有晶体眼后房型人工晶体植入矫治复性超高度近视-第三军医大学学报.doc

有晶状体眼后房型散光性人工晶体植入矫治复性超高度近视散光 胡春明，罗启惠，熊 洁，周青青，汪 辉（400038　重庆，第三军医大学西南医院西南眼科医院） ［摘要］目的 探讨有晶状体眼后房型散光性人工晶体（Toric Implantable Collamer Lens,TICL）植入术矫治超高度复性近视散光的安全性、有效性和预测性。方法；采用瑞士STAAR公司生产的后房型散光性人工晶体在表麻下矫治复性超高度近视散光49例89眼。术前、术后检查主要包括：视力、眼压、扩瞳验光、小瞳验光、角膜直径、角膜测厚、角膜地形图、三面镜检查、眼部A/B超、角膜内皮、UBM检查等。随访时间6个月以上。结果：术前，视力：裸眼视力0.01～0.05，最佳矫正视力0.1~0.8；屈光度：球镜-6.75～-26.50D（-15.37±5.69D），柱镜-1.50～-5.75D（-2.57±1.53D）。术后6个月，视力：裸眼视力0.15～1.0，最佳矫正视力0.15~1.2，有86眼（96.6%）裸眼视力达到或超过0.2，有48眼（53.9%）达到或超过0.5，有13眼（14.6%）达到或超过0.8。没有任何眼最佳矫正视力丢失2行以上，仅1眼（1.12%）丢失1行，而增加1行以上的有71眼（78.8%），增加2行以上的有19眼（21.4%）；屈光度：球镜+0.50～-6.75D（-2.31±1.43D），柱镜0.00～-1.25D（-0.51±0.26D），术后1个月、3个月、6个月，平均球镜屈光度分别为0.55D、0.69D、0.74D，平均柱镜屈光度分别为0.23D、0.26D、0.28D。结论 有晶状体眼后房型散光性人工晶体植入术矫治超高度近视散光具有较好的安全性和预测性，该术式是超高度复性近视散光患者的理想选择。 [关键词] TICL；超高度近视；散光 Toric Posterior Chamber Phakic Intraocular Lenses Implantation for High Myopic Astigmatism ABSTRACT PURPOSE: To evaluate safety, efficacy and predictability after implantation of a Toric Implantable Collamer Lens (TICL) to correct high myopic astigmatism.METHODS: This evaluation was performed in 89 eyes (49 patients) with high myopic astigmatism treated by a TICL. Uncorrected and best-corrected visual acuity (UCVA, BCVA), intraocular pressure, cycloplegic refraction and manifest refraction examination were assessed preoperatively and 1 and 3 months postoperatively. RESULTS: Preoperatively, UCVA was 0.01 to 0.05 and BCVA was 0.1 to 0.8; the manifest spherical refraction was -15.37 diopters (D)±5.69 (-6.75 to -26.50D) and the refractive cylinder, -2.57±1.53D (-1.50 to -5.75D). At 6 months postoperatively, the UCVA was 0.15 to 1.0 and BCVA was 0.15 to 1.2; 96.6% of eyes (86 eyes) had 0.2 or better UCVA, 53.9% (48 eyes) had 0.5 or better UCVA and 14.6% (13 eyes) had 0.8 or better UCVA. Postoperatively, 1 eye (1.12%) lost 1 line of BCVA and none lost line of BCVA. 78.8% of eyes (71 eyes) gained ≥1 line of BCVA and 21.4% (19 eyes) gained ≥ 2 lines of BCVA. At 1,3,6 months postoperatively, the mean sphe