晶状体眼前房型人工晶状体植入术矫正高度近视的临床研究  

Clinical research of the implantation of phakic anterior chamber intraocular lens for high myopia

作　　者：姚克[1] 徐雯[1] 于建春 张伟英 潘永称[4] 杜新华[1] 陈佩卿[1] 易虹 万迪玲 李增琦[6] 叶宏斌[1] 

机构地区：[1]浙江大学医学院附属第二医院眼科中心,杭州310009 [2]江苏省无锡市江南眼科医院 [3]上海东方医院眼科 [4]上海市第七人民医院眼科 [5]重庆市第八人民医院眼科 [6]上海第二医科大学附属新华医院眼科

出　　处：《中华眼科杂志》2003年第6期339-343,共5页Chinese Journal of Ophthalmology

摘　　要：目的　探讨晶状体眼前房型人工晶状体植入术矫正高度近视的有效性和安全性。方法　对近视屈光度数为 - 7 0 0～ - 30 0 0D的 4 1例 (73只眼 )高度近视患者行晶状体眼前房型人工晶状体植入术 ,手术前、后检查患者的视力、屈光状态、眼压、角膜内皮细胞计数 ,裂隙灯下观察角膜、前房、瞳孔、透明晶状体、人工晶状体情况 ,检眼镜下观察眼底情况 ,房角镜下观察房角状况 ;并进行比较分析。术后随访时间 3个月。结果　 73只眼均成功植入前房型人工晶状体。裸眼视力术前为一尺指数至 0 2 ,术后 3个月为 0 1～ 1 0 ;最佳矫正视力术前为 0 0 5～ 1 0 ,术后 3个月为 0 1～ 1 0 ;术后3个月时最佳矫正视力均好于或等于术前。屈光度数术前为 - 7 0 0～ - 30 0 0D ,术后 3个月为 - 6 0 0～ +2 5 0D。术前与术后 3个月比较 ,角膜散光度数差异无显著意义 (t=1 75 1,P =0 0 82 ) ,眼压差异无显著意义 (t=1 181,P =0 2 4 0 )。平均角膜内皮细胞计数术前为 (2 6 80± 5 38)个 mm2 ,术后 3个月为 (2 5 14± 4 2 0 )个 mm2 ,较术前减少了 6 19% ,但差异无显著意义 (t=1 182 ,P =0 2 4 2 )。手术无严重并发症发生。结论　采用晶状体眼前房型人工晶状体植入术矫正高度近视 ,不仅手术操作简便 ,而且术后屈光状态具?Objective To investigate the efficacy and safety of the implantation of phakic anterior chamber intraocular lens (IOL) for high myopia. Methods A consecutive group of 73 eyes in 41 patients with -7.00 to -30.00 diopters (D) of myopia were implanted. Results All of 73 eyes were implanted successfully and have been followed-up for 3 m (months). The uncorrected visual acuity was from FC/33 cm to 0.2 pre-operatively and 0.1 to 1.0 3 m post-operatively. The best corrected visual acuity (BCVA) was from 0.05 to 1.0 pre-operatively and 0.1 to 1.0 3 m post-operatively. The post-operative BCVA of every eye was not worse than the pre-operative one. The refractive diopters were from -7.00 to -30.00 D pre-operatively and -6.00 to +2.50 D 3 m post-operatively. There were no significant differences between pre- and 3 m post-operative mean corneal astigmatism (t=1.751, P=0.082) and mean intraocular pressure (IOP) (t=1.181, P=0.240), respectively. The mean counts of endothelial cells was (2 680±538)/mm 2 pre-operatively and (2 514±420)/mm 2 3 m post-operatively. There was no significant difference (t=1.182, P=0.242) though it decreased 6.19%. No severe complications occurred. Conclusions The implantation of phakic anterior chamber IOL for high myopia is predictable, reversible and controllable with simple manipulation. No severe complication occurred in 3 m post-operatively, and long-time follow-up is still required.

关 键 词：晶状体 眼前房型 人工晶状体植入术 矫正方法 高度近视 并发症 视力 屈光度数 

分 类 号：R779.6[医药卫生—眼科]