有晶状体眼后房型人工晶状体临床应用研究  

Clinical study on implantable Contact lens

作　　者：卓建[1] 李淼[1] 刘蕾[1] 张亚丽[1] 胡明[1] 李招娜[1] 张华[1] 张玉光[1] 

机构地区：[1]济南市第二人民医院济南眼科医院,济南250001

出　　处：《中国实用眼科杂志》2015年第9期970-974,共5页Chinese Journal of Practical Ophthalmology

基　　金：济南市卫计委科技计划项目（201424）

摘　　要：目的 探讨有晶状体眼后房型人工晶状体（ICL）植入术治疗高度近视的安全性、有效性、可预测性及中长期疗效.方法 选取2010年1月至2011年12月在济南眼科医院屈光中心行ICL植入术的高度近视患者45例90只眼,术前、术后1周、1、3、6个月及1、2、3年进行随访,观察指标包括裸眼视力（UCVA）、最佳矫正视力（BCVA）、屈光度、眼轴、眼压、房角、前房深度（ACD）、500um处房角开放距离（AOD500）、屈光品状体拱高（ICL-vault）、角膜内皮细胞计数、对比敏感度、高阶像差等.对数据进行x2检验、t检验及相关性分析.结果 所有患者术后各阶段裸眼视力均达到或超过术前最佳矫正视力,与术前比较差异有统计学意义（P＜0.05）.术后1月屈光状态趋于稳定,球镜度在预期（0±1）D范围内,与术前比较差异有统计学意义（P＜0.05）.术后与术前眼压均正常.术前角膜内皮细胞计数（2 773.73±271.27）个/mm2,术后3年末次随访角膜内皮细胞计数（2 613.90±221.23）个/mm2,较术前减少,但均保有正常生理功能.术后随访3年期间房角、ACD、AOD500稳定,各自与术前比较均减小,差异有统计学意义（P＜0.05）,各自术后期间比较差异无统计学意义（P＞0.05）.术后房角虽然变小,但仍处于宽角状态.术后拱高稳定,其大小与术前ACD及角膜白到白距离呈正相关（r =0.37,r=0.38,P＜0.05）,随访3年拱高有减小趋势,但是差异无统计学意义（P＞0.05）.术后对比敏感度在各空间频率较术前均有显著提高,差异有统计学意义（P＜0.05）;术后总高阶像差较术前增加,差异无统计学意义（P＞0.05）,其中术后慧差较术前增加,差异有统计学意义（P＜0.05）.随访期内未发现瞳孔阻滞性青光眼和晶状体混浊等并发症.结论 随访3年观察,有晶状体眼后房型人工晶状体植入术矫正高度近视安全、有效、预测性好、术后视觉质量佳;ICL植�Objective To investigate the ICL implantation for the treatment of myopia of the safety, effectiveness, predictability and long-term curative effect.Methods Forty-five myopia patients （90 eyes） underwent ICL implantation in January 2010 to December 2011 at Jinan Eye Hospital.The UCVA, best corrected visual acuity （BCVA）, refraction, intraocular pressure （IOP）, anterior chamber angle, ACD, AOD～0, ICL-vault, corneal endothelial cell count, high-order aberration were follow-up at each time point.Results All postoperative visual acuity could reach or exceeded preoperative BCVA, compared with preoperative the difference was statistically significant （P 〈0.05）;1 month after surgery, refractive status tended to be stable, spherical equivalent in expected ± 1DS range, compared with preoperative the difference was statistically significant （P 〈0.05）;Postoperative IOP in the normal range, compared with preoperative the difference was no statistically significant （P 〉0.05）;3 years after operation corneal endothelial cell count reduced than preoperative （P 〈0.05）;Anterior chamber angle, ACD, AOD500 were decreased than preoperative （P 〈0.05）;Postoperative ICL-vault stability, its size were positively correlated with preoperative ACD and corneal white to white distances （r =0.37, r =0.38, P 〈0.05）;3 years follow up, ICL-vault was trended to decrease,compared with the difference was no statistically significant （P 〉0.05）;The postoperative contrast sensitivity at each spatial frequency increased than preoperative （P 〈0.05）;Postoperative high-order aberration increased than preoperative （P 〉0.05）;No complications occurred during follow-up period.Conclusions ICL phakic intraocular lens implantation to correct high myopia is safe, effective, and predictable.It can provide high-quality visuals.The anterior chamber structure is stabile after 3 years of ICL implantation.The effect of long-term is needed to observe continuously.

关 键 词：高度近视 ICL人工晶状体 有晶状体眼后房型人工晶状体植入术 拱高 高阶像差 

分 类 号：R776.1[医药卫生—眼科]