Trans-PRK联合ICL治疗超高度近视疗效观察  

Clinical study of transepithelial photorefractive keratectomy combined with implantable contact lenses in the treatment of ultra-high myopia

作　　者：杨文 马波[1] 戴鹏飞 吴利安[1] 邓瑾 YANG Wen;MA Bo;DAI Peng-fei;WU Li-an;DENG Jin(Department of Ophthalmology,Xi'an People's Hospital(Xi'an Fourth Hospital)/Shaanxi Eye Hospital/Guangren Hospital Affiliated to School of Medicine,Xi'an Jiaotong University,Xi'an 710004,Shaanxi,CHINA)

机构地区：[1]西安市人民医院(西安市第四医院)/陕西省眼科医院/西安交通大学医学院附属广仁医院眼科,陕西西安710004

出　　处：《海南医学》2022年第17期2233-2236,共4页Hainan Medical Journal

基　　金：陕西省社会发展科技攻关项目(编号:2016SF-091)。

摘　　要：目的观察经角膜上皮激光角膜切削术(Trans-PRK)联合可植入式隐形眼镜(ICL)治疗超高度近视的临床效果。方法选择2019年11月至2020年11月西安市人民医院(西安市第四医院)收治的高度近视患者100例(120眼),按随机数表法分为观察组(n=50,62眼)和对照组(n=50,58眼)。对照组患者给予ICL治疗,观察组患者则给予Trans-PRK联合ICL治疗。比较两组患者术前、术后1个月的最佳矫正视力、裸眼视力、角膜光密度、眼压、ICL拱高、前房容积、前房深度及角膜内皮细胞数变化,统计术后1个月患者并发症发生情况。结果术后1个月,两组患者的最佳矫正视力降低,且观察组为(0.22±0.01)logMAR,明显低于对照组的(0.32±0.05)logMAR,而裸眼视力及角膜光密度均升高,且观察组分别为(5.08±0.31)logMAR、21.67±2.31,明显高于对照组的(4.89±0.28)logMAR、19.01±2.40,差异均具有统计学意义(P<0.05);两组患者术前及术后1个月的眼压及ICL拱高比较差异均无统计学意义(P>0.05);术后1个月,两组患者的前房容积、前房深度均降低,且观察组分别为(120.31±19.76)mm3、(2.71±0.09)mm,明显低于对照组的(143.31±20.31)mm3、(2.91±0.21)mm,差异均有统计学意义(P<0.05);术前及术后1个月,两组患者的角膜内皮细胞数比较差异均无统计学意义(P>0.05);术后1个月,两组患者并发症比较差异无统计学意义(P>0.05)。结论Trans-PRK联合ICL治疗超高度近视可促进患者视力恢复,改善角膜光密度,对角膜内皮细胞密度影响小,且操作安全,值得推广运用。Objective To investigate the clinical effect of transepithelial photorefractive keratectomy(trans-PRK)combined with implantable contact lenses(ICL)in the treatment of ultra-high myopia.Methods A to-tal of 100 patients(120 eyes)with ultra-high myopia treated in Xi'an People's Hospital(Xi'an Fourth Hospital)from November 2019 to November 2020 were randomly divided into an observation group(n=50,62 eyes)and a control group(n=50,58 eyes).The control group was treated with ICL,and the observation group was treated with trans PRK combined with ICL.The changes of best corrected visual acuity,naked visual acuity,corneal optical density,intraocu-lar pressure,ICL arch height,anterior chamber volume,anterior chamber depth and corneal endothelial cell number before and one month after operation were compared between the two groups.The complications of patients one month after operation were counted.Results One month after operation,the best corrected visual acuity of the two groups decreased,and the value in the observation group was(0.22±0.01)LogMAR,which was significantly lower than(0.32±0.05)LogMAR of the control group;while the naked visual acuity and corneal optical density increased,and the values in the observation group were(5.08±0.31)LogMAR,21.67±2.31,which were significantly higher than(4.89±0.28)LogMAR,19.01±2.40 of the control group(P<0.05).There was no significant difference in intraocu-lar pressure and ICL arch height between the two groups before and one month after operation(P>0.05).One month after operation,the anterior chamber volume and depth of the two groups decreased,and the values in the observation group was(120.31±19.76)mm3,(2.71±0.09)mm,which were significantly lower than(143.31±20.31)mm3,(2.91±0.21)mm of the control group(P<0.05).There was no significant difference in the number of corneal endothelial cells between the two groups before operation and one month after operation(P>0.05).One month after operation,there was no significant difference in complications between the two groups(P>0.

关 键 词：超高度近视 经角膜上皮激光角膜切削术 可植入式隐形眼镜 视力 角膜光密度 并发症 

分 类 号：R778.11[医药卫生—眼科]