中老年高度近视透明晶状体摘除联合Bigbag人工晶状体植入术的临床观察  

A study on transparent lens replacement with Bigbag IOL for treatment of high myopia in aged people

作　　者：朱福景 王鑫峥 刘静薇 苏金萍 陈建霞 王月兰 

机构地区：[1]北京水利医院眼科,100036 [2]北京民众眼科医院 [3]山西省临猗县眼科医院

出　　处：《眼科》2011年第2期94-97,共4页Ophthalmology in China

摘　　要：目的观察透明晶状体超声乳化吸除联合Bigbag人工晶状体植入术治疗中老年高度近视的有效性及安全性。设计回顾性病例系列。研究对象40～65岁高度近视患者20例(36眼)。方法采用IOL-Master测算人工晶状体度数,患眼均行透明晶状体超声乳化吸除联合Bigbag人工晶状体植入术,比较手术前后视力及屈光状态;观察术中、术后并发症。主要指标视力、屈光状态、后囊膜皱褶。结果术前裸眼视力均<0.3,术前最佳矫正视力>0.6者5眼(13.9%),术后3天裸眼视力>0.6者10眼(27.8%),术后1个月、3个月最佳矫正视力>0.6者分别为21眼(58.3%)、20眼(55.6%)。术后1个月屈光度+1.50～-2.00 D,平均(-0.58±0.68)D;术后3个月屈光度+1.50～-2.00 D,平均(-0.58±0.64)D,与术后1个月比较差异无统计学意义(P=1.000)。术中1眼发生后囊膜破裂,行前部玻璃体切除,人工晶状体植入囊袋内。未发现其他术中、术后并发症。后囊膜未发现皱褶,人工晶状体固定良好。术后3个月3眼(8.3%)后囊膜轻度混浊,观察至6个月无进展。结论透明晶状体超声乳化吸除联合Bigbag人工晶状体植入术治疗中老年高度近视是一种安全、有效的手术方法,Bigbag人工晶状体可对后囊膜起到稳定的支撑作用。Objective To evaluate the efficacy and safety of transparent lens phacoemulsification extraction combined with Bigbag intraocular lens implantation for treatment of high myopia. Design Retrospective case series. Participants 36 eyes of 20 patients aged 40-65 years with high myopia. Methods Intraocular lens refraction was calculated with IOL-Master. Transparent lens phacoemulsification extraction combined with posterior chamber Bigbag intraocular lens implantation was performed on all eyes. The postoperative visual acuity, refraction and complications were recorded. Main Outcome Measures Visual acuity, refraction, and posterior capsular crease. Results The preoperative uncorrected visual acuity of all eyes was less than 0.3. The preoperative best corrected visual acuity was better than 0.6 in 5 eyes （13.9%）. The uncorrected visual acuity was better than 0.6 in 10 eyes （27.8%） 3 days after surgery. The best corrected visual acuity was better than 0.6 in 21 eyes （58.3%） 1 month after surgery and in 20 eyes （55.6%） 5 months after surgery. The mean refraction was （-0.58±0.68）D （from ＋1.50 to -2.00 D） 1 month after surgery, and （-0.58±0.64）D （from ＋1.50 to -2.00 D） 3 months after surgery, which was not statistically different between 1 month and 5 months （P=1.000）. During these operations, only one eye＇s posterior capsular was broken and an anterior vitrectomy was performed on this eye. There was no other complications occurred in follow-up time. All eyes had no posterior capsular creases. Bigbag IOL was fixed perfectly. Slight after-cataract was found in 3 eyes （8.3%） 3 months after surgery, which didn＇t advance until 6 months after surgery. Conclusions Transparent lens phacoemulsification extraction combined with Bigbag intraocular lens implantation is an effective and safe method for high myopia in aged people. Bigbag IOL can support the posterior capsule membrane by its special design.

关 键 词：高度近视 透明晶状体 人工晶状体 晶状体超声乳化吸除术 

分 类 号：R779.66[医药卫生—眼科]