【摘要】
目的 探讨有晶体眼前房型人工晶体植入术治疗高度近视的疗效、安全性及预测性。
方法 于2005年8月至2006年2月在本中心接受前房晶体植入术治疗高度近视的患眼共12例21眼，进行前瞻性研究。观察指标包括：裸眼视力、最佳矫正视力、眼压、角膜地形图、瞳孔形态、角膜内皮记数、晶体在前房的位置形态、人工晶体表面色素沉着情况。
结果 术前最佳矫正远视球镜度为-17.28±2.95D，最大-21.0D，最小-11.5D;散光度-1.90±1.02D，最大-4.0D，最小-1.0D。植入度数平均：-14.53±9.47D，最大-20.0D，最小-12.5D。术后6月无最佳矫正远视力下降病例，其中裸眼远视力较术前最佳矫正远视力提高1行6眼占28.57%，提高2行5眼23.81%，提高3行4眼19.05%，提高4行1眼0.9%；手术后最佳矫正远视力较术前最佳矫正远视力提高1行5眼23.81%，提高2行3眼14.29%，提高3行2眼9.52%，提高4行2眼9.52%，提高5行以上5眼23.81%。术前眼压17.25±2.92mmHg，术后6月眼压17.14±2.52mmHg，配对t检验无统计学差异（P=0.164>0.05）；术前角膜内皮记数2627.89±229.36/mm2，术后6月为2605.28±239.22/mm2，配对t检验无统计学差异（P=0.745>0.05）。
结论 虹膜夹持型前房晶体植入术治疗高度近视安全、有效，并且具有良好的预测性；但远期效果需进一步观察。
【关键词】高度近视; 晶状体,人工; 有晶状体; 前房
Implantation of iris-claw phakic anterior chamber intraocualr lenses for the correction of sever myopia
WANG Zheng, YANG Bin, Huang Guo-fu,ZHANG Xiao-xiao,ZHOU Sheng,QIU Ping,CHEN Jia-qi. State Key Laboratory of Ophthalmology ＆Zhongshan Ophthalmic Center,Sun Yat-sen University,Guangzhou 510060,China
Corresponding author: WANG Zheng,Email:[email protected]
[Abstract] Objective To evaluate efficiency, predictability, and complications after implantation of a iris-clawed phakic intraocular lenses(PIOL) for the correction of myopia. Methods In this prospective study,12 cases(21eyes)with myopia at-11.5～-21.0 dioperts(D) were implanted with Verisyse iris-clawed PIOL with an optical zone of 6.0 or 5.5 mm. The follow-up was longer than 6 months in all cases. Uncorrected visual acuity(UCVA),Best spectacled-corrected visual acuity(BSCVA), refraction, intraocular pressure, topography,contour of pupil, corneal endothelial count, PIOL IOL position and pigment deposits on the surface of IOL were observed. Results At 6 months’ follow-up, no eyes experienced a loss in BSCVA. Uncorrected visual acuity was significantly improved ,28.57%(6 eyes) gained 1 line their preoperative BSCVA, 23.81%(5 eyes) gained 2 lines, 19.05%(4 eyes) gained 3 lines, 0.9%(1 eye) gained 4 lines. Best spectacled-corrected visual acuity was significantly improved, 23.81%(5 eyes) gained 1 or more lines of their preoperative BSCVA, 14.29%(3 eyes) gained 2 lines, 9.52%(2 eyes) gained 3 lines, 9.52%(2 eyes) gained 4 lines, 23.81% gained 5 or more lines.There were no statistically significant difference between pre and post operative mean intraocular pressure, cornealendothelial density(P>0 05). Conclusions Iris-clawed phakic intraocular lenses(PIOL) for the correction of sever myopia is effective, safe and predictable. But follow-up is still required for the evaluation of long-term results.
【Keywords】 Severe myopia; Lens,intraocular; Phakic; Anterior chamber
近20年来，准分子激光角膜屈光手术在矫治近视眼方面取得巨大成功。由于受到角膜厚度安全极限的限制和面临术后视觉质量的捆饶，准分子激光在矫治高度近视方面存在盲区。随着人工晶体材料和设计的不断发展，有晶体眼内人工晶体植入为手术治疗高度近视特别是-12.0D以上的近视提供了新的手段。本研究旨在对有晶体眼前方型人工晶体植入术治疗高度近视的疗效和安全性进行探讨。
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