准分子激光屈光性角膜手术后白内障人工晶状体植入术  

Phacoemulsification with intraocular lens implantation after excimer photorefractive keratectomy for myopia

作　　者：冯其高[1] 罗恒[1] 黎明[1] 唐松[1] 闻慧[1] 

机构地区：[1]暨南大学深圳市眼科中心深圳市眼科医院,广东深圳518001

出　　处：《眼外伤职业眼病杂志》2006年第9期664-667,共4页Journal of Injuries and Occupational Diseases of the Eye with Ophthalmic Surgeries

摘　　要：目的探讨准分子激光屈光性角膜手术后白内障吸出术中、植入人工晶状体的屈光度计算方法。方法对4例(4眼)准分子激光屈光性角膜手术后的白内障行超声乳化吸出及人工晶状体植入术,术前采用OrbscanⅡ角膜地形图及角膜曲率计测量角膜的K值,分别应用第二代经验公式(SRKⅡ)计算所需人工晶状体的屈光度。术后验光记录术眼屈光状况,与术前结果对比,评价所选择的人工晶状体屈光度的准确性。结果OrbscanⅡ角膜地形图和角膜曲率计分别测量的角膜K值,以及所计算的人工晶状体的屈光度,均有明显的差别。尽管按预留近视状态,选用角膜地形图测量的K值计算人工晶状体的屈光度,术后仍然欠矫,平均产生远视+1.57D,较术前预留度数仍相差约+3.44D。结论采用OrbscanⅡ角膜地形图的K值来计算人工晶状体屈光度误差小,在预留的屈光度数基础上加3.50D来选择人工晶状体是较为精确和安全的。Objective To study the surgical skills and clinical results of phacoemulsification with intraocular lens implantation after excimer photorefractive keratectomy for myopia, and to find a method to predict intraocular lens （IOL） power in these cases. Methods The patients with complicated cataract after excimer photorefractive keratectomy were operated with phacoemulsification and intraocular lens implantation. The keratometric value （K value） was measured by corneal topography and keratometry preoperatively, and the K value measured by corneal topography were used to calculated the IOL power. After the operation the K value was measured by the corneal topography again and all the patients took a optometry. And then compare the results preoperatively and postoperatively to assess the accuracy of IOL power. Results The corrected vision after operation was improved. The K value measured by Orbscan Ⅱ corneal topography was not significantly changed after operation. If used these K value to predict IOL power the eye sight will be insufficiently correct. The mean refractive error was ＋ 1.57D postoperatively, which had ＋ 3.44D error with the predictability IOL power refractive error preoperatively . Conclusions Phacoemulsification with intraocular lens implantation can cure the cataract after excimer photorefractive keratectomy effectiveky. It is safe to keep - 3D to - 5D refractive error of IOL power preoperatively if the K value measured by Orbscan Ⅱ corneal topography was used to calculated the IOL power .

关 键 词：白内障 光学屈光性角膜手术 晶状体 人工 

分 类 号：R779.63[医药卫生—眼科] R779.66[医药卫生—临床医学]