高度近视白内障超声乳化吸除人工晶状体植入术

目的 :评价高度近视白内障超声乳化吸除人工晶状体植入术临床疗效。方法 :对高度近视白内障 48例 ( 5 6眼 )行超声乳化吸除人工晶状体植入术 ,本组眼轴为 2 6.5 0mm～ 3 2 .80mm ,平均 2 9.2mm。观察术中、术后并发症 ,术后视力 ,随防 6mon～ 2 6mon ,平均 17.6mon。结果 :术后 5 5只眼视力有不同程度提高 ,视力≥ 0 .3者 46眼 ( 82 .14% )。以视力≥ 0 .5为标准 ,眼轴 2 6.5mm～ 3 0mm组有 13眼 ( 40 .0 6% ) ,>3 0mm组有 4眼 ( 16.67% ) ,差异有显著性 ( χ2 =5 .3 6,P <0 .0 5 )本组术中无并发症发生 ,术后早期有轻度角膜水肿 13眼 ( 2 3 .2 % ) ,前房纤维素性渗出 2眼 ( 3 .5 7% ) ,急性迟发性葡萄膜炎 1眼 ( 1.78% )。随访期内 2 6眼 ( 46.43 % )发生后囊混浊 ,仅 2眼 ( 7.69% )需行Nd :YAG激光切开术 ,无视网膜脱离、黄斑囊样水肿发生。结论 :高度近视白内障超声乳化吸除人工晶状体植入术安全、有效 ,但眼轴 >3 0mm者术后视力恢复程度较差

Phacoemulsification with intraocular lens implantation for cataract with high myopia

Objective: To assess the therapeutic effect of phacoemulsification with intraocular lens ( Iol ) implantation for Cataract with high myopia.Methods: phacoemulsification and Iol implantation were performed on 48 cases (56 eyes) with high myopia, the average axial length of eyeballs measured was 29.2mm ( 26.50mm～ 32.80mm ) . Intraoperative and postoperative complication, visual acuity were observed with follow-up visits for 6 to 26months (average 17.6 months) .Results: Postoperation the visual acuity of 55 eyes were improved to different extent ,that of 46 eyes was over or equaled to 0.3(82.14%). With the standard of visual acuity≥0.5 , there were 13 eyes ( 40.06% ) with axial length of eyeballs 26.5mm～30mm , while there were 4 eyes ( 16.67% ) with axial length of eyeballs over 30mm. Difference of visual acuity between the two groups was statistically signifcent. No intraoperative complication occurred. Slight corneal edema was found in 13 eyes (23.12%) , and anterior chember fibrin was observed in 2 eyes ( 3.57% ) on early days after surgery . The delayed acute uveitis occurred in one eye (1.78% ). 26 eyes ( 46.43% ) developed to posterior capsule opacification during follow-up. Nd: YAG laser capsulotomy was needed only in 2 eyes(7.69%) . Retinal detachment and yellow macula edema were not observed.Conclusion: Phacoemulsification with intraocular lens implantation for cataract with high myopia is safe and effective, while the recovery of visual acuity postoperative for eyes with axial lengths over 30mm is less satisfactory.