高度近视白内障超声乳化术后低视力原因分析

目的:探讨高度近视白内障超声乳化术后低视力原因。方法:研究167例(197只眼)高度近视白内障。按眼轴长度分A组26-30 mm 124眼,B组≥30 mm 73眼,术前最佳矫正视力光感-0.15,屈光度-8.00--24D。行超声乳化白内障,植入折叠型IOL于囊袋内。术后随访1周-12月,观察与术后低视力有关的因素。结果:术后裸眼或矫正视力≥0.5者A组124眼(94.4%),B组12只眼(16.4%),两组比较有显著差异。术中1眼后囊破裂(0.5%),术后24 h一过性高眼压6眼,45眼(22.84%)后发性白内障,7眼行Nd∶YAG激光后囊切开术,2眼视网膜脱离,25例行预防性视网膜光凝术。结论:高度近视白内障超乳+人工晶体植入术后视力主要与眼底病变有关。术前精确计算人工晶体度数;术中保持后囊完整,降低后性白内发障等并发症;术后早期预防性视网膜光凝有助于提高患者术后视力。

Causes of Low Vision After Phacoemulsification and Intraocular Lens Implantation in High Myopia with Cataract

Objective:To discuss the causes of low vision after phacoemulsification and foldable intraocular lens(IOL) implantation in high myopia with cataract. Methods:According to axial lengh,197 eyes with high myopia with cataract were divided into group A(26-30 mm,n=124) and group B(≥30 mm,n=73 eyes).The best corrected visual acuity ranged from LP to 0.15,and diopter was-8.00 D to-24 D before phacoemulsification and intraocular lens(IOL) implantation.All cases were followed up for 1 week to 12 months.Results:The percent uncorrected or corrected visual acuity ≥0.5 was 94.45% in group A versus 16.4% in group B.Posterior capsular rupture occurred in 1 eye(0.5%),high intraocular pressure in 6 eyes,posterior capsular opacity in 45 eyes(22.8%),and retinal detachment in 2 eyes.Nd∶YAG laser capsulotomy was performed in 7 eyes.Prophylactic laser treatment was carried out in 25 eyes.Conclusion:The main cause of the poor vision postoperatively is due to the pathologic changes of retinal in high myopia with cataract.Precisely calculating diopter of IOL,avoiding posterior capsular rupture,decreasing operative complications and prophylactic laser treatment in time are helpful for the protection of vision after the operation.