CAJ | 학술논문

目的：观察有晶状体眼后房型人工晶状体( implantable contact lens, ICL)植入术治疗高度、超高度近视的有效性和安全性。方法：回顾性分析43例79眼已行 ICL 或 TICL ( toric implantable contact lens)近视矫正手术治疗的患者,术后观察1d~2a的视力、屈光状态、眼压、角膜内皮细胞密度、拱高、晶状体和眼底情况等。结果：所有术眼术后裸眼视力(4.89±0.17)较前(3.49±0.24)显著提高。末次随访,术后UCVA高于术前BCVA有72眼(91%),所有患者手术前后BCVA无下降。等效球镜：术前-12.14±4.14D,末次随访-0.43±0.90D。术后1d眼压(14.82±3.46mmHg)与术前(15.59±2.66mmHg)比较差异有统计学意义(P<0.05),末次随访眼压(15.77±2.36mmHg)与术前比较无明显统计学差异。术后1a拱高(481±219μm)和术后2a 的拱高(475±196μm)与术后6mo拱高(502±225μm)相比有所降低。术后6mo,1、2a的角膜内皮细胞密度与术前相比略有降低,角膜内皮丢失率分别为5.9%、6.7%、8.2%。术后随访,有2眼出现晶状体前囊下混浊,经相应处理后,视力无明显影响,尚未发现黄斑出血、视网膜脱离等其他并发症。结论：ICL植入术矫正高度、超高度近视疗效好且稳定,术后安全性高。通过术前的精确检查和测算、术中的精细操作及术后的严密观察随访可以有效防治并发症。术后出现的拱高下降的情况尚需进一步的观察并分析其影响因素及远期效应。
목적：관찰유정상체안후방형인공정상체( implantable contact lens, ICL)식입술치료고도、초고도근시적유효성화안전성。방법：회고성분석43례79안이행 ICL 혹 TICL ( toric implantable contact lens)근시교정수술치료적환자,술후관찰1d~2a적시력、굴광상태、안압、각막내피세포밀도、공고、정상체화안저정황등。결과：소유술안술후라안시력(4.89±0.17)교전(3.49±0.24)현저제고。말차수방,술후UCVA고우술전BCVA유72안(91%),소유환자수술전후BCVA무하강。등효구경：술전-12.14±4.14D,말차수방-0.43±0.90D。술후1d안압(14.82±3.46mmHg)여술전(15.59±2.66mmHg)비교차이유통계학의의(P<0.05),말차수방안압(15.77±2.36mmHg)여술전비교무명현통계학차이。술후1a공고(481±219μm)화술후2a 적공고(475±196μm)여술후6mo공고(502±225μm)상비유소강저。술후6mo,1、2a적각막내피세포밀도여술전상비략유강저,각막내피주실솔분별위5.9%、6.7%、8.2%。술후수방,유2안출현정상체전낭하혼탁,경상응처리후,시력무명현영향,상미발현황반출혈、시망막탈리등기타병발증。결론：ICL식입술교정고도、초고도근시료효호차은정,술후안전성고。통과술전적정학검사화측산、술중적정세조작급술후적엄밀관찰수방가이유효방치병발증。술후출현적공고하강적정황상수진일보적관찰병분석기영향인소급원기효응。
Abstract?AlM:To evaluate the efficacy and safety of the surgical correction of high myopia using a posterior chamber phakic implantable contact lens ( PCPlCL) .?METHODS: Totally 79 eyes of 43 consecutive patients undergone lCL implantation or toric implantable contact lens ( TlCL) up to 2a postoperative were retrospectively analyzed. Visual acuity, refraction, intraocular pressure ( lOP ) , average cornea endothelial cell density ( ECD ) , central vault of the lCL and slit-lamp findings, etc. at 1d~2a after operation were observed.?RESULTS:The uncorrected visual acuity ( UCVA) of all eyes was significantly improved from preoperative 3. 49 ± 0. 24 to postoperative 4. 89 ± 0. 17. Best corrected visual acuities ( BCVA ) didn’t decline after operation and 91%( 72 eyes) of UCVAs were better than preoperative BCVAs. The preoperative spherical equivalent was -12. 14 ± 4. 14 diopters (D) while it was -0. 43±0. 90D at last follow-up. The difference on lOP at 1d after operation ( 14. 82 ± 3. 46mmHg) and preoperative (15. 59 ± 2. 66mmHg) had statistical significance ( P< 0. 05 ), while there was no significant difference between last follow-up ( 15. 77 ± 2. 36mmHg) and preoperative. The vaults of 1a ( 481 ± 219μm) and 2a (475 ± 196μm) after operation decreased comparing with that of 6mo (502±225μm). And the ECD of 6mo, 1 and 2a after operation slightly decreased comparing with that of preoperative. The corneal endothelial loss was 5. 9%, 6. 7%, 8. 2% respectively. No severe complications occurred expect that 2 eyes appeared anterior lens capsules had limited opacities and the visual acuities didn’t degrade with dispose in time. Other complications such as macular hemorrhage, retinal detachment, etc. were not found.?CONCLUSlON: After 2a of follow-up, lCL implantation has good visual and refractive results with excellent biocompatibility and few adverse reactions. By accurate preoperative examination and measurement, intraoperative fine operation and close observation of postoperative follow - up, the complications can be effectively prevented. lt still needs further observation and analysis of the cause and long - term effects of postoperative vault decline.