高度近视眼合并白内障低负度数人工晶体植入的临床观察

Phacoemulsification and Low or Negative Powered Posterior Chamber Intraocular lens Implantation in High Myopia and Cataract

目的:评价高度近视眼合并白内障行超声乳化白内障摘除并低、负度数人工晶体植入的疗效。方法63例68眼高度近视眼合并白内障行反眉状隧遂道式自闭性切口行超声乳化摘除术,5.5mm切口植入人工晶体,眼轴26mm-30mm者38眼,>30mm者30只眼。随访0.5年-2年,观察超声能量、时间、术后不同眼轴视力和并发症。结果:眼轴26mm-30mm组术后3月视力≥0.5者34只眼,占89.5％;>30mm组术后3月视力≥0.5者15只眼,占50.0％。后囊膜破损并玻璃体溢出3只眼(4.4％)半年后发生视网膜脱离2只眼(2.9％),角膜水肿11只眼(16.1％)。术后3个月视力比较有显著性差异(p<0.05)。结论:高度近视眼合并白内障行超声乳化白内障摘除并低、负度数人工晶体植入术可提高患者视力,改善视功能,但>30mm组效果较差。

Objective: To evaluate the therapeutic effect of phacoemulsification and low or negative powered posterior chamber intraocular lens implantation in high myopia and cataract. Methods: Phacoemulsification and intraocular lens implantation were performed on 68 eyes of 63 patients with high myopia and cataract through an against frown shape scleral tunnel incision, a PMMA IOL inserted through a 5.5mm incision. There were two groups between 26mm^30mm axial lens group and >30mm group. The phaco energy and duration were observed. Postoperative visual acuity and complications were assessed after 6 months to 2 years follow-up. Results: 34 eyes (89.5%) of visual acuity after 3 months were higher 0.5 in the first group, while only 15 eyes (50.0%) were similar situation in second group. There were 3 eyes of posterior capsular damage and vitreous body emersion, including 2 eyes with retinal detachment 6 months later, and 11 eye (16.1%) with corneal edema. 3 months later the visual acuity was evidently different (P<0.05). Conclusion: The visual acuity and visual function could be promotied by phacoemulsification and low or negative powerd posterior chamber intraocular lens implantation in high mtopia and cataract, whereas the effect of 26mm-30mm group are better than the >30mm group.