高度近视白内障超声乳化及人工晶状体植入术

Phacoemulsification and intraocular lens implantation in high myopia with cataract

目的 评价高度近视白内障超声乳化吸出及后房型人工晶状体植入的效果。方法 对 78例 (93眼 )老年性、并发性白内障施行巩膜隧道切口超声乳化吸出 ,通过 5 .5～ 6.0mm切口植入PMMA硬性人工晶状体。平均年龄 64 .5岁 ,眼轴长2 6.0 0～ 3 4.66mm ,平均长 (2 9± 2 .0 2 )mm ,其中 2 6～ 3 0mm者 63眼 ,>3 0mm者 3 0眼。随访 6～ 2 0月 ,平均 15月。结果 眼轴2 6～ 3 0mm组术后 3月视力≥ 0 .5者 5 1眼 (80 .95 % ) ,后囊破裂 2眼 (3 17% ) ,悬韧带断裂 2眼 (3 .17% )。眼轴 >3 0mm组视力≥ 0 .5者 14眼 (4 6.67% ) ,后囊破裂 2眼 (6.67% ) ,悬韧带断裂 1眼 (3 3 3 % ) ;视网膜脱离 1眼 (3 .3 3 % )。术后 3月两组视力差异显著。结论 高度近视白内障手术能改善患者的视力 ,降低视网膜脱离的发生。

Objective To evaluate the clinical effect of phacoemulsification and intraocular lens implantation in high myopia with cataract.Methods 93 eyes (78 cases) of senile and secondary cataract with high myopia were extracted with phacoemulsification through 5.5-6 mm tunnel incision and implanted IOL.The average axial length is (29±2.202)mm.63 eyes axial length are 26-30 mm,30 eyes are above 30 mm.All cases were follwoed up 6-20 months,averaging 15 months.Results 80.9% of the patients with ocular axial length of 26 to 30 mm achieved corrected visual acuities of 0.5 or over three months after operating,3.17% of the cases acheved rupture of posterior capsule,3.17% zonular fibers broken,46.67% of the patients with ocular axial length over 30 mm achieved corrected visual acuities of 0.5 or over three months after operationg, 6.67% rupture of posterior capsule,3.33% zonular fibers broken and 3.33% retinal detachment.There is a great significance between two groups.Conclusion Phaconemulsification and intraocular lens implantation could improve the vision of high myopia with cataract.It lower the occurrence rate of the retinal detachment.