摘要
目的研究有晶状体眼后房型人工晶状体(ICL)联合角膜松解术(AK)治疗高度近视及散光的安全性、有效性、预测性。方法对21例(34眼)高度近视患者行有晶状体眼ICL植入术,对其中20眼散光度数≥1.5 D的联合AK术。观察术前及术后1、3、6个月的裸眼视力、最佳矫正视力、屈光度、眼压、内皮细胞密度等。结果所有患者成功植入ICL,手术前后等效球镜分别为(-13.5±2.2)、(-0.30±0.84)、(-0.28±0.86)、(-0.28±0.84)D;术后裸眼视力分别为4.80±0.16、4.81±0.17、4.82±0.17;手术前后最佳矫正视力分别为4.74±0.26、4.86±0.17、4.87±0.17、4.9±0.18,差异有统计学意义(P<0.01);内皮细胞密度术前为(2 871±256)个/mm2,术后为(2 773±267)个/mm2,差异有统计学意义(P<0.01);行AK术眼术前后散光分别为(-2.31±0.64)、(-1.22±0.57)、(-1.02±0.40)、(-0.93±0.39)D,差异有统计学意义(P<0.01)。结论有晶状体眼ICL联合AK术治疗高度近视及散光有较好的安全性、有效性、预测性,长期疗效有待进一步观察。
Objective Phakic intraocular lens implantation has shown a good prospect. However,postoperative astigmatism is a main complication. This study aimed at evaluating the safety,efficacy,predictability and stability of posterior chamber phakic intraocular tens combined with astigmatic keratotomy for the correction of high myopia with astigmatism. Methods Posterior chamber phakic intraocular lens implantation was performed in 14 eyes of 21 patients with high myopia. Posterior chamber phakic intraocular lens implantation combined with astigmatic keratotomy were performed in 20 eyes of 21 patients with the astigmatism ≥ - 1.50 D. The clinical ocular examinations included uncorrected visual acuity （UCVA） , best corrected visual acuity （BCVA） , refraction,intraocular pressure （IOP）, slit-lamp findings, cornea topography and cornea endothelial cell density before and after surgery. The astigmatic vector was calculated followed the formula： SIRC （surgically induced refractive change ） = Kpostop- Kpreop. Results Posterior chamber phakic intraocular lens were implanted successfully in all the operative eyes. The postoperative average UCVA was 4.80 ± 0. 16,4.81 ± 0.17,4.82±0.17 at 1 month,3 months and 6 months after operation respectively. The average BCVA,SE and astigmatism power was 4.74±0.26,4.86±0. 17,4.87±0. 17,4. 9 ±0. 18 ; （ - 13.5± 2.2）D,（ -0.30±0.84）D,（ -0.28±0.86）D,（ -0.28 ±0.84）D,（ -2.31±0.64）D and （ - 1.22±0.57）D,（ -1.02±0.40） D, （ - 0.93 ±0.39） D and at 1 month,3 months and 6 months respectively（ P 〈 0.05 ）. The average cornea endothelial cell density was （2 871 ±256） cells/mm^2 before operation and （2 773 ±267） cells/mm^2 after operation, showing a significant difference （t = 3.24,P 〈 0.01 ）. A positive correlation was found between SIRC and coupling ratio （r = 0. 340, R^2 = 0. 116, P = 0. 022）. Conclusion The combination procedure of posterior chamber intraocular lens implantation and astigmatic keratotomy for high myop
出处
《眼科研究》
CSCD
北大核心
2009年第10期923-926,共4页
Chinese Ophthalmic Research
