新型后房型有晶状体眼IOL植入术治疗伴有低度散光的高度近视
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山东医药卫生科技发展计划项目(No.2015BJYB29)


Therapeutic effect of a new posterior chamber intraocular lens implantation for high myopia with low astigmatism
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Medical and Health Technology Development Project of Shandong(No.2015BJYB29)

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    摘要:

    目的:观察伴有低度散光的高度近视眼患者行新型中央孔型有晶状体眼后房型人工晶状体(ICMO V4c)植入术的疗效及安全性,以期为此类患者的临床诊疗提供参考。

    方法:分析2015-01/2016-12在我院接受ICMO V4c植入术伴有低度散光的高度近视眼患者的临床资料,术后对患者进行1、3、6mo随访,分析比较术前和术后裸眼视力(uncorrected visual acuity,UCVA)和最佳矫正视力(best corrected visual acuity,BCVA)。比较术前和术后屈光度,球、柱镜及显性折射球面镜片等值(manifest refraction spherical equivalent,MRSE)。比较手术前后眼压、角膜内皮计数、前房深度、拱高和术后并发症情况。

    结果:患者术后UCVA和BCVA较术前均有所好转,手术前后比较差异有统计学意义(P<0.05)。所有患眼术前球镜、柱镜和MRSE在手术后均有所降低,且三组患者手术前后比较,差异均有统计学意义(t=38.510、20.100、34.300,P<0.01)。患者术后1、3mo术眼平均眼压升高(t=3.998、2.837,P<0.05),但术后6mo恢复正常(t=0.383,P>0.05); 患者术后3、6mo患眼角膜内皮计数较术前减少(t=2.119、2.411,P<0.05)。患者手术后6mo内前房深度一定程度减少,在术后6mo时较手术后有所恢复,但仍低于术前水平(t=5.850、5.260、2.556,P<0.05)。患者术后患眼拱高整体水平平稳,未见明显波动。手术眼术后并发症发生率较低,积极处理后均有明显改善。

    结论:新型后房型有晶状体眼IOL植入术治疗合并有低度散光的高度近视眼的治疗效果满意,且并发症较少,是角膜屈光手术的有利补充。

    Abstract:

    AIM: To observe the efficacy and safety of a new posterior chamber intraocular lens(ICMO V4c)implantation in patients with high myopia and low astigmatism and to provide reference for the clinical diagnosis and treatment of these patients.

    METHODS: The study was to analyze the clinical data of patients with high myopia who underwent ICMO V4c implantation with low degree of astigmatism in our hospital from January 2015 to December 2016. The patients were followed up for 1, 3 and 6mo after operation. The items we analyzed including preoperative and postoperative uncorrected visual acuity(UCVA)and best corrected visual acuity(BCVA), diopter, spherical and cylinder equivalent, and manifest refraction spherical equivalent(MRSE), intraocular pressure(IOP), endothelial cell counting, anterior chamber depth(ACD), arch height and postoperative complications.

    RESULTS: Postoperative UCVA and BCVA improved compared with preoperative, and the difference between preoperative and postoperative was statistically significant(P<0.05). All spherical and cylinder equivalent, and MRSE were reduced after surgery(t=38.510, 20.100, 34.300; P<0.01). The mean intraocular pressure increased at 1 and 3mo after operation(t=3.998, 2.837, all P<0.05), but it returned to normal at 6mo(t=0.383, P>0.05). The corneal endothelium counts in the patients at 3mo and 6mo after surgery were lower than those before surgery(t=2.119, 2.411; all P<0.05). The depth of anterior chamber was reduced to a certain extent within 6mo after operation, and recovered after surgery at 6mo after surgery, but it was still lower than the preoperative level(t=5.850, 5.260, 2.556; all P<0.05). The overall level of ocular arch after operation was stable and no significant fluctuations were observed. The incidence of postoperative complications in the surgical eye was low and significantly improved after active treatment.

    CONCLUSION: The new posterior chamber intraocular lens implantation in the treatment of high myopia with low astigmatism reaches satisfaction with less complications, is a good supplement to corneal refractive surgery.

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范华,季鹏,祖培培,等.新型后房型有晶状体眼IOL植入术治疗伴有低度散光的高度近视.国际眼科杂志, 2018,18(7):1346-1348.

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  • 收稿日期:2018-02-27
  • 最后修改日期:2018-06-07
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  • 在线发布日期: 2018-06-27
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