CAJ | 학술논문

背景近年来随着屈光手术的不断进步,有晶状体眼人工晶状体植入手术在矫治超高度近视、散光、远视等方面逐步体现出其特有的优越性,其安全性、有效性在临床上越来越受到关注.目的观察有晶状体眼散光矫治型后房型人工晶状体(TICL)植入治疗超高度近视并散光的有效性、稳定性及安全性.方法回顺性系列病例研究.观察分析2008年5月-2009年2月经手术治疗的超高度近视并散光患者27例33眼的病例资料,均在眼球周围阻滞麻醉下经3 mm颞侧透明角膜切口植入TICL,随访18个月,随访内容包括术前及术后1 d,1周,2周,1、3、6、12、18个月的裸眼远近视力、最佳矫正视力、裂隙灯显微镜检查、TICL轴向、屈光度数、眼压、角膜内皮细胞分析等.结果术后96.97%眼裸眼视力等于或高于术前最佳矫正视力,术后球镜度数均在-1.00～+O.25 D,柱镜度数均在-1.00～0 D,TICL轴向偏差在10°以内者占93.94%(31/33),手术前后眼压及角膜内皮细胞计数的差异均无统计学意义(眼压:F=3.350,P=5.490;角膜内皮细胞计数:t=1.835,P=0.082),术后1眼出现须手术调整的散光轴向旋转,1眼因TICL直径较大,发生术后高眼压,行TICL置换后眼压恢复正常,目前尚无白内障发生.结论 TICL植入矫治超高度近视并散光具有有效性、安全性及稳定性.
배경 근년래수착굴광수술적불단진보,유정상체안인공정상체식입수술재교치초고도근시、산광、원시등방면축보체현출기특유적우월성,기안전성、유효성재림상상월래월수도관주.목적 관찰유정상체안산광교치형후방형인공정상체(TICL)식입치료초고도근시병산광적유효성、은정성급안전성.방법 회순성계렬병례연구.관찰분석2008년5월-2009년2월경수술치료적초고도근시병산광환자27례33안적병례자료,균재안구주위조체마취하경3 mm섭측투명각막절구식입TICL,수방18개월,수방내용포괄술전급술후1 d,1주,2주,1、3、6、12、18개월적라안원근시력、최가교정시력、렬극등현미경검사、TICL축향、굴광도수、안압、각막내피세포분석등.결과 술후96.97%안라안시력등우혹고우술전최가교정시력,술후구경도수균재-1.00～+O.25 D,주경도수균재-1.00～0 D,TICL축향편차재10°이내자점93.94%(31/33),수술전후안압급각막내피세포계수적차이균무통계학의의(안압:F=3.350,P=5.490;각막내피세포계수:t=1.835,P=0.082),술후1안출현수수술조정적산광축향선전,1안인TICL직경교대,발생술후고안압,행TICL치환후안압회복정상,목전상무백내장발생.결론 TICL식입교치초고도근시병산광구유유효성、안전성급은정성.
Background In recent years,with the contiunous progress of the refractive surgery,the operation skill of phakic intraocular lens(PIOL)implantation for correcting extreme high myopia,astigmatism,farsightedness have made greater progression,and its security,effectiveness in clinical attract much more attention. Objective This study was to evaluate the efficacy,safety and stability of Toric Implantable Collamer Lens(TICL)for extreme high myopic astigmatism. Methods This retrospective case series included 33 eyes of 27 patients from May 2008 to February 2009.A TICL was intraocularly implanted via a 3 mm clear corneal incision after paraocular anesthesia.Patients were examined preoperatively and followed-up at 1 day,1 week,1 month,3,6,12 and 18 months postoperatively.The examinations included uncorrected visual acuity,best corrected visual acuity(BCVA),slit lamp examination,refraction,intraocular pressure,endothelial cell morphometry,etc.The written informed consent was obtained from each patient before any medical procedure. Results The uncorrected visual acuity in 96.97% eyes was equal or improved after operation in comparison with BCVA of preoperation.The spherical refraction was within-1.00 D-+0.25 D.The cylinder refraction was within-1.00 D-0 D.The axial deviation of TICL within 10 degree was 93.94%(31/33).No significant differences were found in the intraocular pressure and endothelial cell morphometry between preoperation and postoperation(intraocular pressure:F=3.35,P=5.49;endothelial cell morphometry:t=1.835,P=0.082).The visual acuity and refraction were stable during the follow-up.Astigmatic axial rotation required surgical intervention on one eye.One eye occurred high intraocular pressure because of bigger TICL diameter.The intraocular pressure returned to normal after TICL was exchanged.No cataract occurred during the follow-up duration. Conclusion TICL implantation appears to be an effective,safe and reliable method for extreme high myopic astigmatism.