CAJ | 학술논문

目的评价有晶状体眼后房散光型人工晶状体(TICL)矫正超高度近视复合散光的安全性和有效性.方法回顾接受TICL植入术的超高度近视散光者15例(30只眼).表面麻醉下透明角膜切口植入TICL.术前屈光度为球镜-8.0～-21.0D,平均(-12.42±3.86)D;柱镜-1.50 ～-6.50D,平均(-2.56±1.32)D,等效球镜(-14.56 ±0.32)D.随访12个月.结果术后12个月球镜度为-0.25～ +0.25D,平均(-0.16 ±0.17)D;柱镜度为0～+0.50D,平均(-0.15 ±0.16)D.UCVA较术前BCVA提高1行者占66.67％(20只眼),提高2行者占20.00％(6只眼).术前眼压平均为(15.49±1.07) mmHg,术后1d的眼压平均为(15.75 ±1.32) mmHg(1 mmHg=0.133 kPa),与术前眼压相比较,差异无统计学意义(t=0.42,P=0.67);术后12个月平均眼压(15.40±1.04)mmHg,与术前眼压相比较,差异无统计学意义(t=0.33,P=0.74).术前平均角膜内皮细胞计数为(2840.75±83.04)个/mm2,术后12个月平均角膜内皮细胞计数为(2837.75±82.95)个/mm2,二者差异无统计学意义(t=0.518,P=0.776).1例(1只眼)术后3个月复查视力下降,散瞳检查发现右眼TICL拱高失常,位置不平衡,手术调整TICL位置后散光纠正后,视力恢复.结论精准测量术前参数,选择合适的TICL,术中彻底抽吸透明质酸钠,术后眼压平稳,是TICL植入术矫治有晶状体眼超高度近视复合散光的有效、安全、稳定的关键.
목적 평개유정상체안후방산광형인공정상체(TICL)교정초고도근시복합산광적안전성화유효성.방법 회고접수TICL식입술적초고도근시산광자15례(30지안).표면마취하투명각막절구식입TICL.술전굴광도위구경-8.0～-21.0D,평균(-12.42±3.86)D;주경-1.50 ～-6.50D,평균(-2.56±1.32)D,등효구경(-14.56 ±0.32)D.수방12개월.결과 술후12개월구경도위-0.25～ +0.25D,평균(-0.16 ±0.17)D;주경도위0～+0.50D,평균(-0.15 ±0.16)D.UCVA교술전BCVA제고1행자점66.67％(20지안),제고2행자점20.00％(6지안).술전안압평균위(15.49±1.07) mmHg,술후1d적안압평균위(15.75 ±1.32) mmHg(1 mmHg=0.133 kPa),여술전안압상비교,차이무통계학의의(t=0.42,P=0.67);술후12개월평균안압(15.40±1.04)mmHg,여술전안압상비교,차이무통계학의의(t=0.33,P=0.74).술전평균각막내피세포계수위(2840.75±83.04)개/mm2,술후12개월평균각막내피세포계수위(2837.75±82.95)개/mm2,이자차이무통계학의의(t=0.518,P=0.776).1례(1지안)술후3개월복사시력하강,산동검사발현우안TICL공고실상,위치불평형,수술조정TICL위치후산광규정후,시력회복.결론 정준측량술전삼수,선택합괄적TICL,술중철저추흡투명질산납,술후안압평은,시TICL식입술교치유정상체안초고도근시복합산광적유효、안전、은정적관건.
Objective To study the safety and efficacy of toric implantable collamer lens (TICL)for the correction of high compound myopic astigmatism.Methods Thirty eyes of 15 patients with high myopic astigmatism were retrospectively analyzed.They were treated with TICL implantation via corneal incision under surface anesthesia.The range of preoperative myopia diopters was-8.00 ～-21.00D with average (-12.42 ±3.86) D.Astigmatism ranged from-1.50 to-6.50D with average (-2.56 ± 1.32) D.and the equivalent spherical diopters was (-14.56 ± 0.32)D; All patients were followed up for 12 months.Results The range of myopia diopters 12 months after operation was-0.25D to + 0.25D with average (-O.16 ±0.17) D and the range of postoperative astigmatism was 0 ～0.50D with average (-0.15 ±0.16) D UCVA in 20 eyes (66.67％) was improved by one line after operation compared with BCVA before operation.UCVA in 6 eyes (20.00％) was improved by two lines.Preoperative intraocular pressure of patients was (15.49 ± 1.07) mmHg,and the intraocular pressure 1 day after operation was(15.75 ± 1.32) mmHg.The difference of intraocular pressure was not statistically significant between preoperation and one day after operation (t =0.42,p =0.67) ; The intraocular pressure 12 months after surgery was (15.40 ± 1.04) mmHg (1 mm-Hg =0.133 kPa),and compared with the preoperative intraocular pressure,the difference was not statiatically significant(t =0.33,P =0.74).The mean preoperative endothelial cell counting was (2840.75 ±83.04)/mm2,and 12 months after operation,the average endothelial cell counting was (2837.75 ±82.95)/mm2.The difference was not statistically significant between preoperation and postoperation(t =0.518,P=0.776) ;The vision decreased in one eye 12 months after operation,and the imbalance of TICL arch height in right eye was found under mydriasis.The astigmatism was corrected by adjusting the TICL position,and the visual acuity was recovered.Conclusion The keys of TICL implantation for the correction of high myopic astigmatism are accurate preoperative parameters measurement,appropriate TICL selection,complete aspiration of sodium hyaluronate and stable postoperative intraocular pressure.