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目的:探讨透明晶体超声乳化吸出并植入后房型折叠人工晶体矫正高度近视的安全性和有效性.方法:对32例(50眼)均采用表麻下经透明角膜切口行透明晶体超声乳化吸出并植入后房型折叠人工晶体.眼轴长平均29.64mm.比较手术前后最佳矫正视力(BCVA),散光度及角膜内皮计数,随访观察手术并发症情况.并对术前BCVA低于0.3的37只患眼应用扫描激光检眼镜(SLO)的微视力软件,检查微视力,评估术后潜在视力.周边视网膜格子样变性7只眼,均行氩激光周边变性区光凝.结果:术后随访平均24月.BCVA由术前0.20±0.19,术后提高到0.61±0.24,其中≥0.5的由术前4只眼(8％)增加到34只眼(68％)。手术前后平均散光度比较,经t检验无显著性差异(P>0.1).手术后无1例发生视网膜脱离,有5只眼发生后发障,均行YAG激光治疗.角膜内皮计数术后平均损失207个/mm2±96个/mm2.且SLO作为术后潜在视力预测手段拥有很高的准确度(94.6％).结论:透明晶体超声乳化摘除加后房型折叠人工晶体植入矫正高度近视是少数屈光矫正有效方法之一,可获得较好的术后BCVA.但是熟练掌握超声乳化手术操作及采取术前积极的预防性治疗是开展此项技术的根本和关键,且需进行长期的临床随访.
Objective: To investigate the safety and effectiveness of phacoemulsification and implantation of posterior chamber intraocular lens in the correction of high myopia.Methods: 32 cases (50 eyes) underwent phacoemulsification with clear corneal incision And the posterior chamber fold intraocular lens was implanted.The average length of axial length was 29.64mm.The best corrected visual acuity (BCVA), astigmatism and corneal endothelial count before and after operation were compared.Results The preoperative BCVA was lower than 0.3 37 eyes were scanned with microdiagnism by scanning laser ophthalmoscope (SLO) to evaluate the potential visual acuity.All 7 eyes with peripheral retinal cell degeneration were treated with photocoagulation in the peripheral area of argon laser.Results: The mean follow-up was 24 months. The mean preoperative BCVA was 0.20 ± 0.19 and increased to 0.61 ± 0.24 postoperatively, with ≥ 0.5 preoperatively from 4 eyes (8%) to 34 eyes (68%). The average astigmatism before and after surgery, no significant difference by t test (P> 0.1) .After surgery no retinal detachment occurred in 5 eyes after the onset of the obstacle, were YAG laser treatment. Loss of 207 / mm2 ± 96 / mm2, and SLO as a means of postoperative potential vision prediction with high accuracy (94.6%) .Conclusion: Transparent crystal phacoemulsification combined with posterior chamber fold intraocular lens implantation correction of high myopia is A small number of effective methods of refractive correction, can obtain better postoperative BCVA.But master phacoemulsification operation and take preoperative positive preventive treatment is the fundamental and key to carry out this technology, and the need for long-term clinical Follow-up.