单切口植入有晶状体眼后房型人工晶状体治疗高度近视

目的：评价单切口有晶状体眼后房型人工晶状体植入术治疗高度近视的有效性和安全性。

方法：对9例18眼高度近视患者行有晶状体眼后房型人工晶状体植入术。术后随访3～9mo，观察手术前后裸眼视力、最佳矫正视力、屈光度、散光变化、眼压、内皮细胞计数等。

结果：所有患者成功植入眼内接触镜(implantable contact lens，ICL)，18眼手术前后平均屈光度分别为-13.38±-5.32，

-0.25±0.38D； 手术前后裸眼视力分别为0.06±0.04，0.6±0.2； 最佳矫正视力分别为0.5±0.3，0.7±0.3； 术后裸眼视力和最佳矫正视力均明显好于术前(P<0.05)。术前平均眼压为13.23±3.18mmHg，术后平均眼压为15.03±1.25mmHg； 内皮细胞计数术前为3 008±298个/mm²，术后为2 896±246个/mm²； 前房深度术前平均为3.56±0.29mm，术后为3.68±0.37mm，角膜散光术前0.52±0.30D，术后角膜散光0.67±0.45D，差异均无统计学意义(P>0.05)。

结论：单切口植入有晶状体眼后房型人工晶状体矫正高度近视近期临床效果有效、可靠，具有手术操作风险低、眼表损伤小、成本低、术源性散光小的优点，为一种适用的手术方式。

Implantation of phakic posterior chamber intraocularlens for high myopia by a single incision

AIM: To evaluate the efficacy and safety of implantation of phakic posterior chamber intraocular lens for high myopia by a single incision.

METHODS: Phakic posterior chamber intraocular lens implantation surgery by a single incision was performed in 9 patients(18 eyes)with high myopia. All patients were followed up for 3 to 9 months to record the clinical ocular data including uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), diopter, astigmatism, intraocular pressure, the number of endothelial cell etc. before and after surgery.

RESULTS: Phakic posterior chamber intraocular lens were implanted successfully in all the operative eyes. The mean preoperative diopter was(-13.38±-5.32)D, and postoperative diopter was(-0.25±0.38)D. All eyes of the preoperative and postoperative uncorrected visual acuity(UCVA)and the best corrected visual acuity(BCVA)were 0.06±0.04, 0.6±0.2, 0.5±0.2, 0.7±0.3 respectively. It was obvious that postoperative UCVA and BCVA were better than the preoperative UCVA and BCVA(P<0.05). The mean preoperative and postoperative IOP was(13.23±3.18)mmHg,(15.03±1.25)mmHg, respectively. The cornea endothelial cell density was(3008±298)/mm² before operation and(2896±246)/mm² after operation; average preoperative anterior chamber depth was(3.56±0.29)mm; postoperative anterior chamber depth was(3.68±0.37)mm; preoperative corneal astigmatism was(0.52±0.30)D and postoperative refractive cylinder was(0.67±0.45)D, showing no statistical differences(P>0.05).

CONCLUSION: Phakic posterior chamber intraocular lens implantation for high myopia by a single incision is a reliable and effective method with low risk, small ocular surface injury, low cost and small astigmatism induced by surgery. It can be a suitable operation method.