高度近视白内障植入Bigbag及MI60人工晶体的早期临床观察

目的：探讨高度近视并发性白内障行超声乳化吸出植入Bigbag及MI60两种人工晶体后的早期临床疗效。方法分析该科高度近视并发性白内障行超声乳化吸出并植人工晶体83例（117眼）。其中植入Bigbag人工晶体44例（61眼）为A组，植入MI60人工晶体39例（56眼）为B组。记录两组围手术期相关评价指标：眼轴及前房深度、裸眼视力、最佳矫正视力、对比敏感度、屈光状态、晶体位置、并发症等。结果（1）术后6个月两组前房深度较术前增加，同时组间有统计学意义（P＜0．01）。术后6个月与术前玻璃体腔前后径（视轴区后囊膜至视网膜的距离）的差值：B组（4．51±0．81）mm明显大于A组（2．92±0．79）mm，P＜0．01。（2）两组术后6个月实际屈光度与术前预留屈光度差值：A组≤±1．0D有43眼（70．49％），B组≤±1．0D 有32眼（57．14％）。（3）两组术后裸眼视力较术前改善明显（P＜0．01）；两组术后6个月BCVA（最佳矫正视力）及对比度视力均无统计学意义（P＞0．05），术后主观视觉问卷调查显示A组满意度高于B组。（4）并发症：A组后囊膜混浊4例、玻璃体后脱离2例；B组后囊膜混浊5例、人工晶体偏心1例、玻璃体后脱离5例。结论高度近视性白内障植入特殊设计的Bigbag人工晶体使手术前后前房深度、玻璃体腔前后径的改变较小，预留晶体度数更准确，术后视力提高明显，主观满意度较高。

Early clinical observation on the application of Bigbag and MI60 intraocluar lens implantation in cataract patients with high myopia

Objective To discuss and explore the early clinical effects between the Bigbag and MI60 intraocluar lens (IOL)implanta-tion in cataract patients with high myopia.Methods We investigated the clinical data of 83 patients who had received phacoemulsifica-tion and IOL implantation.The patients were divided into two groups:group A (n=44,61 eyes)all used the Bigbag IOL and group B (n=39,56 eyes)all used MI60 IOL.Preoperative and postoperative axial length,anterior chamber depth,visual acuity,BCVA (best corrected visual acuity),contrast sensitivity,refractive status were recorded.Position of the intraoeular lens and postoperative complica-tions were observed.Results (1 )The postoperative anterior chamber increased in two groups than preoperative one,and group B in-creased more significantly than group A (P <0.05).The variations in distance from the posterior capsule membrane to the retina were significantly different between group A (2.92 ±0.79)mm and group B (4.51 ±0.81)mm.(2)The diopter of refractive error 6 months after surgery:43 eyes (70.46%)of bigbag group were within 1.0 D,and 32 eyes (57.14%)of M160 group were within 1.0 D.(3)The postoperative visual acuity of two groups was improved significantly compared with the preoperative (P<0.05),but there was no signif-icant difference on best corrected visual acuilty and curves of contrast sensitivity.Postoperative subjective visual satisfaction in group A was superior to group B.(4)Complications:goup A has 4 cases of capsular opacification and 2 cases of posterior vitreous detachment;group B has 5 cases of capsular opacification,1 case of IOL deviation,and 5 cases of posterior vitreous detachment.Conclusions This clinical research showed Bigbag IOL is more suitable than MI60 IOL in cataract patients with high myopia,which is more effective and safe.