Methods A total of 110 patients(220 eyes)with high myopia admitted to our hospital from June 2017 to February 2019 were selected,and all of them underwent PC-PRL implantation.The uncorrected visual acuity(UCVA),best corrected visual acuity(BCVA),intraocular pressure(IOP),corneal endothelial cell count and the position of artificial lens(anterior chamber depth,arch height)were observed and compared before and after treatment,and the incidence of retinal complications was analyzed.Results Six months after treatment,0.6≤UCVA≤0.9,UCVA≥1.0,BCVA≥1.0 accounted for 68.18%,31.81%,100.00%,respectively.The BCVA and UCVA values of 1 week,1 month,3 months and 6 months after operation were significantly higher than those before operation(P<0.05).There was no statistically significant difference in the BCVA and UCVA values between groups at 1 week,1 month,3 months and 6 months after operation(P>0.05).The intraocular pressure of one week after operation was significantly higher than that before operation(P<0.05);the intraocular pressure at 1 month,3 months and 6 months after operation showed no difference from those before surgery(P>0.05).There was no significant difference in corneal endothelial cell count and arch height before and after treatment(P>0.05).The depth of the anterior chamber at 3 months and 6 months after surgery was significantly less than that before surgery(P<0.05);the depth of the anterior chamber at 3 months and 6 months after surgery showed no difference with those before surgery(P>0.05).There were 7 cases of corneal edema,4 cases of hypertensive eyes,2 cases of refractive regression within 6 months,and 1 case of myopia.The total complication rate was 12.73%.ConclusionPC-PRL implantation in the treatment of high myopia can effectively improve the naked vision and corrected visual acuity of patients,while the incidence of retinal complications is low,which can be widely used in clinical practice.