Verisyse人工晶状体植入对比准分子激光矫治高度近视临床研究
杨 阳 何 阳 赵红霞 李 刚 赵春玲 刘艳
云南省昆明市延安医院 眼科 650051
摘要
目的 评估有晶状体眼虹膜固定型人工晶状体植入及准分子激光矫治高度近视的安全性、有效性、可预测性及稳定性。方法 行有晶状体眼虹膜固定型人工晶状体植入术21例33眼（为I组）及LASIK或EK术（II组31例52眼）的高度近视患者52例（85眼）。术后随访视力，眼压，屈光，角膜内皮计数，前房反应，人工晶状体位置，瞳孔改变等6月~18月。 结果 术后2组裸眼视力均比术前提高，1月后I组裸眼视力达术前矫正视力者27眼(81.82%)，II组裸眼视力达术前矫正视力者45眼(86.53%)，两组无显著性差异（P>0.05）；术后6月及12月两组视力差异有显著性（P<0.05）。术后6月平均屈光度 I组-0.67±0.37D，II组1.36±2.18D；两组术后裸眼视力较术前最佳矫正视力提高1~3行不等，I组占75.5%，II组17.3%；I组术后平均眼压15.17mmHg，有4眼一过性高眼压。术后6月角膜内皮细胞较术前减少4.17%。II组主要并发症术后6月黄斑出血1眼，干眼者6眼，屈光回退20眼。结论：有晶状体眼虹膜固定型人工晶状体植入术矫治高度近视安全，有效，可预测性及稳定性较准分子激光角膜性屈光手术更好，术后具有较好的视觉功能，并发症少等优点。但远期疗效有待观察。
作者单位：650051 昆明市延安医院眼科
责任作者：杨 阳Email:cnynyy@163.com
[关键词] 高度近视；晶状体；人工；屈光手术
Abstract:
Objective: To compare and evaluate the efficacy, safety and stability of the selection of corneal or lens refractive surgery in high myopia. Design:Case-control study. Participants Fiftieth-two patients(phakic IOL 33eyes and LASIK &EK 52 eyes.) Methods The result of treating 85 eyes in high myopia was analyzed respectively. The mean preoperative spherical equivalent refraction was(-12.25±1.53)D. 33 eyes were treated with phakic IOL for high myopia while 52 eyes were treated with LASIK. Main Outcom Measures : The uncorrected visual acuity improved in all cases in two groups postoperatively, at one month after surgery with 27 eyes (81.82%)achieving >0.5 in group I and 45 eyes (86.53%) achieving >0.5 in group II(P>0.05). The average fellow-up was 6 months with 28 eyes (84.84%) achieving >0.5 and 42eyes(80.77%) achieving>0.5 respectively. (P<0.05) The mean postoperative spherical equivalent refraction was（-0.67±0.36）D and（0.76±1.91)D respectively. Complication of dry eye,regression Macular hemorrhage was found in II group after 6 months. Conclusion Phakic IOL implantation is an efficient method which is more safer and more stable than applying LASIK for high myopia.
Keywords: high myopia/surgery, keratomileusis, laser in situ/methods, lens, crystalline/surgery
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