虹膜夹型与房角支撑型有晶状体眼人工晶状体矫正高度近视对比观察

目的 观察虹膜夹型(IC-PIOL)和房角支撑型(AS-PIOL)有晶状体眼人工晶状体植入术矫正高度近视的临床疗效,探讨两者的安全性、有效性等情况.方法 应用手术植入IC-PIOL组23例35只眼,等效球镜(SE)(-9.38～-24.13)D;植入AS-PIOL组22例31只眼,SE(-9.88～-22.25)D.术后随访18个月,比较两组的裸眼视力(UCVA)、最佳矫正视力(BCVA)、屈光状态、眼压、角膜内皮、瞳孔、人工晶状体等情况.结果 术前IC-PIOL组和AS-PIOL组UCVA,BCVA,SE和散光差异无统计学意义.与术前相比,两组组内UCVA、BCVA和SE均显著改善,术后7d至18个月两组组内和组间差异无统计学意义.术后18个月时IC-PIOL组和AS-PIOL组结果分别如下,安全性系数(术后BCVA/术前BCVA):1.018±0.017和1.019±0.022,有效性系数(术后UCVA/术前BCVA):0.983±0.024和0.979±0.036,两组组内和组间差异无统计学意义;角膜内皮细胞丢失率:4.41%和4.46%,手术前后和两组间差异无统计学意义;瞳孔阻滞:1只眼和1只眼;瞳孔形态异常:8只眼(药物散瞳下)和4只眼;人工晶状体位置异常:2只眼和3只眼;光晕或眩光:2只眼和8只眼;未见其他严重并发症.结论 IC-PIOL和AS-PIOL矫正高度近视18个月内均安全、有效,远期效果和并发症需进一步长期观察.

Clinical comparison of iris-claw phakic intraocular lens with angle-supported phakic intraocular lensfor correction of high myopia:18-month follow-up

Obiective To observe the therapeutic effect of iris-claw phakic intraocular lens(IC-PIOL) and angle-supported phakic intraocular lens (AS-PIOL) implantation for correction of high myopia,and investigate the efficacy, safety and complications of the two lenses. Methods 35 myopic eyes of 23 patients with spherical equivalent(SE) (-9.38～-24.13) D was implanted with the Verisyse IC-PIOL (IC-PIOL group), 31 myopic eyes of 22 patients with SE (-9.88～-22.25)D was implanted with the Phakic 6H AS-PIOL(AS-PIOL group). The follow-up period was 18 months. All of the treated eyes were observed for uncorrected visual acuity (UCVA),best corrected visual acuity (BCVA),manifest refraction,intraocular pressure,corneal endothelial cell and complications preoperatively and postoperatively. Results There is no significant difference in UCVA,BCVA,SE and astigmatism between the IC-PIOL group and AS-PIOL group preoperatively. Compared with preoperative data, UCVA, BCVA and SE of the two groups were improved significantly, furthermore there is no significant change from 7d to 18months among the groups. At 18-months, the data of IC-PIOL group and AS-PIOL group were as follows,the safety index (SI) was 1.018±0.017 and 1.019±0.022,the efficacy index (EI) was 0.983±0.024 and 0.979±0.036,and there is no significant difference in SI and EI between the two groups; the corneal endothelial cell loss rate was 4.41% and 4.46%, and there is no significant difference between preoperatively and postoperatively. Pupil block: 1 eye and 1 eye, pupil size abnormality: 8 eyes (under medical mydriasis) and 4 eyes ,IOL position abnormality: 2 eye and 3 eyes,halos or glare: 2 eyes and 8 eyes. NO other severe complications occurred. Conclusions During 18 months follow-up period, the implantation of the IC-PIOL and AS-PIOL proved to be safe and effective for the correction of high myopia in phakic eyes. However, longer follow-up period with larger numbers of patients is necessary to evaluate long-term efficacy, safety and complications.