个性化人工晶状体植入治疗高度近视的研究

目的评价所设计的个性化人工晶状体植入方案治疗高度近视的临床效果及安全性。方法将无角膜屈光手术适应证的高度近视患者分为三组:1年龄小于40岁不合并有白内障的高度近视患者,这部分病人接受有晶状体眼的Artisan人工晶状体植入术(20例40眼),进行术后早期及远期视觉质量评价、术后远期并发症评估等;2合并有白内障的超高度近视患者,接受白内障超声乳化吸除联合Bigbag人工晶状体植入术(25例37眼),进行临床效果评价;3合并有白内障而近视度数较低的患者,接受白内障超声乳化吸除联合低度数多焦点人工晶状体植入术(Array 25例31眼,IQ Restor13例26眼),完成术后视力、对眼镜依赖程度评估等。结果 Artisan植入组术后裸眼视力提高,视觉效果良好,远期观察安全;Bigbag植入组患者获得良好的术后视力,玻璃体后脱离发生率低于文献报道的其他低度数人工晶状体;低度数多焦点人工晶状体应用于高度近视合并白内障患者安全、有效,视觉效果良好,临床满意度优秀。结论个性化植入人工晶状体可以使不同条件的高度近视患者在获得良好视觉效果的同时兼具了安全稳定的临床效果。

Individual intraocular lens implantation for correction of high myopia

Objective To evaluate the clinical effect and the safety of the individual intraocular lens implantation system for correction of high myopia. Methods The patients who suffered from high myopia but have no cornea refractive surgery indication were divided into three groups： ① Those who were younger than40 years old and without cataract accepted phakic eye Artisan implantation（ 20 cases with 40 eyes）. The short- term and long-term vision and complications were followed up. ② Those who had super-high myopia combined cataract（ 25 cases,37 eyes） received phacoemusification combined Bigbag intraocular lens implantation. The clinical effects were evaluated. ③ Those who had relatively low diopter myopia and cataract accepted phacoemusification combined multifocal intraocular lens implantation（ AMO Array in 25 cases with31 eyes; IQ Restor in 13 cases with 26 eyes）. The visual acuity and the dependence of the glasses were evaluated. Results The Artisan implantation provided good uncorrected visual acuity,good visual effect operatively,and safety in long-term follow-up. Those patients who accepted Bigbag implantation obtained improved visual acuity after operation and relatively low post vitreous detachment rate compared with other intraocular lens reported. Low power multifocal intraocular lens implantation led to effective,safe clinic results,excellent visual performance,and excellent clinic satisfaction in myopia patients with cataract.Conclusions Individual intraocular lens implantation system can provide good vision and safe,stable clinical effect for myopia patients with different situations.