两种有晶状体眼人工晶状体治疗高度近视的初步疗效分析  

Implantation of two kinds of phakic intraocular lens for high myopia:an analysis of clinical efficacy

作　　者：陈轶卉[1] 盛敏杰[1] 林安娟[1] 谢春蕾[1] 汪维芳[1] 赵菲[1] 

机构地区：[1]同济大学附属第十人民医院眼科,上海200072

出　　处：《上海医学》2007年第11期818-821,共4页Shanghai Medical Journal

摘　　要：目的探讨两种有晶状体眼人工晶状体植入术治疗高度近视的初步临床疗效。方法对19例37眼高度近视患者施行有晶状体眼人工晶状体植入术,其中前房虹膜夹型的人工晶状体Verisyse(Artisan)植入9例17眼,后房型可折叠的人工晶状体Staar Visian ICL植入10例20眼。术前裸眼视力0.01～0.1,最佳矫正视力为0.4～1.0,近视平均屈光度为-(11.29±2.90)D,平均角膜内皮细胞计数为(2331±347)个/mm^2,平均六角形细胞比例为(59.2±1.8)%。术后随访4～10个月。结果所有手术均顺利,术中未出现并发症。术后裸眼视力为0.4～1.0,最佳矫正视力为0.5～1.0。随访结束时平均角膜内皮细胞计数为(2210±506)个/mm^2,损失率中位数为5.2%;平均六角形细胞比例为(58.2±10.1)%,与术前的差异无统计学意义(P>0.05)。所有患者术后球面等值屈光度均在预期屈光度士1.00D范围内。术后第1天,1眼前房虹膜夹型的人工晶状体植入者眼压升高,局部应用降眼压眼液后,恢复正常,其他眼术后随访期间眼压均维持正常。术后2例4眼出现夜间视力降低和眩光,其中前房型Verisyse(Artisan)和后房型Staar Visian ICL各1例2眼。结论有晶状体眼人工晶状体植入术可有效治疗高度近视。手术具有安全性、有效性及可预测性。Objective To evaluate the clinical efficacy of the two kinds of phakic intraocular lens（IOL） for high myopia. Methods Totally 37 eyes of 19 patients with high myopia were included in the present study. Seventeen eyes of 9 patients were implanted with an Artisan anterior chamber iris-claw phakic IOL; another 20 eyes of 10 patients were implanted with a Staar posterior chamber foldable phakic IOL. Preoperative uncorrected visual acuity （UCVA） of patients was 0.01-0.1; the best spectacle-corrected visual acuity（BSCVA） was 0.4-1.0; the mean preoperative myopia was -（11.29±2.90） diopters（D）; the mean endothelia cell density（ECD） was 2 331 ± 347 cells/mm^2 , and the mean proportion of hexagonal cells was（59.2± 1.8） %. The patients were followed up for 4-10 months. Results All implantations were uneventful and there were no operative complications. Postoperatively, the UCVA was 0.4-1.0 and BSCVA was 0.5-1.0. The mean endothelia cell density was 2 210±506 cells/mm^2 at the end of follow-up, with a mean loss of 5.2%. The mean proportion of hexagonal cells was（58.2 ± 10. 1）%, with no significant difference when compared with that of pre-operation（P 〉 0.05）. The mean spherical equivalent refraction of all eyes was within ± 1.00 D of the targeted refraction. One eye had increased intraocular pressure at the first day of post-operation after implantation of an Artisan anterior chamber iris-claw phakic IOL, but the situation was controlled after intervention. Other patients had normal intraocular pressure after operation. Four eyes（2 patients） had decreased night vision and glare, with 2 eyes（1 patients） of Artisan anterior chamber iris-claw phakic IOL group and another 2 eyes in Staar posterior chamber foldable phakic IOL group. Conclusion The implantation of phakic intraocular lens is safe and effective approach for high myopia. （Shanghai Med J, 2007, 30：818-821）

关 键 词：高度近视 人工晶状体 有晶状体眼 

分 类 号：R779.6[医药卫生—眼科]