Monovision法超声乳化透明晶状体吸除术治疗高度近视的临床观察

目的 探讨Monovision法超声乳化透明晶状体吸除术联合人工晶状体植入治疗高度近视的临床疗效.方法 对45例(90眼)高度近视患者行双眼透明晶状体超声乳化吸除联合人工晶状体植入术,术前行常规眼科检查和眼底检查、视觉需要调查、主视眼检测、生物测量,术中植入单焦点折叠式IOL.根据患者视觉需要分为两组:Monovision组28例,男11例,女17例,根据生物测量结果,术中植入的人工晶状体度数使患者主视眼术后目标屈光度-0.5～0.0D,非主视眼术后目标屈光度-2.0～-2.5D;对照组17例,男5例,女12例,双眼术后目标屈光度-0.5～0.0D.对术后双眼裸跟远近视力、屈光度等随访观察3个月,结合术后问卷评估结果进行统计学分析.结果 两组术后屈光度与术前预留屈光度无统计学差异(P＞0.05).术后3个月,Monovision组和对照组双眼同时视裸眼远视力分别为(0.83±0.15)、(0.81±0.13),差异无统计学意义(P＞ 0.05).Monovision组双眼同时视近视力(0.68±0.25)好于对照组(0.38±0.21),差异有统计学意义(P＜ 0.03).术后3个月远距离用眼,两组不带眼镜分别是97.5％、98.3％,差异无统计学意义(P＞0.05 ).术后3个月近距离用眼从不带眼镜的比例,两组分别为78.5％,20.3％,差异有统计学意义(P＜0.05).术后3个月,两组均无视网膜脱离、黄斑囊样水肿发生.结论 Monovision法超声乳化透明晶状体吸除术治疗高度近视是安全有效的方法,具有术后视力好、并发症少、预测屈光状态准确、远近用眼均不用戴镜等优点.

Clear lens phacoemulsification with monovision for the correction of high myopia

ObJective To explore the clinical efficacy of clear lens phacoemulsification with monovision combined with artificial lens implantation for the correction of high myopia. Methods This study included 45 patients （ 90 eyes ） diagnosed as high myopia, The distant and near visual acuity （ VA ） and the dominant eye were examined. All the eyes received binocular phacoemulsification and monofocal intraocular lens （ IOL ） implantation. Monovision correction was chosen for 28 patients （ 11 males and 17 females ）. Implantation of I OL was designed to yield a spherical equivalent of -2.0±-2,5D for the nondominant eye. Full correction was performed on 17 control subjects. Distant and near VA in both eyes and the diopter were followed up for 3 months postoperatively. Results Predicted refraction and ideal distance binocular vision were achieved in all the patients, The mean uncorrected distance binocular VA was（ 0.83± 0.15 ） in the monovision group and （ 0.81 ± 0.13 ） in the control group （ P 〉 0.05 ）. The mean uncorrected near VA was （ 0,68 ± 025 ） in the monovision group and （ 0,38 ± 0,21 ） in the control group （ P 〈 0,05 ）, 3 months after treatment, the rate of patients reading without glasses was 78.5% and 20.3%, respectively （ P 〈 0.05 ）. No retinal detachment and cystoid macular edema occurred 3 months after the treatment. Con-clusions Clear lens phacoemulsification with monovision is a safe and effective procedure in the corection of high myopia. The patients do not need to we~ reading glasses whenever seeing far or near postoperatively.