超声乳化人工晶状体植入术治疗高度近视白内障  

Phacoemulsification combining with IOL implantation in cataract patients with high myopia

作　　者：鲁宇容[1] 石浔[1] 郭海科[2] 

机构地区：[1]江西省南昌市第一医院眼科,330008 [2]广东省人民医院眼科,广州510080

出　　处：《眼科新进展》2004年第6期472-474,共3页Recent Advances in Ophthalmology

摘　　要：目的　观察超声乳化联合人工晶状体植入术治疗高度近视白内障患者的术后疗效。方法　对 2 87例 (30 2眼 )高度近视白内障患者 (球镜度数 - 6 .0～ - 4 0 .0D)行超声乳化联合人工晶状体植入术 ,观察眼轴长度 ,术前、术后远视力(DVA)、最佳矫正视力 (BCVA) ,术后并发症发生情况。随诊时间 3～ 36月 ,平均 19.8月。结果　术后 1月远视力、BC VA均较术前明显提高 ;眼轴 <2 9mm的患者组术后视力好于眼轴≥ 2 9mm的患者组 (P <0 .0 5 ,差异有显著性 ) ;术后 1月术眼的屈光状态 :球镜度数 :+1.0～ - 5 .0D ,18眼仍残留- 3.0～ - 5 .0D的近视 ,散光度数 :术前、术后无显著差异性(P >0 .2 5 ) ,单眼术后屈光参差 >3.0D者 16 3眼 ;术后主要并发症为后囊混浊 (110眼 ) ,7眼眼底出血 ,4眼视网膜脱离 ,33眼进行性高度近视视网膜病变 ,6 1眼感觉术后眼前飞蚊及黑影增多 ;双眼同时手术或手术时间相隔 3月以内的 15例 (30眼 )患者 ,术中、术后均未发现明显特殊并发症。结论超声乳化联合人工晶状体植入术治疗高度近视白内障具有视力恢复较好、矫正屈光不正等优点 ,是高度近视白内障较有效、安全、理想的手术方式。Objective To observe the clinical effect of pha coemulsification combining with LOL implanation in cataract patients with high m yopia. Methods Two hundred and eighty-seven cases(302 eyes) of highly myopic cataract patient s(spherical lens:-6.0～-40.0D)were involved.All eyes had undergone phacoemul si fication with IOL implantation.The ocular axial length,distance visual acuity (D VA) and best corrected v isual acuity (BCVA) were examined before and after operation.The postoperative complications were also observated.These patients were followed up for 3～36 months(mean 19.8 months). Results DVA and BCVA were improved sig nificantly in 1 month after operation;The BCVA in cases with axial length be low 29mm was better than in cases with axial length over 29mm(P<0.05,the dif ference was statistically significant);One month following operation,the refrac tive conditions:spherical lens:+1.0～-5.0D,18 eyes still had the spherical ref raction of -3.0 ～-5.0D,the difference of astigmatism between the preoperatim and the post-operation was unobvious(P>0.25,there was no statistically si gnificant difference).There was over 3.0D anisonetropia of single eye in 163 ey es after operation;The main postoperative complications were posterior capsule opacification in 110 eyes, fundus hemorrhage in 7 eyes,retinal detachment in 4 eyes and farther high myopia retinopathy in 33 eyes.Some patients (61 eyes) felt more floaters and black-shadows after operation;There were no obvious and p articular intraoperative and postoperative complications in these patients who both eyes had undergone operation at the same time or in 3 months. Conclusion Phacoemu lsification combining with IOL implantation offers advantages of better rehabili tation of visual acuity, proper correction of ametropia and is a effective,safe, and an ideal technique for highly myopia cataract patients.

关 键 词：高度近视 白内障 超声乳化 人工晶状体 

分 类 号：R779.66[医药卫生—眼科]