高度近视微切口白内障术后远期临床疗效  

Long-term clinical effects of 2.0 mm microincision phacoemulsification for the patients with cataract and high myopia

作　　者：李汭澧 缪娜[1] 范玮[1] 

机构地区：[1]四川大学华西医院眼科,四川成都610041

出　　处：《中国医药导报》2017年第35期96-101,共6页China Medical Herald

基　　金：国家自然科学基金面上项目(81371023)

摘　　要：目的观察高度近视白内障患者行2.0 mm微切口白内障超声乳化手术的远期临床疗效。方法选取2015年10月~2016年3月于四川大学华西医院行2.0 mm微切口白内障超声乳化手术的高度近视白内障患者40例(68眼),采用前瞻性非随机对照研究。所有患者术前均行全身系统检查和眼部详细专科检查,包括:视力(非矫正远视力、最佳矫正远视力、最佳矫正近视力)、对比敏感度测试、裂隙灯、眼压、IOL Master、A/B型眼部超声、角膜地形图检查、角膜内皮镜检查、视网膜光学相干生物测量仪、视觉诱发电位检查。术后1 d、1周、3个月和1年随访,检查并记录非矫正远视力、最佳矫正远视力、最佳矫正近视力、对比敏感度、手术源性散光、人工晶状体位置、角膜内皮细胞丢失率、主切口处角膜厚度及并发症等。结果术后裸眼视力、最佳矫正远视力、最佳矫正近视力均较术前升高(P<0.01)。术后各空间频率对比敏感度均有所提高(P<0.05)。术后1年手术源性散光稳定在(0.154±0.214)D。术后3个月和术后1年人工晶状体在囊袋内无明显偏心或倾斜。术后3个月平均角膜内皮细胞丢失率为(6.21±19.79)%。术后3个月主切口处角膜厚度比术后1周明显减小(P<0.05)。术后主要并发症包括:术后3个月2眼(2.94%)前囊口收缩和术后1年2眼(2.94%)后发性白内障。结论高度近视白内障患者行2.0 mm微切口白内障超声乳化手术安全、有效,远期临床疗效良好。Objective To study the long-term clinical effects of 2.0 mm microincision phacoemulsification for the patients with cataract and high myopia. Methods In this consecutive observational noncomparative clinical trial, a total of 40 patients （68 eyes） with cataract and high myopia were enrolled in the study from October 2015 to January 2016, who underwent 2.0 mm microincision cataract surgery. Preoperatively, all patients underwent a comprehensive systemic and ophthalmic examination including slit-lamp microscopy, uncorrected distance visual acuity （UCVA）, best-corrected distance visual acuity （BCDVA）, best-corrected near visual acuity （BCNVA）, intraocular pressure （IOP）, biometry （IOLMaster 500; Carl Zeiss Meditec, Jena, Germany）, ocular ultrasound, corneal topography, corneal specular microscopy, and optical coherence tomography （OCT）. Follow-up visits were conducted at 1 day, 1 week, 3 months and 1 year postoperatively. The outcomes were uncorrected corrected distance visual acuity（UDVA）, best corrected distance acuitiy（BCDVA）, best corrected near acuity （BCNVA ）, contrast sensitivity（CS）, surgically induced astigmatism （SIA）, IOL position stability, endothelial cell count loss, corneal incision thickness and complications. Results A statistically significant improvement was observed in UDVA between preoperative and postoperative （P 〈 0.05）, as well as for BCDVA （P 〈 0.05）. Contrast sensitivity was significantly improved（P 〈 0.05）, and the mean SIA was only （0.154±0.214）D at 1 year postoperatively. Effective lens positions of all IOLs remained well though 1 year postoperatively. Mean endothelial cell count loss was （6.21±19.79）% at 3 months postoperatively. There was statistically significant difference in CCT at the incision site between postoperative 1 week and 3 months （P 〈 0.05）. Postoperatively major complications included 2 eyes （2.94%） with anterior capsule contraction at 3 months and 2 eyes （2.94%） with posterior caps

关 键 词：高度近视 白内障手术 微切口 临床疗效 

分 类 号：R776[医药卫生—眼科]