眼轴>28mm高度近视眼的晶状体超声乳化和后房型人工晶状体植入  

Phacoemusification and posterior chamber intraocular lens implantation in high myopia with axial length more than 28mm

作　　者：王琳[1] 惠延年[1] 韩泉洪[1] 王英[1] 黄蔚[1] 

机构地区：[1]中国西安第四军医大学西京医院眼科全军眼科研究所,710032

出　　处：《国际眼科杂志》2003年第2期24-26,共3页International Eye Science

摘　　要：目的 评价眼轴>28mm的高度近视眼的晶状体超声乳化和后房型人工晶状体(intraocular lens,IOL)植入手术的效果。方法 回顾性研究2000-10/2002-01 41例54眼的临床和随访材料。患者年龄19—81(平均56.3±14.0)岁。平均眼轴为30.58±1.41(28.18～34.0)mm。术前戴镜度数在-12～-24D。除3例(4眼)为透明晶状体外,其他为核性和混合性白内障。1眼手术前做了预防性视网膜光凝。手术采用微流超声乳化晶状体,植入折叠IOL、或植入光学直径为6mm的硬性IOL于囊袋内。所有患眼的术前视力为光感～0.15。手术后随访患者10～26月。结果 10眼IOL度数在+6～+11D,植入Acrysof折叠IOL;其余44眼为PMMA一体式IOL,度数范围在-6～+5D。手术中4例后囊膜局部破裂,但未影响计划的手术操作。1例有少量晶状体皮质遗留于下方玻璃体,但眼压不高,视力0.3。手术后2眼有少量前房出血,1周内完全吸收。术后所有眼视力进步,未矫正视力为0.05,3眼;0.1～<0.5,28眼(52％);≥0.5的23眼(42％)。其中11眼获得0.8-1.5的良好视力。随访期间视力稳定,未发现视网膜脱离病例。结论 晶状体超声乳化和后房型IOL植入手术,对眼轴>28mm的高度近视眼是一种安全、有效的增视手术。Aim To evaluate the effects of phacoemusification and posterior chamber lens (IOL) implantation in high myopia with axial length >28mm between Oct. 2000 and Jan. 2002. Methods Clinical and follow-up data of 54 eyes (41 patients) were retrospectively studied. The age of patients ranged from 19 to 81 years with a mean of 56.3+14.0 years. The mean axial length was 30.58±1.41mm ranging from 28.18 to 34.0 mm. The refractive error was -12D to -24D. Except 4 eyes of 3 patients with clear lens, all of the other eyes had nuclear or mixed cataract. One eye had prophylactic retinal photocoagulation before the operation. Microflow phacoemusification was performed followed by implantation of foldable IOL or of one-piece hard IOL, 6mm in diameter, into the capsular bag. Preoperative visual acuity was LP to 0.15 in all eyes. The patients were followed up for 10 to 26 months. Results Acrysof foldable IOL of +6D to + 11D was implanted in 10 eyes; one piece of PMMA IOL of -6D to +5D was implanted in 44 eyes. During operation, 4 eyes had limited posterior capsular tear, which did not interfere with planned procedures. One eye had a small piece of lens dropping into the inferior part of the vitreous but after surgery the vision was 0.3 and intraocular pressure was normal. Two eyes had mild hyphema postoperative-ly, which was completely absorbed within one week. Postoperatively, visual improvement was achieved in all eyes and uncorrected visual acuity was 0.05, 0.1-<0.5, and ≥0.5 in 3, 28 (52%) and 23 (42%) eyes, respectively. Eleven eyes obtained excellent vision of 0.8-1.5. Visual acuity remained stable and no retinal detachment was found during follow-up. Conclusion Phacoemusification with posterior chamber IOL implantation is a safe and effective surgery to improve vision in high myopia with axial length >28mm.

关 键 词：眼轴〉28mm 高度近视眼 超声乳化手术 后房型人工晶状体植入手术 白内障 

分 类 号：R779.66[医药卫生—眼科]