中华眼视光学与视觉科学杂志
中華眼視光學與視覺科學雜誌
중화안시광학여시각과학잡지
CHINESE JOURNAL OF OPTOMETRY OPHTHALMOLOGY AND VISUAL SCIENCE
2014年
12期
712-716
,共5页
罗栋强%王华%陶思思%何书喜%陈蛟
囉棟彊%王華%陶思思%何書喜%陳蛟
라동강%왕화%도사사%하서희%진교
有晶状体眼人工晶状体植入术%近视,退行性%治疗结果
有晶狀體眼人工晶狀體植入術%近視,退行性%治療結果
유정상체안인공정상체식입술%근시,퇴행성%치료결과
Phakic intraocular lenses%Myopia,degenerative%Therapy outcome
目的 评估有晶状体眼后房型人工晶状体(PPC-ICL)植入术矫正超高度近视的安全性.方法 回顾性系列病例研究.对接受普通型PPC-ICL或散光型PPC-TICL植入矫正手术的超高度近视患者32例(64眼),术前球镜度-10.0～-19.0 D,柱镜度0.0～-3.0 D,等效球镜度为(-15.16±3.15)D,术后随访2年,观察指标包括UCVA、BCVA、屈光度、眼压、角膜内皮细胞计数、中央前房深度(ACD)、前房角(ACA)宽度、PPC-ICL拱高及晶状体透明度.手术前后数据比较采用配对t检验.结果 术后2年所有患者UCVA较术前明显提高,等效球镜度小于±1.0 D者达75％(48眼).术前患者眼压平均为(15.0±3.6)mmHg,术后2年平均为(16.0±3.3)mmHg,术前术后相比差异无统计学意义(t=0.474,P＞0.05),术前患者ACD平均为(3.14±0.19)mm,术后2年平均为(2.70±0.26) mm,两者相比差异有统计学意义(t=6.327,P＜0.05).术前ACA宽度平均45.00°±7.19°,术后平均32.80°±6.75°,术后ACA宽度较术前降低,平均减少13.20°±6.17°,术前术后相比差异有统计学意义(t=6.686,P＜0.05).术前患者角膜内皮细胞计数平均为(2 844±266)个/mm2,术后2年平均为(2 729±255)个/mm2,术前术后比较差异无统计学意义(t=0.606,P＞0.05).术后位于理想拱高(250～750 μm)者58眼,占总眼数91％.术后2眼发生晶状体前囊下混浊,无继发性青光眼和视网膜脱离发生.结论 PPC-ICL植入术矫正超高度近视具有良好的安全性.
目的 評估有晶狀體眼後房型人工晶狀體(PPC-ICL)植入術矯正超高度近視的安全性.方法 迴顧性繫列病例研究.對接受普通型PPC-ICL或散光型PPC-TICL植入矯正手術的超高度近視患者32例(64眼),術前毬鏡度-10.0～-19.0 D,柱鏡度0.0～-3.0 D,等效毬鏡度為(-15.16±3.15)D,術後隨訪2年,觀察指標包括UCVA、BCVA、屈光度、眼壓、角膜內皮細胞計數、中央前房深度(ACD)、前房角(ACA)寬度、PPC-ICL拱高及晶狀體透明度.手術前後數據比較採用配對t檢驗.結果 術後2年所有患者UCVA較術前明顯提高,等效毬鏡度小于±1.0 D者達75％(48眼).術前患者眼壓平均為(15.0±3.6)mmHg,術後2年平均為(16.0±3.3)mmHg,術前術後相比差異無統計學意義(t=0.474,P＞0.05),術前患者ACD平均為(3.14±0.19)mm,術後2年平均為(2.70±0.26) mm,兩者相比差異有統計學意義(t=6.327,P＜0.05).術前ACA寬度平均45.00°±7.19°,術後平均32.80°±6.75°,術後ACA寬度較術前降低,平均減少13.20°±6.17°,術前術後相比差異有統計學意義(t=6.686,P＜0.05).術前患者角膜內皮細胞計數平均為(2 844±266)箇/mm2,術後2年平均為(2 729±255)箇/mm2,術前術後比較差異無統計學意義(t=0.606,P＞0.05).術後位于理想拱高(250～750 μm)者58眼,佔總眼數91％.術後2眼髮生晶狀體前囊下混濁,無繼髮性青光眼和視網膜脫離髮生.結論 PPC-ICL植入術矯正超高度近視具有良好的安全性.
목적 평고유정상체안후방형인공정상체(PPC-ICL)식입술교정초고도근시적안전성.방법 회고성계렬병례연구.대접수보통형PPC-ICL혹산광형PPC-TICL식입교정수술적초고도근시환자32례(64안),술전구경도-10.0～-19.0 D,주경도0.0～-3.0 D,등효구경도위(-15.16±3.15)D,술후수방2년,관찰지표포괄UCVA、BCVA、굴광도、안압、각막내피세포계수、중앙전방심도(ACD)、전방각(ACA)관도、PPC-ICL공고급정상체투명도.수술전후수거비교채용배대t검험.결과 술후2년소유환자UCVA교술전명현제고,등효구경도소우±1.0 D자체75％(48안).술전환자안압평균위(15.0±3.6)mmHg,술후2년평균위(16.0±3.3)mmHg,술전술후상비차이무통계학의의(t=0.474,P＞0.05),술전환자ACD평균위(3.14±0.19)mm,술후2년평균위(2.70±0.26) mm,량자상비차이유통계학의의(t=6.327,P＜0.05).술전ACA관도평균45.00°±7.19°,술후평균32.80°±6.75°,술후ACA관도교술전강저,평균감소13.20°±6.17°,술전술후상비차이유통계학의의(t=6.686,P＜0.05).술전환자각막내피세포계수평균위(2 844±266)개/mm2,술후2년평균위(2 729±255)개/mm2,술전술후비교차이무통계학의의(t=0.606,P＞0.05).술후위우이상공고(250～750 μm)자58안,점총안수91％.술후2안발생정상체전낭하혼탁,무계발성청광안화시망막탈리발생.결론 PPC-ICL식입술교정초고도근시구유량호적안전성.
Objective To analyze the safety of phakic posterior chamber implantable contact lens (PPC-ICL) implantation for extreme high myopia.Methods This study was a retrospective analysis.Spheric PPC-ICL or toric PPC-ICL implantation was performed in 64 eyes of 32 patients with extreme high myopia.The spherical refraction of these patients was-10.0 to-19.0 D and cylinder refraction was 0 to-3.00 D.Uncorrected visual acuity (UCVA),best-corrected visual acuity (BCVA),slit-lamp examination,intraocular pressure (IOP),topography examination,corneal endothelial cell count,refraction,anterior chamber depth (ACD),the width of the angulus iridocornealis,PPC-ICL vault,and lens transparency were examined in these patients.The follow-up period was 2 years.A paired t test was used for data analysis.Results At 2 years after surgery,all patients had better UCVA than before surgery.Forty-eight eyes (75％) had a refractive error between ±1.0 and-1.0 D after surgery.Average intraocular pressure (IOP) before surgery was 15.0±3.6 mmHg and was 16.0±3.3 mmHg after surgery.There was no significant difference in IOP before and after surgery (t=0.474,P＞0.05).Preoperative ACD was 3.14±0.19 mm and was 2.70±0.26 mm postoperatively.There was a significant difference between preoperative and postoperative ACD (t=6.327,P＜0.05).The width variation of the angulus iridocornealis between before surgery and after surgery was 13.20°±6.17°,and the difference was significant (t=6.686,P＜0.05).There was no significant difference in the average number of corneal endothelial cells before surgery (2 844±266 cells/mm2) and 2 years after surgery (2 729±255 cells/mm2).After surgery,58 eyes (91％) had a suitable vault of the PPC-ICL from 250 to 750 μm.Two eyes of one patient had cataract complications but no other complications occurred after surgery.Conclusion PPC-ICL implantation is safe for extreme high myopia.
