角膜基质透镜取出及自体移植术矫正远视及屈光参差的尝试  

The attempt for correcting the hyperopia and anisometropia with the femtosecond laser corneal stromal lenticule extraction and autologous transplantation

作　　者：胡萌菲 李世洋[1] 邢星[1] Hu Mengfei;Li Shiyang;Xing Xing(Department of Ophthalmology,the 989th Hospital of the Joint Logistics Support Force of the Chinese PLA,Luoyang 471031,China)

机构地区：[1]中国人民解放军联勤保障部队第989医院眼科,洛阳471031

出　　处：《中华眼外伤职业眼病杂志》2021年第11期855-860,共6页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的评价飞秒激光角膜基质透镜取出术(SMILE)及角膜基质透镜自体移植术矫正远视及屈光参差的效果。方法回顾性分析解放军第989医院2019年3月至2020年6月成人混合性屈光参差12例的临床资料,患者一眼近视,对侧眼为远视,双眼屈光度恰相匹配,近视的一眼采用SMILE手术,取出的角膜基质透镜备用,远视的一眼参照SMILE的术式,但将备用的角膜基质透镜植入角膜瓣下。术后进行随访观察。结果全部手术均顺利完成。植入的透镜居中、透明,术中及术后均无严重并发症;术后视远及视近能力均有不同程度提高,角膜曲率明显增加,角膜厚度明显增厚,视疲劳症状明显减轻,患者满意率为83.3%(10/12)。结论飞秒激光SMILE及对侧眼自体移植术矫正远视及屈光参差早期效果良好,但仍需大样本深入研究,而且远期效果有待进一步观察。Objective To evaluate the efficacy of small incision lenticule extraction(SMILE)and corneal stromal lenticule autologous transplantation for correction of hyperopia and anisometropia.Methods The clinical data of 12 cases of mixed anisometropia in adult from Mar.2019 to Jun.2020 in the 989th Hospital of the Joint of Logistics were analyzed retrospectively.One eye of the patients was myopia and the other eye was hyperopia.The diopter of both eyes was just matched.The myopia was corrected with SMILE,and the corneal stromal lens was taken out for reserve.The procedure of SMILE was followed for hyperopia,and the spare corneal stromal lens was implanted under the corneal flap.The intraoperative and postoperative complications,corneal morphology and lens implantation were observed.The uncorrected distant and near visual acuity,diopter,corneal curvature,corneal thickness and patient satisfaction were observed at 1,3 and 6 months after surgery.Results All operations were successful,and the implanted lens were centered and transparent.There was no serious intraoperative or postoperative complication.After operation,the distant and near visual acuity were improved in varying degrees,the corneal curvature and the corneal thickness increased significantly,and the symptoms of visual fatigue were relieved significantly.The satisfaction rate of patients was 83.3%(10/12).Conclusion Femtosecond laser corneal stromal lens extraction and opposite eye autologous transplantation for hyperopia and anisometropia are with good efficacy in early stage,but it still needs in-depth study of large sample cases,and the long-term efficacy needs to be further observed.

关 键 词：矫正 远视 矫正 屈光参差 取出术 角膜基质透镜 移植术 角膜基质透镜 自体 

分 类 号：R779.6[医药卫生—眼科]