有晶状体眼后房型人工晶状体植入术矫治高度近视

【摘要】 目的 观察有晶状体眼后房型人工晶状体植入术矫治高度近视的有效性、稳定性 、安全性。设计 回顾性病例系列。研究对象 2009年7月至2012年3月在解放军第211医院行有晶状 体眼后房型人工晶状体植入术的高度近视（-6.00～-24.00 D）患者38例（73眼）。方法 对上述患 者行有晶状体眼后房型人工晶状体（瑞士STAAR公司）植入术矫治高度近视，选取随访资料完整的 患者38例（73眼），48眼植入矫正近视接触镜（ICM），25眼植入矫正近视合并散光的接触镜 （TICL）。随访时间6个月。主要指标 裸眼视力、最佳矫正视力、屈光状态、眼压、TICL轴向、裂 隙灯显微镜检查。结果 术后6个月，裸眼视力0.15～1.0，≥0.8者40眼（54.79%），好于术前最佳 矫正视力（BCVA）者72眼（98.63%），比术前BCVA提高1行者33眼（45.21%），提高2行者13眼 （17.81%），提高3行者8眼（10.96%）。术后屈光度球镜与预期球镜相差±1.00 D以内者54眼 （73.97%），与预期球镜相差±0.50 D以内者12眼（16.44%），术后屈光度柱镜与预期柱镜度数相 差±0.50D以内者19眼（76%）。7例（10眼）术后2小时发生急性眼压升高，术后6个月平均眼压与 术前平均眼压相比差异无统计学意义（P=0.197）。术后早期眩光者6眼（8.22%），未发现TICL明 显偏转、晶状体明显混浊。结论 有晶状体眼后房型人工晶状体植入术可明显提高高度近视的裸眼 视力，并具有良好的可预测性，稳定性好，6个月时无严重并发症，适合屈光范围广。（眼科， 2012, 21： 390-394）

Clinical research on the implantation of posterior chamber phakic intraocular lens for high myopia

Objective To evaluate the efficacy, safety and stability of the implantation of posterior chamber phakic intraocular lens for high myopia. Design Retrospective case series. Participants Seventy three eyes of 38 cases with high myopia （-6.00 - -24.00 D） who were implanted with posterior chamber phakic intraocular lens in 211 Hospital of the People＇s Liberation Army, Haerbin from July 2009 to March 2012. Methods The patients were implanted with posterior chamber phakic intraocular lens, 48 eyes with im- plantable contact lens-myopia （ICM） and and 25 eyes with Toric implantable contact lens （TICL）. The follow-up was 6 months. Main Outcome Measures Visual acuity, refraction, inraocular pressure （IOP）, cornea, and space between crystals. Results The uncorrected visual acuity （UCVA） after surgery varied from 0.15 to 1.0, and was found in 40 eyes ≥0.8 （54.79%）. The UCVA of 72 eyes （98.63%） after surgery was better than the best corrected visual acuity （BCVA） before surgery. The post-operation UCVA exceeded pre-operation BCVA one row on visual chart in 33 eyes （45.21%）, two rows in 13 eyes （17.81%） and three rows in 8 eyes （10.96%）. The post-opera- tion spherical refractive error was within ±1.00 D of expected diopters in 54 eyes （73.97%）, within ±0.50D in 12 eyes （16.44%）. The post-operation cylindrical refractive error was within ±0.50 D of expected diopters in 19 eyes （76%）. The post-operation IOP was not significantly different from pre-operation IOP （P=0.197）. A transient IOP elevation was found in seven patients （10 eyes） within two hours after surgery. There were 6 eyes （8.22%） had halo at night. There was no axial deviation of TICL and cataractogenesis in any patients. Condusion Posterior chamber phakic intraoeular lens implantation can significantly improve visual acuity in high myopia. It is an effective, safe and reliable method for correction of high myopia with a wide range of suitable diopters.