白内障超声乳化摘出及后房折叠型人工晶状体植入术治疗高度近视合并白内障

目的　评价高度近视合并白内障行超声乳化摘出及后房折叠型人工晶状体植入术的疗效。方法　对４６例（７７眼）高度近视合并白内障患者施行透明角膜切口超声乳化吸出术，通过３．２ｍｍ切口植入后房折叠型人工晶状体。于术后１周、１个月、３个月、６个月随访复查，比较手术前后最佳矫正视力、球镜度数、柱镜度数、角膜曲率、角膜内皮细胞计数和眼轴长度的变化。结果　手术均顺利完成，人工晶状体１００％囊袋内植入。术后１周、１个月、３个月、６个月最佳矫正视力≥０．５者分别有５９眼、６０眼、６５眼和６５眼。术后６个月患者球镜度数、柱镜度数、角膜曲率、眼轴长度、角膜内皮细胞计数分别为（ －１．０４±０．５９）Ｄ、（－０．２３±１．１４）Ｄ、（４３．７２±１．１６）Ｄ、（２８．４６±１．７７）ｍｍ、（２０４１±８２５）个·ｍｍ－２。与术前相比，球镜度数、角膜内皮细胞计数两项差异具有统计学意义（均为Ｐ＜０．０５）。结论　超声乳化摘出及后房折叠型人工晶状体植入术治疗高度近视合并白内障效果良好，术后视力恢复快、屈光状态稳定。

Phacoemulsification and foldable posterior chamber intraocular lens implantation for high myopia and cataract

Objective To evaluate the therapeutic effects of phacoemulsification and foldable posterior chamber intraocular lens ( IOL) implantation for high myopia and cataract. Methods Phacoemulsification with foldable posterior chamber IOL implantation was performed on 77 eyes of 46 cataract patients with high myopia through a 3. 2 mm small corneal incision. A1l patients were followed at the point of I week, I month ,3 months and 6 months after surgery. The best corrected visual acuity, mean diopter of spheres , keratometry, corneal endothelium . axial length before and after surgery were compared. Results All surgeries were finished smoothly. The IOL were all implanted in the capsular bag. Postoperatively , the best corrected visual acuity equal t0 0. 5 0r better at I week.l month.3 months and 6 months were in 59 eyes,60 eyes,65 eyes and 65 eyes,respectively. The parameters of mean diopter of spheres, mean diopter of columns , corneal curvature , ocular axial length , corneal endothelial cell density at postoperative 6 months were ( - 1. 04 +0. 59) D. ( - 0. 23 + 1. 14 ) D, (43. 72 + 1. 16 ) D. ( 28. 46 + 1. 77 ) mm. (2041 + 825 ) cells . mm . , respectively. There was significant differences in diopter of sphere and corneal endothelial cell density between pre-operation and post-operation( both P < 0. 05 ) . Conclusion Phacoemulsification and foldable posterior chamber IOL implantation for high myopia and cataract has the better efficacy , the postoperative visual acuity recovery is rapid , and the postoperative refraction is stable.