晶状体超声乳化联合多焦点人工晶状体植入矫治高度近视疗效观察

目的 探讨透明晶状体超声乳化吸除联合多焦点人工晶状体植入术矫治高度近视的疗效.方法 对62例(90只眼)高度近视患者根据自愿原则,采用非随机对照方式分成两组,试验组32例(48只眼)植入Array SA40N多焦点人工晶状体(MIOL),对照组30例(42只眼)植入单焦点人工晶状体(SIOL),平均随访时间32个月,术后18个月查远近视力,立体视敏度,视野等视功能检查,问卷调查视觉症状及生活质量.结果 MIOL眼具有与SIOL眼一样良好的裸眼远视力(分别为0.89± 0.34,0.81± 0.22,P ＞0.05),裸眼近视力明显优于SIOL眼(分别为0.71± 0.20,0.39± 0.21,P ＜0.01),双眼植入MIOL近立体视觉优于双眼植入SIOL,多数患者对术后效果满意,脱镜率MIOL组53.1%,SIOL组无人能脱镜.术后未发生明显并发症.结论 透明晶状体超声乳化吸除联合多焦点人工晶状体植入术矫治高度近视安全、疗效明显,但高度近视患者术后阅读的脱镜率较低.

The effect of clear lens phacoemulsification with multifocal intraocular lens implantation for high myopia

Objective To assess the visual efficacy after clear lens removal with multifocal intraocular lens implantation in high myopia. Methods A total of 90 eyes from 62 patients undergoing phacoemulsification received intraocular lens implantation based on the principle of voluntary. Thirty-two patients (48 eyes) who had implantation of Array SA-40N MIOL were randomized into experimental group, 30 patients (42 eyes) who had implantation of ALCON SA60AT SIOL were randomized into control group. Distance visual acuity and near visual acuity, stereopsis acuity and visual field were measured in 18 months postoperative. Visual symptoms and quality-of-life were observed by questionnaire. The mean follow-up was 32 months (18 to 48months). Results MIOL eyes showed excellent UCDVA as SIOL eyes (0.89±0.34 versus 0.81±0.22, P >0.05) and better UCNVA than later (0.71±0.20, 0.39±0.21, P <0.01). Patients with bilateral MIOL implantation had better stereoscopic visions than the one with bilateral SIOL implantation. Most patients were satisfied with the result of the operation. The spectacle independence was 53.1% in MIOL group. No severe surgical complications occurred. Conclusions Phacoemulsification with the implantation of multifocal intraocular lens in high myopia is safe, effective, but spectacle independence proportion in high myopia is low.