后房型有晶状体眼人工晶状体植入术治疗高度近视  

Posterior chamber phakic intraocular lens implants for high myopia

作　　者：罗岩[1] 胡六梅[1] 徐婧[1] 李莹[1] 

机构地区：[1]中国医学科学院北京协和医院,100730

出　　处：《中华眼视光学与视觉科学杂志》2012年第9期551-554,共4页Chinese Journal Of Optometry Ophthalmology And Visual Science

摘　　要：目的评价后房型有晶状体眼人工晶状体（ICL）植入术治疗高度近视术后1年的有效性和安全性。方法回顾性病例研究。高度近视患者149例（290眼）接受ICL植入手术。其中男107眼，女183眼，平均年龄（29．0±6．5）岁。术前平均等效球镜度（-13．2±5．6）D。随诊时检查视力、眼压、屈光度和其他副作用。结果所有眼睛的术后裸眼视力都有提高，接近术前最佳矫正视力。最后一次随访时199眼（68．6％）术后裸眼视力高于术前最佳矫正视力1行以上，无最佳矫正视力下降的病例。术后3h内32眼眼压超过35mmHg，其中13眼为瞳孔阻滞，19眼考虑为黏弹剂残留。术后随诊时发现3眼眼压在21～25mmHg之间。2眼术后3个月以后发生黄斑区出血，3个月后出血吸收。3眼（2例）因为术后光晕干扰视物不适而取出ICL。12眼因为术后拱高欠佳而进行了人工晶状体置换术。结论随诊1年显示ICL植入治疗高度近视是一种安全、有效而并发症少的治疗方法。Objective To evaluate the efficacy, safety, and biocompatibility of a posterior chamber phakie intraocular lens （PCPIOL） to correct high myopia within 1 year. Methods In a retrospective case series study, an implantable intraocular lens was implanted in 290 eyes of 149 patients with a mean age of 29.0±6.5 years （range 20 to 49 years）. There were 107 eyes from males and 183 eyes from females. Mean preoperative myopia was -13.2±5.6 D （range -6.0 to -32.0 D）. The follow-up included tests for visual acuity, intraocular pressure, manifest refraction, and adverse reactions. Results Postoperatively, all eyes had a significant increase in uncorrected visual acuity （UCVA）. Best corrected visual acuity （BCVA） had improved by 1 or more lines in 199 eyes （68.6%） at 1 year. No eye lost BCVA. Thirty-two eyes developed intraocular pressure （IOP） more than 35 mmHg within 3 hours after the implantation. Pupillary blockage caused an increase in IOP in 13 eyes and insufficient removal of viscoelastic material caused an increase in 19 eyes. IOP returned to normal in the following days after quick treatment. Three eyes had intraocular pressure between 21-25 mmHg. Two eyes had macular hemorrhage 3 months after the implantation, and the hemorrhage regressed 3 month later. Three IOLs were removed from 2 patients because of an intolerant halo. The IOLs were exchanged in 12 eyes in 1 year because of high or low vault. Conclusion After 1 year of follow-up, IOL implantation had good visual and refractive results with excellent biocompatibility and fewer adverse reactions.

关 键 词：近视 退行性 有晶状体眼 人工晶状体植入术 

分 类 号：R779.6[医药卫生—眼科]