眼轴超长白内障超声乳化术后临床观察

目的探讨白内障超声乳化吸除联合人工晶状体植入术治疗眼轴超长白内障的临床疗效。方法对71例(101眼)眼轴超长合并白内障患者和同期的70例(98眼)单纯老年性白内障患者(对照组)行超声乳化吸除联合人工晶状体植入术。观察术中术后并发症、术后视力、术后眼压等。随访时间5～12个月。结果高度近视组眼轴长度26.04～34.81 mm,术中后囊膜破裂3眼(2.97%),术后3个月最佳矫正视力(BCVA)≥0.5者55眼(54.46%),0.3～0.4者20眼(19.80%),0.1～0.25者20眼(19.80%),<0.1者6只眼(5.94%),术后早期角膜水肿19眼(18.81%),晶状体后囊膜浑浊6眼(5.94%),一过性眼压升高者9眼(8.91%),术中及术后无视网膜脱离者,术后最佳矫正视力与眼轴长度差异有统计学意义(P<0.05);对照组眼轴长度21.48～24.76 mm,术中后囊膜破裂2眼(2.04%),术后3个月最佳矫正视力≥0.5者86眼(87.76%),0.3～0.4者10眼(10.20%),0.1～0.25者1眼(1.02%),<0.1者1眼(1.02%),术后早期角膜水肿18眼(18.37%),晶状体后囊膜浑浊4眼(4.08%),一过性眼压升高者10眼(10.20%),术中及术后无视网膜脱离者,术后最佳矫正视力与眼轴长度差异无统计学意义(P>0.05)。结论眼轴超长白内障患者行超声乳化白内障吸除术后视力的恢复较非高度近视患者差,眼轴过长导致的眼底病变可能是术后视力不良的主要原因,白内障超声乳化吸除联合人工晶状体植入术治疗眼轴超长白内障是安全有效的。

Clinical observation of cataract with long ocular axis after phacoemusification

Objective To evaluate the clinical effects of phacoemulsification and intraocular(IOL)implantation for treatment of cataract with long ocular axis.Methods Seventy-one(101eyes) of cataract with long ocular axis and seventy(98 eyes)age-related cataract(control group)received phacoemulsification and intraocular(IOL) implantation.Intraoperative and postoperative complications,visual acuity and postoperative intraocular pressure were observed.The follow-up period was 5 to 12 months.Results In the high myopia(cataract with long ocular axis)group,the length of axis oculi was 26.04~34.81 mm,posterior capsular rupture was found in 3 eyes(2.97%).During 3 months of follow-up the corrected visual acuity was more than 0.5 in 55 eyes(54.46%),0.3~0.4 in 20 eyes(19.80%),0.1~0.25 in 20 eyes(19.80%),less than 0.1 in 6 eyes(5.94%),early corneal edema in 19 eyes(18.81%),postoperative posterior capsular opacity in 6 eyes(5.94%),a transient increased intraocular pressure in 9 eyes(8.91%),no retinal detachment was seen,there was statistical significance between the postoperative visual acuity and the axis oculi(P<0.05);In the control group,the length of axis oculi was 21.48~24.76 mm,posterior capsular rupture was found in 2 eyes(2.04%),during 3 months of follow-up the corrected visual acuity was more than 0.5 in 86 eyes(87.76%),0.3~0.4 in 10 eyes(10.20%),0.1~0.25 in 1 eyes(1.02%),less than 0.1 in 1 eyes(1.02%),early corneal edema in 18eyes(18.37%),postoperative posterior capsular opacity in 4 eyes(4.08%),a transient increased intraocular pressure in 10 eyes(10.20%),no retinal detachment was seen,there was no statistical significance between the postoperative visual acuity and the axis oculi(P>0.05).Conclusion Postoperative visual acuity of the cataract with long ocular axis group is short than the control group,it is closely associated with fundus pathology.It is safe and effective for cataract with long ocular axis patients to implant IOL after phacoemulsification.