表麻下小切口透明晶状体吸出及人工晶状体植入术治疗高度近视

Clear lens extraction and posterior chamber intraocular lens implantation for high myopia

目的 :评价高度近视患者表麻下行透明晶状体吸出及人工晶状体植入术的术后效果。方法 :5 6例 10 6眼高度近视患者在表面麻醉下行小切口透明晶状体吸出及人工晶状体植入术。使用超声乳化仪 ,但未用超声能量。平均年龄 3 8 5 9± 9 44岁 ;术前裸眼视力 0 0 1～ 0 2 ,矫正视力 0 0 5～ 1 0 ;平均近视度 (-19 47± 5 41)D ,平均眼轴长(3 0 45± 1 94)mm ,平均植入人工晶状体屈光度数 (+ 3 96± 4 2 7)D。术后平均随访时间 16个月。结果 :术后裸眼视力均好于或等于术前矫正视力。术后裸眼视力≥ 0 5者 79眼 (74 5 % )。术后矫正视力≥ 0 5者 99眼 (93 4% )。术后平均屈光度 (-1 49± 1 11)D。发生后囊膜混浊及玻璃体前界膜混浊 8眼 ,无视网膜脱离及黄斑囊样水肿发生。结论 :表麻下小切口透明晶状体吸出及人工晶状体植入术矫正高度近视 ,安全有效 ,预测性好 ,视力稳定。

Objective:To evaluate the postoperative outcomes of clear lens extraction and PC-IOL implantation under the topical anesthesia for the patients with high myopia. Methods:106 eyes of high myopia had clear lens extraction and IOL implantation in the capsular bag.Phacoemulsification was used but no ultrasonic power.The mean refractive error was (-19 47±5 41) D,mean axial length was (30 45±1 94) mm,and the mean diopter of IOL was (+3 96±4 27) D.Average follow-up was 16 months. Results:The postoperative uncorrected visual acuity improved or equaled to the preoperative corrected visual acuity in all cases.Uncorrected visual acuity achieved 0 5 or better was found in 74 5% of eyes.The mean postoperative spherical equivalent was (-1 49±1 11) D.The postoperative complication was membrana vitreous anterior opacification (MVAP) and posterior capsular opacification (PCO) (8 eyes,7 55%).No retinal detachment and cystoid macular edema were observed. Conclusions:Clear lens extraction and IOL implantation through a small incision with topical anesthesia might be a safe,effective,stable,predictable method to correct high myopia.