微切口无黏弹剂有晶状体眼后房型人工晶状体植入术治疗高度近视  

Clinical efficiency of micro-incision posterior chamber phakic intraocularlens implantation without viscoelastics in the treatment of myopia

作　　者：李海燕[1] 郭琳[1] 杨文[1] 王从毅[1] 马波[1] LI Hai-Yan;GUO Lin;YANG Wen;WANG Cong-Yi;MA Bo(the Department of Ophthalmology,Xi’an No.4 Hospital,Xi’an 710054,Shaanxi Province,China)

机构地区：[1]西安市第四医院眼科

出　　处：《眼科新进展》2019年第6期544-548,共5页Recent Advances in Ophthalmology

基　　金：陕西省自然科学基础研究计划项目(编号:S2015YFJ-M1486);陕西省社会发展科技攻关项目(编号:S2016YFSF0464)~~

摘　　要：目的观察2.2 mm微切口无黏弹剂有晶状体眼后房型人工晶状体(implantable collamer lens,ICL)植入术治疗高度近视的临床效果。方法选取2017年10月至2018年5月在我院就诊的高度视患者40例(80眼),按术中是否使用黏弹剂随机分为无黏弹剂组(2.2 mm微切口ICL植入)(n=22)和有黏弹剂组(3.2 mm切口ICL植入)(n=18)。对比术前及术后1 d、1周、1个月两组患者裸眼视力(uncorrected visual acuity,UCVA)、眼压、角膜内皮细胞数、手术时间和手术相关并发症。结果与术前相比,术后1 d两组患者左右眼UCVA和角膜内皮细胞数均降低,眼压升高,差异均有统计学意义(均为P<0.05)。术后1周无黏弹剂组UCVA恢复正常(左眼:1.00±0.09;右眼:1.01±0.08),而有黏弹剂组患者左右眼UCVA分别为0.84±0.09和0.89±0.10。术后1周无黏弹剂组患者左、右眼眼压降低至(17.85±3.05)mmHg(1 kPa=7.5 mmHg)和(17.64±3.55)mmHg,而有黏弹剂组为(22.11±1.68)mmHg和(21.78±1.96)mmHg。术后1周无黏弹剂组患者左右眼角膜内皮细胞数接近术前水平,分别为(2650.91±227.98)个·mm^-2和(2624.41±161.82)个·mm^-2,而有黏弹剂组为(2524.22±183.83)个·mm^-2和(2570.39±218.67)个·mm^-2。术后1个月有黏弹剂组患者UCVA、眼压和角膜内皮细胞数恢复正常。无黏弹剂组较有黏弹剂组手术时间短,两组除部分患者眼压较高外均无手术相关并发症发生。结论 2.2 mm微切口无黏弹剂ICL植入术早期视力恢复快、眼压稳定、手术时间短,手术安全可靠。Objective To evaluate the clinical efficiency of 2.2 mm micro-incision posterior chamber phakic intraocularlens implantation(ICL) without viscoelastics application in the treatment of myopia.Methods We enrolled 40 patients(80 eyes) with hypermyopia in our hospital from October 2017 to May 2018 and randomly devided them into non-viscoelastics group(2.2 mm micro-incision ICL)(n=22) and viscoelastics group(3.2 mmincision ICL)(n=18) according to the intraoperative use of viscoelastics or not.The uncorrected visual acuity(UCVA),intraocular pressure,corneal endothelial cells counts,surgical time and surgery-associated complications in the two groups of patients were compared preoperatively and 1 day,1 week and 1 month postoperatively.Results Compared with the parameters prior to the operations,patients in the two groups had reduced UCVA and corneal endothelial cell mumbers as well as increased intraocular pressure 1 d after operations(all P<0.05).The UCVA of the non-visceral group returned to normal 1 week after surgery(OS:1.00±0.09;OD:1.01±0.08),while the OS and OD UCVA of the viscoelastic group were 0.89±0.10 and 0.84±0.09,respectively.At 1 week after the surgery,the OS and OD intraocular pressure of the patients in the non-viscous group decreased to(17.85±3.05)mmHg(1 kPa=7.5 mmHg) and(17.64±3.35)mmHg,while the intraocular pressure of the viscoelastic group was(22.11±1.68)mmHg and(21.78±1.96)mmHg.The numbers of OS and OD endothelial cells in the non-viscerous group at 1 week after surgerywere close to the preoperative level,which were respectively(2650.91±227.98)cells·mm^-2 and(2624.41±161.82)cells ·mm^-2,while the cell counts of the viscoelastic group were(2524.22±183.83)cells·mm^-2 and(2570.39±218.67)cells·mm^-2,respectively.UCVA,corneal endothelial cellcounts and intraocular pressure returned to normal levels in the viscoelastic group 1 month after the surgery.The surgical time was shorter in non-viscoelastics group than the viscoelastics group.No surgery related complications occurred in the two g

关 键 词：高度近视 后房型人工晶状体植入 无黏弹剂 临床效果 

分 类 号：R776[医药卫生—眼科]