Bigbag人工晶状体应用于高度近视白内障眼玻璃体后脱离的临床观察

目的 观察Bigbag人工晶状体在治疗高度近视白内障眼中玻璃体后脱离的发生情况。方法 对38例(66眼)高度近视并发白内障患者行白内障超声乳化吸除联合Bigbag人工晶状体植入术后随访6个月，观察手术前后视力、屈光状态、术后并发症，A型超声检测眼轴长度及中轴区晶状体后嚢膜至视网膜的距离，B型超声结合裂隙灯前置镜检查玻璃体后脱离情况。结果 术后6个月的裸眼远视力及最佳矫正远视力较术前明显提高，差异有统计学意义；术后6个月屈光度较术前明显降低，差异有统计学意义；术后6个月眼轴长度与术前比较，差异无统计学差异；术后6个月中轴区晶状体后嚢膜至视网膜的距离比术前增长，差异有统计学意义；术后6个月与术前眼轴长度差值的平均值为(1.56±0.41)mm；术前玻璃体后脱离发生率为68.18%(45/66眼)；术前无玻璃体后脱离21眼，术后6个月出现玻璃体后脱离14眼，术后发生率为66.67%(14/21眼)；术后随访6个月，无视网膜脱离发生。结论 Bigbag人工晶状体在高度近视白内障眼中的应用安全、有效，术后玻璃体后脱离的发生率较低。

Effect of posterior vitreous detachment in high myopia eyes after Bigbag intraocular lens implantation

Objective To evaluate the occurrence of posterior vitreous detachment (PVD) in high myopia patients’ cataract surgery with Bigbag intraocular lens implantation. Methods Sixty-six eyes in 38 high myopia patients received phacoemulsification to remove cataract. Then Bigbag intraocular lens were implanted into capsular bag. Pre-operative and post-operative best uncorrected distance visual acuity (BUDVA), best corrected distance visual acuity(BCDVA), refractive status were collected. The axial length of the eyeballs and the distance from the central of posterior capsule to the retina were measured by A-mode ultrasound. Occurrence of PVD was evaluated by B-scan ultrasonography and Non-contact slit lamp lenses. Results Six months after the operations, BUDVA and BCDVA were significantly improved compared with those pre-operatively, while the spherical diopter was significantly decreased. But the axial length had not significantly changed. The distance from the central of posterior capsule to retinal became longer than that before the operations, with the average margin for distance variation of (1.56±0.41)mm. Pre-operatively, PVD was detected in 45 eyes (68.18%). Of the 21 eyes without PVD before the operation, 14 eyes (66.67%) developed PVD post-operatively. No retinal detachment was detected. Conclusion Bigbag intraocular lens implantation is safe and effective for high myopia eyes with cataract. The incidence of PVD in such patients is relatively low.