高度近视白内障患者植入Bigbag人工晶状体的疗效观察

目的观察高度近视并发白内障患者行超声乳化吸除联合Bigbag人工晶状体植入术的有效性及安全性。方法 31例（55只眼）高度近视白内障患者行超声乳化吸除联合人工晶状体植入术。其中18例（30只眼）植入Bigbag人工晶状体,13例（25只眼）植入Matrix Acrylic 400型人工晶状体。比较手术前后视力及屈光状态;观察术中及术后并发症。结果 55只眼人工晶状体均植入囊袋内且固定良好,术前裸眼视力均〈4.5,术前最佳矫正视力〉4.8者Bigbag组3只眼（10%）,400组6只眼（24%）;术后1个月Bigbag组最佳矫正视力〈4.5者1只眼,4.5～4.8者10只眼,〉4.8者19只眼,与400组相比差异无统计学意义（χ2=0.066,P〉0.05）;Bigbag组术后1个月屈光度-0.50～-2.00 D,平均（-0.68±0.38）D,与术前相比较差异有统计学意义（t=12.79,P〈0.05）。与术后3个月屈光度比较无统计学意义（t=1.366,P〉0.05）。术后3个月Bigbag组,后囊膜未发现皱褶,2只眼（6.66%）后囊轻度混浊;400组2只眼（8%）后囊膜皱褶,3只眼（12%）后囊轻度混浊,随诊观察至6个月病情无进展。结论白内障超声乳化吸除联合Bigbag人工晶状体植入术治疗高度近视是一种安全、有效的手术方法。Big-bag人工晶状体不但可获得与其它人工晶状体相同的良好视力,还可对后囊膜起到相对稳定的支撑作用,减少并发症的发生。

Analysis effect of Bigbag intraocular lens implantion with phacoemlsification on patients with high myopia combine cataract

Objective To evaluate the efficacy and safety of treatment of high myopia with cataract with phacoemulsification extraction combined with IOL implantation.Methods Retrospective analyzed of 55 eyes of parents with cataract combined high myopia performed phacoemulsification extraction combined with IOL implantation.18 patients(30 eyes) were underwent phacoemulsification and Bigbag IOL implantation;13 patients were underwent phacoemulsification and Matrix Acrylic 400 IOL implantation.Compare the visual activity and refraction status before surgery with that after surgery.Observe the operative and post operative complications.Results 55 eyes IOL were all planted in capsules and fixed perfectly.The preoperative uncorrected visual acuity of all eyes were less than 4.5.The preoperative best corrected visual acuity was more than 4.7 in 3 eyes(10%) in Bigbag group and in 6 eyes(24%) in 400 group.There is one eye which best corrected visual acuity was less than 4.5 in Bigbag group 1 month after surgery,and there are 10 eyes’ best corrected visual acuity was between 4.5 and 4.7,19 eyes are better than 4.7.The average refraction was(-0.68±0.38)D,from-0.50 to-2.00 D 1 month after surgery in Bigbag group.There was no difference from 400 group(χ2=0.066,P> 0.05).There was no posterior capsular membrane stretched in all eyes 3 months after surgery in Bigbag group(t=1.366,P>0.05).There were 2 eyes(6.66%) posterior turbid slightly.The posterior capsular membrane was stretched in 2 eyes(8%) in 400 group.The posterior capsular membrane was turbid slightly in 3eyes(12 %).Observe the patients status in the later 6 months.Conclusion Transparent lens phacoemulsification extraction combined with Bigbag intraocular lens implantation is an effective and safe method for high myopia in those aged people.Bigbag IOL not only help the patients obtain good distance acuity but also can support the posterior capsular membrane stably which can release the complication.