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1.
目的 评价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、安全性及稳定性.方法 后房型人工晶状体植入术治疗高度近视患者26例(40只眼),随访术前及术后1天、1周及1、6、12个月,随访内容包括裸眼视力、最佳矫正视力、屈光度数、裂隙灯显微镜检查、眼压、角膜内皮计数、Pentacam、光学相干断层成像等,观察屈光状态及术后并发症.结果 所有手术均顺利进行,所有患者裸眼视力均有明显提高,40只眼术前裸眼视力和最好矫正视力分别为0.05+0.02,0.61+0.28;术后分别提高为0.62±0.17,0.62±0.31,术后裸眼视力均明显好于术前(P<0.05).术前平均屈光度为(-18.95±4.73)D,术后1个月平均屈光度为(-0.76±0.75)D.术前角膜内皮细胞数(2917.42+208.36)个/mm2,术后1个月角膜内皮细胞为(2797.03+ 210.25)个/mm2.术前平均眼压为(16.65±4.75) mm Hg,术后第一天眼压为(15.47±4.36) mm Hg.通过Pentacam观察术前前房深度(3.25+0.27) mm,而术后1月复查减少到(2.97+0.19) mm,两者相比较差异具有统计学意义(P<0.05),而以后随访中前房深度没有明显差异.40只眼均未发生瞳孔阻滞性青光眼、晶状体前囊下混浊等并发症.结论 有晶状体眼后房型人工晶状体植入术对高度近视的治疗是一种有效的方法,具有有效性、稳定性及矫正效果好等优点,但需要有更长时间的随访.  相似文献   

2.
目的评价有晶状体眼后房型人工晶状体(ICL)植入术矫治高度近视的临床效果。方法自2009年2月至2011年2月接受ICL植入的高度近视患者82例(160只眼),术前平均屈光度球镜(-13.65±4.25)D,柱镜(-2.65±0.75)D。观察术后裸眼视力、最佳矫正视力、屈光度、内皮细胞计数等情况,分析并发症的发生情况。结果术后裸眼视力:0.5~1.0,平均0.78±0.32。术前最佳矫正视力:0.3~1.0,平均0.59±0.36,术后最佳矫正视力0.79±0.30。达到术前矫正视力92只眼(57.5%),超过术前最佳矫正视力68只眼(42.5%),随访6个月至2年,无明显变化。术后屈光度数平均球镜(-0.75±0.65)D,柱镜(-0.55±0.25)D。角膜内皮细胞计数术前(3126±260)个/mm2,术后6个月为(3069±308)个/mm2,差异无统计学意义。结论有晶状体眼后房型人工晶状体(ICL)植入矫治高度近视及超高度近视安全有效,是高度近视患者的理想治疗方法。  相似文献   

3.
目的 分析高度近视眼患者植入有晶状体眼后房型人工晶状体(Visian ICL V4)术后眼前节解剖结构的变化.方法 本研究入选行有晶状体眼人工晶状体植入术的高度近视患者93例(175眼),平均年龄(30.52 ±7.00)岁(18~48岁),其中119眼接受ICL植入术,46眼接受Toric-ICL植入术.比较术前和术后1周前房容积(ACV)、前房深度(ACD)、房角角度(ACA)(3:00 ~9:00位方向)变化、ICL光学区后表面到晶状体前囊膜中央距离(拱高)、角膜-晶状体间距、虹膜-晶状体间距、人工晶状体等效球镜(pIOL SE)等各参数间的关系.结果 术前、术后1周ACV分别为(200.29±31.76) mm3及(116.49±21.88) mm3,ACV减少(t=48.456,P=0.000).术前、术后ACD由(3.17 ±0.23) mm减少到(2.89±0.33) mm(t=12.237,P=0.000),术前、术后房角由(36.40 ±4.90)°减少到(23.44 ±5.07)°(t=31.131,P=0.000);术后ACV和术后ACD与术后ACA呈现正相关(分别为r=0.637,P=0.000;r=0.393,P=0.000).术后的角膜-晶状体间距较术前增加(0.40 ±0.31) mm(t=-16.935,P=0.000),其与拱高呈正相关(r=0.446,P=0.000).多因素回归分析,拱高与角膜-晶状体间距比值、手术前后的瞳孔变化率是独立的手术前后角膜-晶状体间距变化的影响因素(分别是P =0.001和P=0.048).结论 ICL植入术后,虹膜平面抬升,使前房容积变小和房角变窄.  相似文献   

4.
李琴  张少维  黄毅 《国际眼科杂志》2016,16(9):1709-1711
目的:通过超声生物显微镜(UBM)及光学相干断层扫描(OCT)评估有晶状体眼后房型人工晶状体矫正高度近视的疗效及安全性.方法:观察2015-01/04期间在我院行有晶状体眼后房型人工晶状体(implantable collamer lens,ICL)或散光型后房型人工晶状体(TICL)治疗的高度近视患者24例48眼,观察中央前房深度(ACD)、前房开放距离(AOD500)、术后拱高(ICL-vault)、术后最佳矫正视力(BCVA)、术后裸眼视力(UCVA)、角膜内皮细胞计数、眼压测量(IOP)、裂隙灯检查泪膜破裂时间(BUT).结果:术前与术后1、3、6、12mo均采用UBM测量ACD与AOD500四个方位,术前与术后4个随访时间节点的值比较差异均存在统计学意义(P<0.05),术后测量值均较术前降低,OCT测量拱高术后各时间点比较,差异无统计学意义(P>0.05),术后BCVA、UCVA均较术前提高,与术前相比差异具有统计学意义(P<0.05),但术后各时间点相比,差异无统计学意义.术前患者平均眼压、角膜内皮细胞计数及BUT与术后4个随访节点相比较差异无统计学意义(P>0.05).结论:ICL植入术矫正高度近视具有良好的疗效和安全性,术后泪膜稳定性变化不大,患者舒适度较好,满意度高.  相似文献   

5.
目前,屈光性手术方法众多,主要可分为两大类:一类是角膜屈光性手术,另一类是晶状体屈光性手术.前者包括角膜镜片术或表面角膜移植术、角膜磨镶术、角膜内镜片植入术(如角膜基质内角膜环植入术)、放射状角膜切开术(RK)、自动板层角膜成形术(ALK)、准分子激光角膜切削术(PRK)以及准分子激光原位角膜磨镶术(LASIK)等.后者如透明晶状体摘出术包括植入与不植入后房型人工晶状体、有晶状体眼植入双凹或凹凸前房型人工晶状体、有晶状体眼植入后房型人工晶状体等.以往的各种屈光性手术均存在诸多的缺点和并发症,相对而言,有晶状体眼后房型人工晶状体植入术,除具备有晶状体眼前房型人工晶状体植入术的诸多优点外,人工晶状体植入更符合生理解剖状态,并大大减少了并发症,被视作一种前景甚好的屈光性手术.  相似文献   

6.
目的 观察有晶状体眼前房型人工晶状体植入矫正高度近视的临床效果.方法 12例(17眼)-6.25~-18.75D之间的高度近视患者表面麻醉下在前房内植入phakic6H120型人工晶状体,随访半年以上,进行临床总结.结果 术后半年,12例(17眼)术后裸眼视力(平均4.75±0.15)与术前矫正视力(平均4.72±0.21)的差异无统计学意义(P>0.05).术后平均矫正视力为4.83±0.14,高于术前的4.72±0.21,差异有统计学意义(P<0.05).手术后平均散光度数为-0.82±0.64,低于术前的-1.49±0.81,差异有统计学意义(P<0.05),平均眼内压无明显变化.术前平均角膜内皮细胞计数为(3 078.35±363.71)个/mm2,高于术后的(2 745.88±373.95)个/mm2,差异有统计学意义(P<0.05).1例单眼术后眼压高、前房反应较重,术后1年查角膜内皮计数较术前损失50﹪;1例(双眼)瞳孔略呈椭圆形;1例(双眼)人工晶状体轻微旋转,人工晶状体上襻缘端滑入虹膜根切孔,所有患者未发生晶状体混浊及眼底并发症.结论 有晶状体眼前房型人工晶状体植入治疗高度近视有一定优势,不适宜做准分子激光的高度近视者可谨慎选择该手术,但其远期疗效尚不明确,仍需大样本病例进一步观察.(中国眼耳鼻喉科杂志,2007,7:366-368)  相似文献   

7.
超声生物显微镜(UBM)是一种高频超声波成像技术,对活体眼的眼前节结构进行实时观察、测量,可提供高清晰的眼前节图像。近年来UBM在有晶状体眼后方型人工晶状体植入中的应用逐渐成为研究的热点。本文着重就UBM在有晶状体眼后房型人工晶状体植入术中睫状沟直径、前房深度测量以及人工晶状体位置观察等方面的应用进展做一综述。  相似文献   

8.
有晶状体后房型人工晶状体植入术是矫正高度近视的有效方法之一,其具有较好的临床疗效、安全性和稳定性,本文将对此治疗方法的研究进展进行综述。  相似文献   

9.
吴敬明  冯琛  陈艳路  王弘媛  赵周婷 《眼科》2012,21(6):390-394
【摘要】 目的 观察有晶状体眼后房型人工晶状体植入术矫治高度近视的有效性、稳定性 、安全性。设计 回顾性病例系列。研究对象 2009年7月至2012年3月在解放军第211医院行有晶状 体眼后房型人工晶状体植入术的高度近视(-6.00~-24.00 D)患者38例(73眼)。方法 对上述患 者行有晶状体眼后房型人工晶状体(瑞士STAAR公司)植入术矫治高度近视,选取随访资料完整的 患者38例(73眼),48眼植入矫正近视接触镜(ICM),25眼植入矫正近视合并散光的接触镜 (TICL)。随访时间6个月。主要指标 裸眼视力、最佳矫正视力、屈光状态、眼压、TICL轴向、裂 隙灯显微镜检查。结果 术后6个月,裸眼视力0.15~1.0,≥0.8者40眼(54.79%),好于术前最佳 矫正视力(BCVA)者72眼(98.63%),比术前BCVA提高1行者33眼(45.21%),提高2行者13眼 (17.81%),提高3行者8眼(10.96%)。术后屈光度球镜与预期球镜相差±1.00 D以内者54眼 (73.97%),与预期球镜相差±0.50 D以内者12眼(16.44%),术后屈光度柱镜与预期柱镜度数相 差±0.50D以内者19眼(76%)。7例(10眼)术后2小时发生急性眼压升高,术后6个月平均眼压与 术前平均眼压相比差异无统计学意义(P=0.197)。术后早期眩光者6眼(8.22%),未发现TICL明 显偏转、晶状体明显混浊。结论 有晶状体眼后房型人工晶状体植入术可明显提高高度近视的裸眼 视力,并具有良好的可预测性,稳定性好,6个月时无严重并发症,适合屈光范围广。(眼科, 2012, 21: 390-394)  相似文献   

10.
目的 评价有晶状体眼后房型人工晶状体植入术治疗高度近视的安全性和有效性.方法 高度近视患者18例(34只眼)接受有晶状体眼后房型人工晶状体植入,每只眼术前及术后进行眼部检查,包括:裸眼视力、矫正视力、睫状肌麻痹验光、角膜曲率、裂隙灯检查、眼压测量、角膜地形图、角膜厚度、角膜内皮细胞计数、UBM、B超、角膜水平直径散瞳眼底检查.手术在表面麻醉下进行,作透明角膜隧道式切口,可植入式接触镜(implantable contact lens,ICL)置于透明晶状体与虹膜之间,术中1点位作虹膜周切口.结果 34只眼术前裸眼视力和最好矫正视力分别为0.08±0.06,0.5±0.3;术后分别提高为0.5±0.2,0.7±0.2,术后裸眼和矫正视力均明显好于术前(P<0.05).术前平均屈光度为(-19.9±5.4)D,术后1个月平均屈光度为(-1.5±1.5)D.术前角膜内皮细胞数(3249.6±337.1)/mm~2,术后1个月角膜内皮细胞为(3103.4±305.5)/mm~2丢失率为4.5%.术前平均眼压为(15.5±2.7)mmHg,术后第一天眼压为(19.4±7.3)mmHg,增高率25.2%.通过UBM观察术前前房深度(3.20±0.30)mm,而术后1月明显减少到(2.99±0.19)mm,两者相比较差异具有统计学意义(P<0.05),而以后随访中前房深度没有明显差异.结论 有晶状体眼后房型人工晶状体植入术对高度近视的治疗是一种有效的方法,具有矫正效果好、预测性好、可逆性和简单等优点,但要谨慎看待这种手术长期的安全性,更长时间的随访是必需的.  相似文献   

11.
There is an increasing demand for refractive surgery stemming from a heightened awareness among patients wearing spectacles or contact lenses. Cosmetic or occupational reasons prompt patients to seek the alternative option of refractive surgery.  相似文献   

12.
目的探讨后囊破损Ⅱ期后房型人工晶体植入术的临床疗效。方法对22例(22只眼)后囊破损的白内障术后患者,根据后囊破损的大小和位置,分别采用睫状沟或囊袋内固定和缝线睫状沟单襻或双襻固定的Ⅱ期后房型人工晶体植入术。结果后囊破损的Ⅱ期后房型人工晶体植入术术后矫正视力≥0.5者占59.1%(13例),术后前房及人工晶体表面渗出者占22.7%(5例),而同期所做的后囊破损的Ⅰ期后房型人工晶体植入术者术后矫正视力≥0.5者占40%,术后前房及晶体表面渗出者占40%。结论后囊破损的白内障患者,在破损的范围不能确定或范围过大时,主张选择Ⅱ期后房型人工晶体植入术。  相似文献   

13.
PURPOSE: To analyze the appearance, incidence, and characteristics of choroidal neovascularization (CNV) in patients with high myopia corrected by implantation of a phakic anterior chamber intraocular lens (PACL). SETTING: University Miguel Hernández, Instituto Oftalmológico de Alicante, Alicante, Spain. METHODS: The CNV observed in 294 consecutive eyes (181 patients) implanted with a PACL for the correction of high myopia (-7.0 to -38.0 diopters) was studied. The mean follow-up was 50.6 months +/- 32.8 (SD) (range 6 to 120 months). RESULTS: Choroidal neovascularization occurred in 5 eyes (1.70%); 3 eyes were in women, and 2 were in men. The interval between PACL implantation and CNV was 63.2 +/- 27.3 months (range 18 to 87 months). The CNV was subfoveal in 4 eyes and juxtafoveal in 1 case. The mean best spectacle-corrected visual acuity (BSCVA) after PACL implantation and before the appearance of CNV was 0.53 +/- 0.18 (range 0.4 [20/50] to 0.8 [20/25]); after CNV appeared, it was 0.26 +/- 0.18 (range 0.05 [20/400] to 0.5 [20/40]), a statistically significant difference (P =.001, paired Student t test). In 2 cases, the CNV was treated with photodynamic therapy (PDT); in the other 3 cases, PDT was rejected. The cumulative risk for CNV (Kaplan-Meier survival analysis) in highly myopic patients corrected by PACL implantation was 0.43% at 18 months and 5.4% at 87 months. CONCLUSIONS: Implantation of a PACL to correct high myopia was followed by a small incidence of CNV (cumulative risk of 5.4% at 87 months). The appearance of CNV was followed by a significant decrease in BSCVA.  相似文献   

14.
有晶状体眼前房型人工晶状体植入治疗高度近视   总被引:2,自引:1,他引:1  
目的探讨有晶状体眼前房型人工晶状体植入术矫正高度近视的有效性和安全性.方法高度近视眼患者11例共20眼,近视度数-7.00~-30.00DS,行有晶状体眼前房型人工晶状体植入术,术后随访期限1~3个月,检测术后视力、屈光状态、眼压、角膜内皮计数,裂隙灯观察眼前节(包括虹膜与透明晶状体)和眼底镜观察眼底情况并与术前进行对比.结果 20眼均成功植入人工晶状体,术后视力迅速达到最佳矫正视力,术后屈光度明显降低,随访期内眼压、角膜内皮计数与术前无明显改变,无严重并发症发生.结论有晶状体眼前房型人工晶状体植入术矫正高度近视手术操作简单,具有良好的屈光状态,可预测性、可逆性,术后3个月内无严重并发症,远期效果有待进一步观察.  相似文献   

15.
目的 明确有晶状体眼后房型人工晶状体(ICL)植入术术前及术后眼轴长度在不同设定条件下是否存在差别,由此确定术后眼轴测量的方式,为ICL术后发生的白内障进行人工晶状体测算提供指导.方法 选取自2008年5月至2009年12月间于中国医科大学眼科医院行ICL植入术患者70例(135只眼),年龄21~48岁,于术前1周及术后3个月分别行IOL-Master、A超测量眼轴长度.并设定IOL-Master测量方式为正常眼(即phakic眼)及人工晶体眼(Pseudophakic PMMA)模式,A超为正常眼及特殊眼模式,其中特殊眼晶体声速设为1555 m/s.将所得数据进行统计学分析,术前术后各变量采用配对样本t检验,结果术前以IOL-Master测量眼轴长度平均为(28.02±0.22)mm,A超测量眼轴长度平均为(27.81±0.22)mm;术后以IOL-Master正常眼模式及Pseudophakic PMMA 模式测量眼轴长度平均值分别为:(28.01±0.22)及(28.12±0.22)mm;术后以A超正常眼模式及特殊眼模式测量眼轴长度平均值分别为(27.82±0.22)、(26.40±0.21)mm.术前采用A超及IOL-Master测量眼轴,两者比较差异有统计学意义(t=9.722,P=0.000);术前采用A超,而术后IOL-Master Phakic模式及Pseudophakic PMMA模式测量眼轴,与术前相比差异均有统计学意义(t=-9.058,-14.646;P=0.000);术前采用IOL-Master,术后采用A超正常眼及特殊眼模式下的测量的结果与术前比较,差异均有统计学意义(t=10.832,61.470;P=0.000).结论 有晶状体眼后房型人工晶状体植入后对眼轴长度的测量根据选择测量方式的不同较之术前有一定的变化.建议有晶状体眼后房型人工晶状体植入矫正高度近视眼术前及术后对眼轴的测量尽量采用.IOL-Master正常眼模式,如因白内障造成IOL-Master测量困难,则应采用A超正常模式测量眼轴.
Abstract:
Objective To definitute axial length measuring mode of the phakic eyes after posterior chamber implantation of lens. Methods All patients came from the Ophthalmology Hospital of China Medical University . Seventy patients with 135eyes,aged 21-48 years old. Among this group 28 were male,53eyes;42 were female, 82 eyes. A-ultrasound and IOL-Master was used to measure axial length one week before preoperative and three months after ICL implantation. There are two measuring mode in A-ultrasound and IOL-Master: normal and special. All the results were analysed by the SPSS11.5 statistical methods.Results (1) preoperative AXL of A-ultrasound and IOL-Master average are: (27.81 ±0.22) mm,(28. 02 ±0.22) mm; (2) postoperative AXL of phakic and Pseudophakic PMMA mode of IOL-Master average are: (28.01 ±0. 22) mm, (28. 12 ±0.22)mm; (3) postoperative AXL of normal and special mode of A-ultrasound average are: (27. 82 ± 0. 22 ) mm, ( 26. 40 ± 0. 21 ) mm. Conclusion According to the different meansuring mode, there are some difference of AXL between the preoperative and postoperative ICL.The more accurately meansuring mode is IOL-Master phakic mode before and after operation. A-ultrasound normal mode can be used if the lens become so turbid that the AXL can't be obtained by IOL-Master.  相似文献   

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Purpose

To evaluate the 5-year follow-up of safety, efficacy, predictability, stability, and complications of anterior iris-fixated phakic intraocular lens (pIOL) implantation to correct high myopia, and patients'' satisfaction after implantation.

Design

Prospective, nonrandomized, and comparative (self-controlled) trial.

Methods

A prospective clinical trial of 84 eyes of 43 patients with high myopia was conducted. Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), refraction, endothelial cell count, intraocular pressure (IOP), anterior chamber depth, slit lamp biomicroscopy, and indirect ophthalmoscope were measured preoperatively and postoperatively.

Results

At the 5-year follow-up, UCVA was significantly improved, with 85.7% of eyes reaching 20/25 or better. No eyes experienced a loss in BSCVA, and 71.4% gained one or more lines of their preoperative BSCVA. There was a significant reduction in spherical errors in all patients after operation. Loss of endothelial cells was observed 3 years after operation and no more loss was observed 4 years after operation in statistical analysis. No increase in IOP was observed 5 years after operation in statistical analysis. No intraoperative complications were observed in this study. However, pigment precipitates of varying intensities on the lens optic were noted in all patients 1 day after operation, and only five eyes were observed to have the pigment residual five years after operation.

Conclusion

At the 5-year follow-up, the implantation of the anterior iris-fixated pIOL was proved to be effective, predictable and capable of reversibility to correct high myopia in phakic eyes. It was a safety addition to the laser refractive surgery. However, longer follow-up with larger numbers of patients is still necessary to evaluate long-term complications.  相似文献   

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眼前段外伤修复并Ⅰ期人工晶状体植入术   总被引:1,自引:0,他引:1  
目的 探讨眼前段损伤修复、外伤性白内障摘出并人工晶状体植入联合手术的可行性。方法 对21例角膜裂伤的外伤性白内障行裂伤修复、虹膜复位、白内障摘出并人工晶状体植入。后囊完整者Ⅰ期划开后囊膜。结果 术后视力〉0.5者13例(61.9%),后囊混浊率33.3%,无感染发生。结论 联合手术右减少多次手术对伤眼的损伤吵会增加术后感染和后囊混浊的发生率。  相似文献   

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Medennium posterior chamber phakic refractive lens to correct high myopia   总被引:2,自引:0,他引:2  
PURPOSE: To determine the efficacy and safety of phakic refractive lens implantation to correct high myopia. METHODS: In this prospective study, a phakic refractive lens was implanted in 90 myopic eyes in which refractive errors ranged from -6.00 to -20.00 diopters (D) and laser refractive surgery was contraindicated. Uncorrected visual acuity (UCVA) and best-spectacle corrected visual acuity (BSCVA), manifest and cycloplegic refractions, and intraocular pressure (IOP) were assessed during a 1-year follow-up period. Possible complications, including endothelial cell counts, were evaluated. RESULTS: Spherical equivalent refraction measurements revealed a significant change from the preoperative mean value of -11.90+/-5.00 D to 0.04+/-0.20 D 1 year postoperatively (P=.001). The UCVA and BSCVA significantly improved postoperatively (P=.001 and P=.01, respectively). Seventy-two (80%) eyes and 61 (68%) eyes were within +/-1.00 D and +/-0.50 D of the target refraction, respectively. A significant increase in IOP was found at every postoperative visit (P=.01). There was a trend toward decreased endothelial cell density postoperatively, although the difference did not reach significance. No major complications were found during the 1-year follow-up period. CONCLUSIONS: The implantation of a phakic refractive lens seems to be a predictable and well-tolerated procedure for correcting high myopia. Complications such as development of cataract, implant dislocation, decreases in endothelial cell counts, or development of glaucoma did not occur in this study.  相似文献   

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目的:我们应用眼前节全景分析仪(Pentacam)测量有晶状体眼后房型人工晶状体(ICL)植入术手术前后前节形态指标,评价有晶状体眼后房型人工晶状体植入术的安全性及稳定性。

方法:选取行有晶状体眼后房型人工晶状体植入术治疗的高度近视患者48例90眼,术后随访6mo。Pentacam眼前节全景分析仪测量各时间点的中央前房深度(ACD)、3:00位前房角(ICA)、角膜像差(CA)、角膜曲率(K)和角膜厚度(CCT)等指标。使用SPSS 19.0统计软件,描述术前术后各指标的分布特征,采用配对t检验对各指标进行手术前后的差异性比较。

结果:所有观察指标各时间点均呈正态分布。ACD、3:00位ICA较术前降低(P<0.05)。CA中,总像差(CTA)及低阶像差(CLOA)较术前无统计差异(P>0.05),高阶像差(CHOA)则较术前有所增加(P<0.05); K略有减小(P<0.05)。CCT较术前比较均无统计学差异(P>0.05)。对于术后有统计学意义变化的指标,均在术后1mo时即达到稳定状态。

结论:应用眼前节全景分析仪(Pentacam)观察有晶状体眼后房型人工晶状体植入术眼前节形态的变化主要有ICA变窄,ACD变小,CHOA增加,K减小,尚在安全范围内,6mo随访中各值均保持稳定,未出现并发症,但远期效果需进一步随访观察。  相似文献   


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