白内障摘除手术联合对侧眼ICL植入术对高度近视眼合并单眼白内障患者的疗效观察  

Observation on the efficacy of cataract surgery combined with ICL implantation in the contralateral eye for patients with high myopia complicated with monocular cataract

作　　者：周锦 叶剑 Zhou Jin;Ye Jian(Department of Ophthalmology,Army Medical Center of PLA(Daping Hospital),Chongqing400042,China)

机构地区：[1]解放军陆军特色医学中心(大坪医院)眼科,重庆400042

出　　处：《中华眼科杂志》2024年第12期985-990,共6页Chinese Journal of Ophthalmology

摘　　要：目的探讨白内障摘除手术联合对侧眼有晶状体眼后房型人工晶状体植入术治疗高度近视眼合并单眼白内障患者的手术疗效。方法回顾性病例系列研究。收集2021年6月至2023年12月于陆军特色医学中心眼科白内障眼行超声乳化白内障吸除及人工晶状体植入术(白内障手术眼),对侧眼行植入式Collamer透镜(ICL)植入术(ICL植入术眼)的高度近视眼合并单眼白内障患者10例(20只眼)的临床资料。其中男性4例,女性6例,年龄(35.60±7.62)岁。用国际标准视力表测量裸眼视力,综合验光获取等效球镜度数(SE)和最佳矫正视力(BCVA)。视力均以最小分辨角的对数(logMAR)的形式记录。客观视觉质量参数由视觉质量分析系统获取,问卷调查获取主观视觉质量,并检查术后调节功能和离焦曲线。比较双眼术前和术后5个月的各项指标。结果白内障手术眼术后5个月的BCVA较术前提高(P<0.05),ICL植入术眼手术前后BCVA差异无统计学意义(P>0.05)。白内障手术眼术后的裸眼远、中、近视力分别为0.12±0.12、0.18±0.18、0.28±0.20,ICL植入术眼分别为0.10±0.11、0.00(0.00,0.03)、0.01(0.00,0.06)。术后白内障手术眼和ICL植入术眼的客观散射指数分别为2.20±1.82和0.90(0.48,1.90)。术后所有眼脱镜,6例患者有光晕现象但对生活无影响,患者主观满意度为9.5分。术后ICL植入术眼的调节幅度和调节灵敏度均优于白内障手术眼,差异有统计学意义(均P<0.05)。离焦曲线显示双眼视力较好,未发生严重术中、术后并发症。结论高度近视眼合并单眼白内障患者行白内障手术联合对侧眼ICL植入术可有效提高术后视力、视觉质量,保留原有的调节力,建立双眼视觉的平衡,达到脱镜的目的,改善生活及工作质量,且手术安全可靠。Objective To assess the surgical outcomes of cataract surgery combined with phakic posterior chamber intraocular lens(ICL)implantation in the contralateral eye for patients with high myopia and monocular cataract.Methods This is a retrospective case series study.Clinical data were collected from 10 patients(20 eyes)with high myopia and monocular cataract who underwent phacoemulsification cataract extraction and intraocular lens implantation in the cataract eye(cataract surgery eye),and implantable Collamer lens(ICL)implantation in the contralateral eye(ICL implantation eye)at the Ophthalmology Department of the Army Characteristic Medical Center from June 2021 to December 2023.Among them,there were 4 males and 6 females,with an average age of(35.60±7.62)years.Uncorrected visual acuity was measured using the international standard visual acuity chart,and spherical equivalent(SE)and best corrected visual acuity(BCVA)were obtained through comprehensive optometry.Visual acuity was recorded in the form of logarithm of the minimum angle of resolution(logMAR).Objective visual quality parameters were obtained using a visual quality analysis system,and subjective visual quality was obtained through questionnaire surveys.Postoperative accommodative function and defocus curve were also examined.Various indicators before and 5 months after surgery were compared between the two eyes.Results The BCVA in the cataract surgery eye significantly improved postoperatively(P<0.05),while no significant change was observed in the ICL implantation eye(P>0.05).Postoperative UCVA for the cataract surgery eye was 0.12±0.12 for distance,0.18±0.18 for intermediate,and 0.28±0.20 for near vision.For the ICL implantation eye,these values were 0.10±0.11,0.00(0.00,0.03),and 0.01(0.00,0.06),respectively.Objective scatter indices postoperatively were 2.20±1.82 for the cataract surgery eye and 0.90(0.48,1.90)for the ICL implantation eye.All patients became spectacle-independent postoperatively,with 6 experiencing halo phenomena that did not af

关 键 词：白内障 近视 有晶状体眼人工晶状体植入术 超声乳化白内障吸除术 视敏度 调节 眼 治疗结果 

分 类 号：R779.66[医药卫生—眼科]