Long-term vision-threatening complications of phakic intraocular lens implantation for high myopia

AIMTo report the long-term vision-threatening complications in patients who underwent phakic intraocular lens (pIOLs) implantation for high myopia.

Posterior chamber phakic intraocular lens implantation for high myopia

AIM:To evaluate the efficacy,safety and stability of posterior chamber phakic intraocular lens implantation for the correction of high myopia.METHODS:Retrospective case review of 82 eyes(43patients)undergoing implantable Coliamer lens(ICL)placement by a single surgeon(Xiao-Wei Gao)to correct preoperative mean spherical equivalents between-9.00diopter(D)and-23.00D.Main outcome measures included uncorrected visual acuity(UCVA),refraction,best spectacle-corrected visual acuity(BSCVA),endothelial cell density(ECD),intraocular pressure(IOP),lens transparency,postoperative uveitis.Visante anterior segment optical coherence tomography(AS-OCT)was used to measure anterior chamber depth(ACD)and the position of ICL.RESULTS:Mean follow-up was 6.54±3.26 months(range 3-12 months).Predictability of the manifest spherical equivalent(SE)refraction to within±1.OOD was achieved in 88%of eyes and±0.50D in 72.5%of eyes.The mean postoperative manifest SE refraction was-1.85±0.72D,with 96.34%of eyes maintaining or gaining≥1 line(s)of BSCVA.The mean 3-month postoperative ECD decreased but had no statistically difference compared with the preoperative ECD.Of the 7 eyes(8.54%)with a mild transient increase in intraocular pressure(up to 30mmHg),none required a second surgical procedure or prolonged topical medication.There was no loss of lens transparency.Pigmented precipitates were observed in 5 eyes(6.09%).The mean preoperative ACD measured with AS-OCT was 3.28±0.14mm,three months after surgery,the mean ACD was2.45±0.22mm.Anterior chamber depth showed astatistically significant reduction.One eye(1.22%)had ICL spontaneous rotation,81 eyes(98.78%)of the lens remained correctly centered.CONCLUSION:The implantation of ICL is an effective surgical option for the management of high myopia.But its long time effect and safety still need more time to prove.

Clinical Effect Analysis of Posterior Chamber Intraocular Lens Implantation for Correcting High Myopia and Astigmatism

Objective:To explore the corrective effect of posterior chamber intraocular lens implantation with phakic eyes in the treatment of high myopia and astigmatism.Methods:From May 2023,the hospital began to collect the case data of diagnosis and treatment of high myopia and astigmatism.By May 2024,310 cases were included,all of which were treated with posterior chamber intraocular lens implantation.The visual acuity,astigmatism and axial position of the intraocular lens were observed before and after treatment.Results:At different time points after the operation,the patient’s vision was significantly improved compared with that before the operation(P<0.05),and the vision level was equal to or greater than the best-corrected vision before the operation.At different time points after the operation,the average rotation of the intraocular lens was less than 5 degrees.Astigmatism was significantly lower than that before the operation(P<0.05).After the operation,the intraocular pressure increased in 11 cases,accounting for 3.55%,with no adverse complications such as lens turbidity,glare and obvious halo occurring.Conclusion:The posterior chamber intraocular lens implantation with phakic eyes has an ideal correction effect in the treatment of high myopia and astigmatism,which can effectively improve the vision level of patients and reduce the degree of astigmatism,and has high effectiveness and safety.

AcrySof phakic angle-supported intraocular lens for the correction of high to extremely high myopia:one-year follow-up results

AIM: To assess the safety, efficacy and predictability of the AcrySof phakic angle-supported intraocular lens (IOL) (Alcon Inc., U.S.A.) for correction of high-to-extremely high myopia in adults. METHODS: In this prospective study performed in Tianjin Medical University Eye Center & College of Optometry, Tianjin, China, 25 eyes of 13 patients were implanted with AcrySof phakic angle-supported IOLs and followed for 1 year postoperatively. Preoperative manifest refractive sphere was (-12.08 +/- 2.44) diopters (D) and cylinder was (-1.35 +/- 0.62)D. Visual acuity, predictability and stability of manifest refraction spherical equivalent (MRSE), adverse events, and endothelial cell density were analyzed during 1-year of follow-up. RESULTS: After 1 year of follow-up, no eyes lost 1 line (best spectacle-corrected visual acuity)BSCVA; an uncorrected visual acuity (UCVA) of 20/20 or better was achieved in 60% of eyes; 100% had an UCVA of 20/40 or better; a BSCVA of 20/30 or better was achieved by 100% of eyes; 84% had a BSCVA of 20/20 or better. The overall mean percentage change in endothelial cell density 1 year after surgery was (-0.27 +/- 3.60)%. Two eyes (8%) had increased intraocular pressure (IOP) on the day of surgery. No pupil ovalization, pupillary block, or retinal detachment events were observed. CONCLUSION: After 1 year of follow-up, the implantation of AcrySof phakic angle-supported IOL is proved to be safe, effective and predictable with minimal complications in patients with high-to-extremely high myopia. Due to the limitation of visiting time, long-term of clinical investigation is necessary to verify the safety and efficacy of this IOL.

Short and long-term outcomes of angle supported phakic intraocular lens implantation in high myopic eyes

This cohort study included 36 eyes of 21 patients with high myopia treated with angle supported phakic intraocular lens（p IOL）.Endothelial cell density（ECD） at baseline,6 mo and 3 y were 3017±296,2775±265 and 2558±299 cells/mm^2 respectively.ECD loss at 6 mo was 7.2% and annual ECD loss was 3% over 36 mo.Corrected distance visual acuity at 36 mo was 0.4 log MAR or better in 32（88.9%） eyes.Intraocular pressure did not change（P=0.9）.No eyes developed cataract,retinal detachment or pupillary distortion.Angle supported p IOL gives good visual outcome.Endothelial cell loss should be monitored.

Macular hole following phakic intraocular lens implantation:A case report

BACKGROUND Phakic intraocular lens(pIOL)implantation has been commonly prescribed and is considered as a safe and effective option for correcting high myopia.However,it is associated with multiple complications.CASE SUMMARY This report describes a case of full-thickness macular hole(MH)in a patient with a history of bilateral pIOL implantation for the correction of myopia of–12.00 diopters in both eyes 7 mo ago.The MH closed after pars plana vitrectomy with internal limiting membrane removal and the best-corrected visual acuity improved to 20/40 in the left eye.CONCLUSION In rare cases,MH can occur following pIOL.In this present case report,we analyzed the formation process of MH following the surgery and emphasized that it is important to inform highly myopic patients about the risk of MH occurrence while being aware of the symptoms of this complication.

One-step viscoelastic agent technique for ICL V4c implantation for myopia

AIM:To investigate the safety and efficacy of using a onestep viscoelastic agent technique for posterior chamber phakic implantable collamer lens with a central hole(ICL V4 c)implantation for myopia correction.METHODS:The one-step viscoelastic agent technique for ICL V4 c implantation was used in 100 eyes of 52 patients.Refractive outcomes,intraocular pressure(IOP),corneal endothelial cell,and corneal densitometry values were evaluated at 1 d,1 wk,1 and 3 mo postoperatively.RESULTS:All the surgeries were uneventful.No corrected distance visual acuity was lost after 3 mo.IOP was 16.12±3.18 mm Hg before surgery,and 14.74±3.08 mm Hg at 1d and 14.50±2.56 mm Hg at 3 mo after surgery(P<0.05).Corneal endothelial cell density was 2580±242 cell/mm^(2),the coefficient of variation in cell size was 42.11%±7.92%,and the percentage of hexagonal cells was 40.98%±9.46%before surgery.No significant difference was found when these outcomes were compared between the studied time points(P>0.05).The corneal densitometry values of the central 2 mm and 2 to 6 mm areas showed similar regularities.After surgery,the values significantly increased at 1 d,then decreased to the preoperative values at 1 wk,and then continued to decrease at 3 mo(P<0.05).CONCLUSION:The one-step viscoelastic agent technique for ICL V4c implantation is found to be safe and effective for myopia correction and causes little disturbance to the cornea.

Five‑year outcomes of EVO implantable collamer lens implantation for the correction of high myopia and super high myopia

Background:To evaluate the long-term safety,efficacy,predictability,and stability of implantable collamer lens with a central hole(EVO ICL)implantation for correcting high myopia(HM)and super high myopia(SHM).Methods:This prospective study evaluated 83 eyes of 46 patients who were divided into groups based on their spherical equivalent refractive error(SE):HM group(−12 D≤SE<−6 D)and SHM group(SE<−12 D).They were followed up for 5 years after ICL implantation;assessments of uncorrected distance visual acuity(UDVA),corrected distance visual acuity(CDVA),manifest refractive error,axial length,intraocular pressure,corneal endothelial cell density,and vault were conducted,and a questionnaire was administered.ResuIts:At 5 years postoperatively,the safety indices of the HM and SHM groups were 1.03±0.10 and 1.32±0.39,and the efficacy indices were 0.83±0.25 and 0.86±0.32,respectively.In the HM group,60.47%and 79.07%of the eyes were within±0.50 D and±1.00 D of the attempted correction,while it was achieved for 22.50%and 47.50%of the eyes in the SHM group,respectively.The SE of the HM group decreased from−9.72±1.41 D preoperatively to 0.04±0.39 D 1 month postoperatively and−0.67±0.57 D 5 years postoperatively,while in the SHM group,it decreased from−15.78±3.06 D preoperatively to−0.69±0.97 D 1 month postoperatively and−1.74±1.19 D 5 years postoperatively.Conclusion:EVO ICL implantation is safe,effective,and predictable for correcting HM and SHM.CDVA improved more after surgery for SHM,but the growth of axial length still needs attention.

高度近视有晶状体眼后房型人工晶状体植入术后患者视力恢复的影响因素

目的 探讨高度近视有晶状体眼后房型人工晶状体(ICL)植入术后患者视力恢复的影响因素。方法 前瞻性研究。选取2021年5月至2023年3月郑州大学第二附属医院收治的210例(420眼)行ICL植入术的高度近视患者作为研究对象。根据术后3个月视力恢复情况将患者分为恢复良好组(最佳矫正视力恢复≥0.3 D)、恢复不良组(最佳矫正视力恢复<0.3 D)。比较两组患者基线资料,采用Logistic回归分析影响患者视力恢复的因素,采用受试者工作特征曲线(ROC)分析Logistic回归模型对高度近视患者ICL植入术后视力恢复不良的预测价值。结果 术后3个月,恢复良好组的患者共149例298眼,恢复不良组的患者共61例122眼。两组患者性别、年龄、近视年限、体重指数、学业情况比较,差异均无统计学意义(均为P>0.05)。恢复不良组患者角膜散光度<1.30 D占比(55.74%)、角膜屈光度<45 D占比(59.02%)、匹茨堡睡眠质量指数(PSQI)<7分占比(63.93%)、中央平均曲率半径[(7.82±0.27) mm],均低于恢复良好组[83.89%、81.88%、85.91%及(7.90±0.24)mm],角膜前表面中央扁平子午线曲率(k1)[(43.27±1.43)D]、角膜前表面陡峭子午线曲率(k2)[(44.84±1.53)D]、拱高[(628.49±67.28)μm]均高于恢复良好组[(42.73±1.42)D、(44.12±1.47)D、(417.56±80.14)μm],差异均有统计学意义(均为P<0.05)。Logistic回归分析结果显示,角膜散光度、角膜屈光度、k1、k2、拱高、睡眠PSQI评分均为高度近视患者ICL植入术后患者视力恢复不良的独立影响因素(均为P<0.05)。ROC曲线分析显示,Logistic回归模型预测高度近视患者ICL植入术后视力恢复不良的ROC曲线下面积为0.938(95%CI:0.896~0.966),敏感度为83.61%,特异度为91.95%(P<0.05)。结论 角膜散光度、角膜屈光度、k1、k2、拱高、睡眠PSQI评分等均可影响高度近视ICL植入术后患者视力恢复,基于上述因素构建的Logistic回归模型对ICL植入术后患者视力恢复有较高预测价值。

Phakic 6H型有晶状体眼前房型人工晶状体植入矫正高度近视术后角膜内皮细胞密度临床观察

目的观察Phakic 6H型有晶状体眼前房型人工晶状体(ACP-IOL)植入矫正高度近视手术后远期角膜内皮细胞密度,并评价手术的安全性。方法收集2001年9月—2006年3月间行Phakic 6H型ACP-IOL植入术矫正高度近视患者共170例(283眼),经连续随访,对最终行ACP-IOL取出的7例(7眼)患者的临床资料进行回顾性分析。使用SP-2000P型角膜内皮显微镜定期测量角膜中央、上方、下方、颞侧及鼻侧5个方位的角膜内皮细胞密度。结果 7例患者平均随访时间为5年,6例平均角膜内皮细胞丢失数为2 105个/mm2,平均丢失率为73.71%(1例因角膜失代偿无法测量出内皮细胞密度)。4例行ACP-IOL取出+透明晶状体摘除+后房型人工晶状体(IOL)植入,1例行ACP-IOL取出+超声乳化白内障吸除+后房型IOL植入,2例行ACP-IOL取出。结论 Phakic 6H型ACP-IOL对角膜内皮的远期影响可致角膜内皮功能临界失代偿甚至失代偿,发现角膜内皮功能处于临界失代偿或内皮有明显损伤时须尽快取出ACP-IOL。

20G灌注头辅助下无粘弹剂植入V4c-ICL矫正对高度近视早期调节功能的影响

目的:探讨20G灌注头辅助下无粘弹剂植入有晶状体眼后房型人工晶状体(V4c-ICL)对高度近视(HM)患者早期调节功能的影响。方法:选取HM患者493例(986眼)作为研究对象,按手术方式不同分为V4c-ICL植入术组(研究组,n=247)和全飞秒小切口基质透镜取出术(SMILE)组(对照组,n=246)。随访两组患者术前、术后1个月视力[裸眼视力(UDVA)、最佳矫正视力(BCVA)]、眼压、调节功能[正负相对调节(PRA/NRA)、单眼调节幅度(M-AMP)、远近水平隐斜、调节性集合与调节比值(AC/A)],行国家眼科研究所视功能问卷-25(NEI-VFQ-25)评分,记录并发症情况。结果:术后1个月,两组患者UDVA、BCVA均较术前升高,眼压降低(P<0.05),但两组间比较,差异无统计学意义(P>0.05);两组PRA、远近水平隐斜、AC/A比值较术前降低,M-AMP升高,其中研究组PRA、远水平隐斜、AC/A比值低于对照组,M-AMP高于对照组(P<0.05);两组NEI-VFQ-25评分均较术前升高(P<0.05),其中研究组除色觉(CV)维度外,其余各维度评分均高于对照组(P<0.05)。两组并发症总发生率比较,差异无统计学意义(P>0.05)。结论:SMILE与20G灌注头辅助下无粘弹剂下V4c-ICL矫治HM均可获得良好的术后视力,但相比SMILE,无粘弹剂下V4c-ICL可获得更好的双眼调节功能,改善患者视觉相关生活质量,值得临床优先选择。

ICL植入术后拱高的预测及研究进展

近视被认为是在遗传-环境等因素影响下产生的一种疾病,只能通过矫正手术恢复视力,目前的手术方式有角膜激光手术和有晶状体眼人工晶状体植入手术(PIOL),其中PIOL具有矫正范围广、可重复手术、对角膜组织损伤小等优点,植入人工晶状体后就可获得较好的视力改善,可植入折叠透镜(ICL)植入术是目前其在临床上最常见的手术方式。植入人工晶状体的后表面中心最高点与晶状体前囊膜表面的垂直距离被称为拱高,如果拱高异常则会带来严重并发症,术前可以通过多项检查来预测术后拱高,截至目前尚无最佳预测方式,本文以拱高为中心,讨论术后拱高的理想范围,手术的安全性及有效性,并对现有预测方式做出分析,为日后的临床研究提供方向。

依镜PRL植入术矫正超高度近视的临床疗效观察

目的:观察依镜有晶状体眼后房屈光晶体(phakic refractive lens,PRL)植入术矫正超高度近视的疗效和安全性。方法:纳入自2018年1月—2020年9月在深圳市眼科医院行依镜PRL植入术的超高度近视患者共24例39眼,进行自身对照研究。其中,男8例13眼,女16例26眼,平均年龄(31.15±6.33)岁。观察术后屈光度、视力[裸眼视力(uncorrected visual acuity,UCVA)、最佳矫正视力(best corrected visual acuity,BCVA)]、眼压、角膜内皮细胞计数、拱高、手术并发症等指标。结果:中位随访时间为5.5(3.0,11.0)月。屈光度从术前(-22.29±4.96)D降低至术后(-0.28±1.01)D(t=24.421,P<0.001),其中术后球镜度数±0.5 D占28眼(82.4%),±1.0 D占31眼(91.2%)。LogMAR UCVA从术前1.40(1.30,1.70)改善至术后(0.28±0.20)D,LogMAR BCVA由术前0.40(0.22,0.70)改善至术后0.15(0.00,0.30),差异均有统计学意义(均P<0.001)。术后BCVA较术前提高3.00(1.00,5.00)行,所有患者均无BCVA丢失。术前、术后1 d、末次随访眼压值比较差异有统计学意义(F=8.779,P=0.012),其中术后1 d较术前眼压增高(Z=-3.401,P=0.001),而末次随访较术后1 d眼压降低(Z=-2.685,P=0.007),末次随访与术前眼压之间比较差异无统计学意义(Z=-0.894,P=0.371)。角膜内皮细胞计数从术前(2782.20±296.30)个/mm^(2)降低至术后(2472.54±394.32)个/mm^(2)(t=-5.437,P<0.001),平均丢失角膜内皮细胞数11.2%。末次随访33眼平均拱高值为(379.00±283.27)μm,其中0~250μm占12眼(36.4%),250~750μm占19眼(57.6%),大于750μm占2眼(6%)。21眼PRL术后3个月拱高值为(269.81±194.67)μm,较术后1个月拱高值(373.62±195.75)μm降低(t=-2.917,P=0.009)。术后并发症包括激素性青光眼(1例2眼)、PRL光学面裂痕(1眼)、黄斑出血(1眼)、PRL偏位(2例3眼)。结论:对于超高度近视患者,依镜PRL植入术是一种可供选择的安全、有效的眼内屈光手术方式,但其远期疗效及安全性仍需更长时间和更大样本量进一步观察。

硬性和可折叠前虹膜固定人工晶状体植入治疗亚洲眼高度近视的疗效比较

目的:比较Artisan和Artiflex有晶状体眼人工晶状体(PIOL)矫正亚洲人群高度近视的屈光度和安全性。方法:历史队列研究。回顾2016/2020在印度尼西亚日惹市Yap眼科医院接受PIOL植入术的81例高度近视眼。根据植入PIOL分为Artisan组43眼,Artiflex组38眼。分别记录术前及术后1d、1、3mo的视力、角膜生物显微镜参数和眼压,包括术前前房深度。结果:Artisan和Artiflex组的平均随访时间分别为9.64±6.93mo和8.96±4.28mo(P=0.736)。Artisan组的疗效指数为1.03±0.47,Artiflex组为1.02±0.17(P=0.119);安全性指数分别为1.10±0.45和1.05±0.21(P<0.001)。Artisan组的平均等效球镜度(SE)为-0.64±0.996D,Artiflex组为-0.22±0.58D(P=0.076)。两组术后内皮细胞密度(ECD)较术前均显著下降(P<0.05),累积ECD缺失率为7.44%和5.79%(P=0.418)。结论:Artisan和Artiflex矫正亚洲人高度近视的屈光效果相当。与Artiflex相比,Artisan的安全指数略高,而两组的疗效指数和累积ECD缺失率相似。

PC-PRL植入术治疗超高度近视的研究进展

有晶状体眼后房型人工晶状体植入术是在后房植入有屈光力的人工晶状体来矫正屈光不正,其有效性、安全性、稳定性和可预测性高。依镜—有晶状体眼后房屈光晶状体(PC-PRL)是一种悬浮型人工晶状体,具有良好视觉效果、调节可得到维持、安全、可逆等优势,成为大多数高度、超高度近视患者的选择,术后的疗效受到越来多人的关注。此文就手术优势、晶状体的设计、术后的视力、屈光度、拱高、眼压、角膜内皮细胞计数、视觉质量及光学结果等方面作一概述。

ICL植入术与FS-LASIK矫治中高度近视的临床疗效比较

目的:探讨中高度近视患者采用人工晶状体(ICL)植入术与飞秒激光LASIK(FS⁃LASIK)的矫治效果。方法:选取2020年6月至2022年5月本院收治的中高度近视患者83例(166眼),根据治疗方案不同分为ICL植入术组(n=42,84眼)与FS⁃LASIK组(n=41,82眼),分别采用ICL植入术、FS⁃LASIK进行治疗。术后随访3个月,比较两组手术前后裸眼视力、最佳矫正视力、等效球镜和波前像差,包括高阶像差、垂直彗差、水平彗差及球差,记录两组术后并发症发生情况。结果:术前及术后3个月两组患者裸眼视力、最佳矫正视力及等效球镜比较,差异均无统计学意义(均P>0.05)。与术前比较,术后3个月两组患者裸眼视力、最佳矫正视力均提高,等效球镜均降低(均P<0.05)。术前两组患者波前像差比较,差异均无统计学意义(均P>0.05)。术后3个月两组患者垂直彗差对比,差异无统计学意义(P>0.05),而两组患者高阶像差、水平彗差、球差均较术前提高,ICL植入术组以上指标均低于FS⁃LASIK组(均P<0.05)。两组并发症发生率差异无统计学意义(χ^(2)=0.239,P>0.05)。结论:两种术式治疗中高度近视均可显著提高患者视觉质量,获得满意的矫治效果。

有晶状体眼后房型人工晶状体植入联合AK术治疗高度近视及散光的临床疗效

目的研究有晶状体眼后房型人工晶状体(ICL)联合角膜松解术(AK)治疗高度近视及散光的安全性、有效性、预测性。方法对21例(34眼)高度近视患者行有晶状体眼ICL植入术,对其中20眼散光度数≥1.5 D的联合AK术。观察术前及术后1、3、6个月的裸眼视力、最佳矫正视力、屈光度、眼压、内皮细胞密度等。结果所有患者成功植入ICL,手术前后等效球镜分别为(-13.5±2.2)、(-0.30±0.84)、(-0.28±0.86)、(-0.28±0.84)D;术后裸眼视力分别为4.80±0.16、4.81±0.17、4.82±0.17;手术前后最佳矫正视力分别为4.74±0.26、4.86±0.17、4.87±0.17、4.9±0.18,差异有统计学意义(P<0.01);内皮细胞密度术前为(2 871±256)个/mm2,术后为(2 773±267)个/mm2,差异有统计学意义(P<0.01);行AK术眼术前后散光分别为(-2.31±0.64)、(-1.22±0.57)、(-1.02±0.40)、(-0.93±0.39)D,差异有统计学意义(P<0.01)。结论有晶状体眼ICL联合AK术治疗高度近视及散光有较好的安全性、有效性、预测性,长期疗效有待进一步观察。

有晶状体眼人工晶状体Verisyse植入对高度近视患者视觉质量的影响

目的观察高度近视患者有晶状体眼人工晶状体Verisyse植入术后的视觉质量。方法表面麻醉下对54例(54眼)高度近视患者(-12.00^-24.00D)行Verisyse植入术。手术前后分别检查术眼裸眼及矫正视力、对比敏感度及调节力。将各项检查结果进行t检验或单因素方差分析。结果术后所有术眼裸眼远、近视力均达到或高于术前最佳矫正视力;术眼手术前后在3cpd、6cpd、12cpd、18cpd空间频率的对比敏感度有显著性差异,手术后较术前明显提高(P=0.000);术眼术前调节力平均为(2.19±1.36)D,术后3个月调节力平均为(5.27±2.18)D,较术前明显增加(P=0.036)。结论Verisyse眼内植入术提高了高度近视患者的视觉质量。

有晶体眼后房型人工晶体植入矫治高度近视的临床观察

目的评价有晶体眼后房型人工晶体眼内植入治疗高度近视的临床效果。方法回顾性分析2011年9月-2012年3月于解放军总医院眼科行有晶体眼后房型人工晶体植入的高度近视病例41例共80眼,年龄19~41（27.0±6.2）岁,男15例,女26例,植入晶体均为可植入接触镜（implantable contact lenses,ICL）,分别于术前、术后1 d、1周、1个月、3个月、6个月、12个月进行裸眼视力（uncorrected visual acuity,UCVA）、最佳矫正视力（best corrected visual acuity,BCVA）、等效球镜（manifest refraction spherical equivalent,MRSE）、眼压（intraocular pressure,IOP）、角膜内皮计数（endothelial cell density,ECD）、前房深度（anterior chamber depth,ACD）、自然晶体与人工晶体间距离（拱高）检测。结果术后平均随访（12.3±3.1）个月。术后UCVA均提高,平均较术前提高9行,其中≥0.5和≥1.0者分别为91.3%和71.25%;术后所有患者BCVA≥术前BCVA,平均1.05±0.25,其中45眼（56.3%）提高≥1行,18眼（22.5%）提高≥2行,3眼（3.7%）提高≥3行;手术的有效指数和安全指数分别为1.13±0.33和1.25±0.35。等效球镜由术前-11.62±3.37 D降至术后-0.15±0.96 D,术后等效球镜≤1 D和≤0.5 D者分别为87.5%和63.8%;术后1周内一过性高眼压7眼（8.75%）,6眼药物治疗后稳定,1眼因虹膜孔偏小经YAG激光扩孔控制;术前ECD为（2 861±413）个/mm2,术后1个月为（2 682±498）个/mm2,差异无统计学意义（P〉0.05）;术前ACD为（3.21±0.25）mm,术后为（2.91±0.30）mm,差异有显著统计学意义（P〈0.01）;术后1个月拱高为（711±354）μm;其中有8眼（10%）术后拱高过高≥1 000μm,且在术后3个月内有逐渐降低的趋势,有3眼（3.75%）拱高过低≤200μm;术后1眼（1.25%）出现眩光和光晕。结论 ICL矫正高度近视有效、安全、可预测性好,是一种较为理想的手术方式。

新型后房型有晶状体眼IOL植入术治疗伴有低度散光的高度近视

目的:观察伴有低度散光的高度近视眼患者行新型中央孔型有晶状体眼后房型人工晶状体(ICMO V4c)植入术的疗效及安全性,以期为此类患者的临床诊疗提供参考。方法:分析2015-01/2016-12在我院接受ICMO V4c植入术伴有低度散光的高度近视眼患者的临床资料,术后对患者进行1、3、6mo随访,分析比较术前和术后裸眼视力(uncorrected visual acuity,UCVA)和最佳矫正视力(best corrected visual acuity,BCVA)。比较术前和术后屈光度,球、柱镜及显性折射球面镜片等值(manifest refraction spherical equivalent,MRSE)。比较手术前后眼压、角膜内皮计数、前房深度、拱高和术后并发症情况。结果:患者术后UCVA和BCVA较术前均有所好转,手术前后比较差异有统计学意义(P<0.05)。所有患眼术前球镜、柱镜和MRSE在手术后均有所降低,且三组患者手术前后比较,差异均有统计学意义(t=38.510、20.100、34.300,P<0.01)。患者术后1、3mo术眼平均眼压升高(t=3.998、2.837,P<0.05),但术后6mo恢复正常(t=0.383,P>0.05);患者术后3、6mo患眼角膜内皮计数较术前减少(t=2.119、2.411,P<0.05)。患者手术后6mo内前房深度一定程度减少,在术后6mo时较手术后有所恢复,但仍低于术前水平(t=5.850、5.260、2.556,P<0.05)。患者术后患眼拱高整体水平平稳,未见明显波动。手术眼术后并发症发生率较低,积极处理后均有明显改善。结论:新型后房型有晶状体眼IOL植入术治疗合并有低度散光的高度近视眼的治疗效果满意,且并发症较少,是角膜屈光手术的有利补充。