CAJ | 학술논문

目的：：比较超高度近视白内障患者不同撕囊口直径下行超声乳化人工晶状体植入术后的人工晶状体囊袋内稳定性差异。方法：选择双眼超高度近视拟行白内障患者14例,双眼先后均行Phaco+IOL植入术,随机选择一眼作为5 mm撕囊口直径观察组,对侧眼作为6 mm撕囊口直径观察组,娴熟手术医师完成白内障摘除联合囊袋内人工晶状体植入同型亲水丙烯酸非球面人工晶状体( MCX11),手术经过均顺利,所有入组患者术后次日经Image-pro plus6.0图像分析软件测量确认主要子午线囊口直径与目标撕囊直径不超过±0.2mm。术后1wk；1,3,6mo行散瞳后囊口形态、人工晶状体位置形态观察,屈光状态检查,前房深度测量,观察囊袋内人工晶状体的稳定性。结果：与术后1 wk相比,两组术后1 mo前囊口直径轻度缩小,两组间无显著差异。5 mm组在1~3 mo随访期内有轻度远视漂移,6mm组在术后1mo内有轻度远视漂移,1mo后则趋于稳定。屈光变化与前房深度变化同步。5 mm组3 mo随访期有3眼发生襻缘轻度变形。结论：超高度近视患者采用较小的撕囊口可能引起囊袋-IOL复合体的不均匀收缩或前后移位。术后1 mo屈光状态的进行性变化可早期提示人工晶状体稳定性的变化,及时进行干预可减少远期并发症的发生。
목적：：비교초고도근시백내장환자불동시낭구직경하행초성유화인공정상체식입술후적인공정상체낭대내은정성차이。방법：선택쌍안초고도근시의행백내장환자14례,쌍안선후균행Phaco+IOL식입술,수궤선택일안작위5 mm시낭구직경관찰조,대측안작위6 mm시낭구직경관찰조,한숙수술의사완성백내장적제연합낭대내인공정상체식입동형친수병희산비구면인공정상체( MCX11),수술경과균순리,소유입조환자술후차일경Image-pro plus6.0도상분석연건측량학인주요자오선낭구직경여목표시낭직경불초과±0.2mm。술후1wk；1,3,6mo행산동후낭구형태、인공정상체위치형태관찰,굴광상태검사,전방심도측량,관찰낭대내인공정상체적은정성。결과：여술후1 wk상비,량조술후1 mo전낭구직경경도축소,량조간무현저차이。5 mm조재1~3 mo수방기내유경도원시표이,6mm조재술후1mo내유경도원시표이,1mo후칙추우은정。굴광변화여전방심도변화동보。5 mm조3 mo수방기유3안발생반연경도변형。결론：초고도근시환자채용교소적시낭구가능인기낭대-IOL복합체적불균균수축혹전후이위。술후1 mo굴광상태적진행성변화가조기제시인공정상체은정성적변화,급시진행간예가감소원기병발증적발생。
Abstract?AlM: To compare the in- the- bag lOL stability of different size of continuous curvilinear capsulorhexis ( CCC) in super high myopic eyes with cataract underwent phacoemulsification.?METHODS: A total of fourteen cataract patients with bilateral super high myopia were included, Phaco+lOL implantation were performed on both eyes, one eye was randomly classified into 5mm diameter CCC observation group, the fellow eye was 6mm diameter CCC observation group. Cataract extraction combined with in-the-bag intraocular lens implantation ( lOL ) with the type of hydrophilic acrylic aspheric intraocular lens ( MCX11 ) by well experienced surgeon. The operation was running smoothly, the next day after operation, all patients were confirmed by lmage-pro plus6. 0 image analysis software for the measurement of main meridian sac diameter with target capsulorhexis diameter no more than ±0. 2mm. Slit lamp examination of lOL shape and position, changes of anterior capculorhexis edge, refraction, anterior chamber depth was measured and observed of all eyes after operation 1wk;1, 3, 6mo.? RESULTS: Compared with postoperation 1wk, the former sac diameter of two groups were slightly smaller at postoperation 1mo, with no statistically significant difference between two groups. 5mm diameter CCC observation group had slightly hyperopic shift in follow-up 1-3mo, 6mm diameter CCC observation group had hyperopic shift in follow-up 1mo, and getting stable after 1mo. Refraction change was related to anterior chamber depth changes. 5mm diameter CCC observation group had 3 minor loop folding in follw-up 3mo.?CONCLUSlON:Relatively smaller continuous curvilinear capsulorhexis in super high myopic eyes underwent cataract surgery may cause a tendency of uneven construction or effective lens position change of in-the-bag lOL. Unusual refraction change or shift after operation 1mo could suggest instability of lOL, early noticing or interruption could prevent further complications.