有晶状体眼后房型人工晶状体植入术治疗高度近视临床观察

目的:评价有晶状体眼后房型人工晶状体(ICL)植入术治疗高度近视的有效性和安全性.方法:对7例(14只眼)高度近视患者行有晶状体眼ICL植入术.术后随访3-9个月,观察手术前后裸眼视力、最佳矫正视力、屈光度、眼压、内皮细胞计数等.结果:所有患者成功植入ICL,14只眼手术前后平均屈光度分别为(-14.52±-6.43)D,(-0.01±0.28)D；裸眼视力分别为0.08±0.06,0.6±0.3；最佳矫正视力分别为0.5±0.2,0.7±0.2；术后裸眼视力和最佳矫正视力均明显好于术前(P＜0.05).术前平均眼压为(16.21±2.84)mmHg,术后平均眼压为(17.03±1.95)mmHg；内皮细胞计数术前为(3 028±289)个/mm2,术后为(2 912±2 51)个/mm2；前房深度术前平均为(3.69±0.31)mm,术后为(3.57±0.29)mm,差异均无统计学意义(P＞0.05).结论:ICL矫正高度近视近期临床效果有效、可靠,临床观察未发现手术并发症,远期效果需进一步观察.

Clinical Observation of Posterior Chamber Phakic Intraocular Lens Implantation for High Myopia

Objective: To evaluate the efficacy and safety of the surgical correction of high myopia using an implantation of posterior chamber intraocular lens.Methods: Posterior chamber phakic intraocular lens(ICL) implantation was performed in 14 eyes of 7 patients with high myopia.After follow-up for 3 to 9 months,the clinical ocular examinations were performed including uncorrected visual acuity(UCVA),best corrected visual acuity(BCVA) retraction,intraocular pressure(IOP),slit-lamp findings,cornea topography and cornea endothelial cell density before and after surgery.Results: Posterior chamber phakic intraocular lens were implanted successfully in all the operative eyes.The mean preoperative diopter was-14.52±6.43 D,and postoperative diopter was-0.01±0.28 D.The UCVA and BCVA were 0.08±0.06 and 0.5±0.2 respectively before operation versus 0.6±0.3 and 0.7±0.2 respectively after operation.It is obvious that postoperative UCVA and BCVA were better than the preoperative ones(P<0.05).The mean preoperative IOP was(16.21±2.84) mmHg and postoperative IOP was 17.03±1.95 mmHg.The cornea endothelial cell density was(3 028±289)/mm2 before operation and(2 912±251)/mm2 after operation,and average preoperative anterior chamber depth was 3.69±0.31 mm and the postoperative was 3.57±0.29 mm,showing no significant difference(P>0.05).Conclusion: Phakic ICL is an effective treatment for the correction of high myopia and has significant advantages such as reversibility,immediate correction,stability,and no postoperative complications.However,a long-term evaluation of effectiveness and safety for this phakic ICL should be performed.