超声乳化白内障摘出联合CTR植入治疗高度近视并发白内障
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Phacoemulsification combined with CTR implantation in the treatment of high myopia with cataract
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    摘要:

    目的:探究超声乳化白内障摘出联合囊袋张力环(CTR)植入治疗高度近视并发白内障患者的疗效,并分析其安全性。

    方法:回顾性分析我院186例186眼行超声乳化白内障摘出+人工晶状体(IOL)植入治疗的高度近视并发白内障患者临床资料,其中98例98眼联合CTR植入治疗(联合组),88例88眼未联合CTR植入治疗(对照组)。记录两组术前,术后1、3、6mo时最佳矫正视力(BCVA, LogMAR)、视觉质量\〖高阶像差的均方根值(RMS)\〗、角膜内皮细胞密度,评估术后1、3、6mo时前囊口面积、IOL倾斜角变化情况,并比较两组术后前囊膜混浊、后囊膜混浊、囊袋收缩综合征等并发症发生情况差异。

    结果:两组BCVA具有交互效应(P<0.05),两组术后BCVA值均较术前降低(P<0.05),且联合组术后BCVA值均低于对照组(P<0.05)。两组总高阶像差RMS具有交互效应(P<0.05),两组术后总高阶像差RMS均较术前升高(P<0.05),且联合组术后总高阶像差RMS均低于对照组(P<0.05)。两组术后前囊口面积具有交互效应(P<0.05),组内均随术后时间的延长而降低(P<0.05),且联合组术后3、6mo时均高于对照组(P<0.05)。两组术后IOL倾斜角具有交互效应(P<0.05),组内均随术后时间的延长而升高(P<0.05),且联合组术后3、6mo时均低于对照组(P<0.05)。两组术后角膜内皮细胞密度均较术前降低(P<0.05),但并无交互效应(P>0.05)。

    结论:超声乳化白内障摘出+IOL植入+CTR植入术可改善高度近视并发白内障患者视觉功能,术后并发症少,疗效及安全性良好。

    Abstract:

    AIM: To explore the efficacy of phacoemulsification combined with capsular tension ring(CTR)implantation in the treatment of patients with high myopia complicated with cataract, and to analyze its safety.

    METHODS: A retrospective analysis was performed on the clinical data of 186 patients(186 eyes)with high myopia and cataract who underwent phacoemulsification+ intraocular lens(IOL)implantation treatment in our hospital. Among them, 98 cases(98 eyes)were combined with CTR implantation(combined group)and 88 cases(88 eyes)were not combined with CTR implantation(control group). The best corrected visual acuity(BCVA, LogMAR), visual quality \〖root mean square value(RMS)of higher-order aberration(HOA)\〗 and corneal endothelial cell density were recorded in the two groups before surgery and at 1, 3 and 6mo after surgery, and the area of anterior capsular orifice and inclination angle of IOL were evaluated at 1, 3 and 6mo after surgery, and the occurrence of complications such as postoperative anterior capsule opacification, posterior capsule opacification and capsular contraction syndrome were compared between the two groups.

    RESULTS: There were interaction effects in the BCVA between the two groups(P<0.05). The BCVA of the two groups after surgery was decreased compared with that before surgery(P<0.05), and the BCVA of combined group after surgery was lower than that of control group(P<0.05). There were interaction effects in the total HOA RMS(P<0.05), and the total HOA RMS of the two groups after surgery was increased compared with that before surgery(P<0.05), and the total HOA RMS after surgery in combined group was lower than that in control group(P<0.05). There were interaction effects in the anterior capsular orifice area after surgery between the two groups(P<0.05), and the area in the two groups was decreased with the prolongation of postoperative time(P<0.05), and the area in combined group at 3 and 6mo after surgery was higher than that in control group(P<0.05). The IOL inclination angle of the two groups had interaction effects between the two groups(P<0.05), and the angle of the two groups was increased with the prolongation of postoperative time(P<0.05), and the angle of combined group at 3 and 6mo after surgery was lower than that of control group(P<0.05). The corneal endothelial cell density in the two groups after surgery was lower than that before surgery(P<0.05), but there was no interaction effect(P >0.05).

    CONCLUSION: Phacoemulsification+ IOL implantation + CTR implantation can improve the visual function of patients with high myopia complicated with cataract, with few postoperative complications and good efficacy and safety.

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范永琦,申飞,张晨霞,等.超声乳化白内障摘出联合CTR植入治疗高度近视并发白内障.国际眼科杂志, 2021,21(9):1535-1538.

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  • 收稿日期:2020-09-13
  • 最后修改日期:2021-07-29
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  • 在线发布日期: 2021-08-18
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