有晶体眼后房型人工晶体植入术早期并发症的临床研究  

Early complications of posterior chamber implantable collamer lens implantation

作　　者：叶诗洋 徐燕[2] 徐洁[2] 叶剑[2] 熊鸿燕[1] 

机构地区：[1]第三军医大学预防医学院军事流行病学教研室,重庆400038 [2]第三军医大学大坪医院野战外科研究所眼科,重庆400042

出　　处：《第三军医大学学报》2015年第10期1035-1039,共5页Journal of Third Military Medical University

摘　　要：目的观察有晶体眼后房型人工晶体（implantable collamer lens,ICL）植入治疗高度近视的早期并发症以及处理情况,探讨其发生原因。方法观察在大坪医院眼科行有晶体眼人工晶体植入术的患者40例78眼,术后对患者的裸眼视力（UCVA）、最佳的矫正视力（BCVA）、等效球镜（SE）、眼压（IOP）、角膜内皮细胞计数及人工晶体拱高进行3个月随访,评估临床效果并记录并发症、处理方法以及处理后的情况。结果裸眼视力在术后均有显著提高,等效球镜度数与术前比较差异有统计学意义（P〈0.05）;术后各随访期的眼压、裸眼视力、等效球镜、人工晶体拱高、角膜内皮细胞计数差异无统计学意义（P〉0.05）。早期并发症：激光虹膜周切后有35眼在24 h内出现高眼压,进行降眼压治疗后次日恢复正常,仅1眼高眼压状态22~30 mm Hg持续8 d。2例患者术后发生视网膜黄斑中心凹上皮层脱离,其中1例伴有视网膜黄斑板层裂孔。术后患者的人工晶体表面上都有一定程度的虹膜色素沉着,但无明显视力影响。术后视觉干扰主要表现为夜晚眩光。结论 ICL植入术作为眼内的屈光手术仍具有一定的风险,因此临床上完善术前检查、严格掌握适应证、及时识别及处理早期并发症,能够有效地降低手术带来不良事件的风险,提高手术安全性。Objective To investigate collamer lens （ICL） implantation for the treatment early complications of posterior chamber implantable of high myopia, and explore the reasons causing the complications. Methods Forty patients （78 eyes） who underwent ICL implantation in our hospital from April to September 2014 were recruited. During 3-month follow-up, uncorrected visual acuity （UCVA）, best corrected visual acuity （ BCVA）, spherical equivalent （SE） , intraocular pressure （lOP） , corneal endothelial cell count and lens vault were observed to assess the clinical effectiveness, and the complications and treatment results were recorded. Results After operation, UCVA and SE were improved significantly （P 〈 0. 05）, but there were no significant differences in the IOP, UCVA, SE, lens vault and corneal endothelial cell count in 1 week, and 1 and 3 month after operation （P 〉 0. 05 ）. After laser iridectomy, high intraocular pressure symptoms appeared in 35 eyes within 24 h. In the next day, the intraocular pressure was recovered to the normal level after drug treatment. Only one case of high intraoeular pressure （22 -30 mmHg） lasted for 8 d. Retinal neurepithelium layer detachment was observed in 2 eyes, and 1 eye was accompanied by lamellar macular holes. After operation, the lenses of all the patients showed iris pigmentation, but there was no significant impact on vision. Postoperative visual disturbances mainly were night glare. Conclusion ICLimplantation as intraocular refractive surgery still has some risks. Therefore, to improve the clinical examination, strictly grasp the operation indications and treat the early complications effectively reduce the risk of adverse events and improve surgical safety. preoperative in time can effectively reduce the risk of adverse events and improve surgical safety.

关 键 词：有晶体眼后房型人工晶体 高度近视 并发症 

分 类 号：R181.32[医药卫生—流行病学] R778.11[医药卫生—公共卫生与预防医学]