超声乳化术治疗高度近视白内障的临床观察

目的探讨晶状体超声乳化联合人工晶状体植入术治疗高度近视白内障的临床效果。方法对55例(86眼)高度近视白内障患者采用晶状体囊袋内超声乳化技术行白内障吸出,并植入后房型人工晶状体,手术后随访4个月～2a,观察视力和屈光度变化,并对相关并发症进行分析。结果 83眼(96.5%)的术后最佳矫正视力明显优于术前。术后3个月矫正视力>0.40、>0.03～0.40和≤0.30的患者眼数和构成比,在眼轴≤30mm组,分别为24眼(40.0%)、26眼(43.3%)和10眼(16.7%);在眼轴>30mm组,分别为6眼(23.1%)、13眼(50.0%)和7眼(26.9%)。术中并发症包括环形撕囊不佳者5眼(5.8%)、后囊膜破裂者2眼(2.3%)和悬韧带断裂者2眼(2.3%);术后并发症有一过性角膜水肿16眼(18.6%)、暂时性眼压升高5眼(5.8%)、房水混浊明显15眼(17.4%),以及晶状体后囊膜混浊2眼(2.3%)、孔源性视网膜脱离1眼(1.2%)。结论超声乳化联合人工晶状体植入术既治疗了白内障,同时又矫正了高度近视,术后视功能恢复良好,是高度近视合并白内障患者安全有效的治疗方法。

Clinical observation of phacoemulsification for high myopic eyes with cataract

Objective To investigate clinical outcomes of phacoemulsification combined with intraocular lens implantation for high myopic eyes with cataract.Methods Fifty-five patients(86 eyes) of high myopia with cataract were treated with phacoemulsification combined with posterior chamber intraocular lens implantation.The follow-up time was from 4 months to 2 years,the visual acuity,refraction and complications were observed and analyzed.Results Postoperative best corrected visual acuity of 83 eyes(96.5%) was better than that before operation.The distribution of corrected visual acuity at 3 months after operation was investigated according to axial length.In the group of axial length ≤30 mm,the number(constituent ratio) of eyes with corrected visual acuity >0.40,>0.03~0.40 and ≤0.30 were 24(40.0%),26(43.3%) and 10(16.7%),respectively;In the group of axial length >30.0 mm,they were 6(23.1%),13(50.0%) and 7(26.9%),respectively.Complications during operation included unsuccessful continuous circular capsulorhexis in 5 eyes(5.8%),posterior capsule rupture in 2 eyes(2.3%) and zonule broken in 2 eyes(2.3%).Postoperative complications included transient corneal edema in 16 eyes(18.6%) and temporary high intraocular pressure in 5 eyes(5.8%),obvious turbid aqueous in 15 eyes(17.4%),posterior capsular opacification in 2 eyes(2.3%),rhegmatogenous retinal detachment in 1 eye(1.2%).Conclusion Phacoemulsification combined with intraocular lens implantation is safe and efficient treatment for high myopic patients with cataract,which can not only extract cataract,but also correct high refractive error,and regain good visual function.