[后房型有晶状体眼人工晶状体矫正超高度近视的中长期随访结果]

Zhou Tian-an, Shen Ye, Wang Yang, Xia Jian-hua

Eye Center, the First Hospital Affiliated to College of Medicine, Zhejiang University, Hangzhou 310003, China.

Zhonghua Yan Ke Za Zhi. 2012 Apr;48(4):307-11.

OBJECTIVE

To evaluate the mid-long term stability and safety of posterior chamber phakic intraocular lens (ICL) implantation for the correction of extreme myopia.

METHODS

This retrospective study included 993 eyes of 498 patients received ICL implantation from June 1996 to December 2008. Multivariate analysis and variance analysis were used to evaluate the stability of the results and to identify risk factors of the complications.

RESULTS

Successful implantation was achieved in all patients. Spherical equivalent (SE) was (16.23 ± 4.12, mean ± SD) D before the operation and (-0.92 ± 1.22) D at the last examination. Intraocular pressure was (13.58 ± 2.93) mm Hg (1 mm Hg = 0.133 kPa) preoperatively which was (13.90 ± 3.01) mm Hg at the last examination. There was no statistical significance in follow-up (t = 0.44 ∼ 1.30, P > 0.05). Endothelial cell density was (2858.21 ± 395.13)/mm(2) before the operation and (2567.19 ± 423.45)/mm(2) at last examination. Pupillary block glaucoma occurred in 2 eyes (0.2%) at two hours and 1 eye (0.1%) at one month after the operation. Three eyes developed anterior cataracts between 6 months to 1 year after ICL implantation and another 2 eyes subcapsular opacification at semi-peripheral regions occurred 4 years after the operation, and was not related with age, SE and vaults (F = 2.42, 1.98, 0.81, P > 0.05). Macular puckers were found in 5 eyes (0.5%) 1 year postoperatively, including 2 eyes developed choroidal neovascularization and received PDT, best corrected visual acuity lost more than 2 lines. Retinal detachment occurred in 2 eyes at 1.5 years after the operation. Acute iritis happened in 1 eye (0.1%) and chronic iritis in 1 eye (0.1%) which combined with slight pupil distortion and elevation of intraocular pressure. Iris stroma atrophy and pupil distortion were found in 2 eyes (0.2%).

CONCLUSION

Correction of high myopia by ICL implantation is a safe procedure and the results are stable.

目的

评估后房型有晶状体眼人工晶状体（ICL）植入矫正超高度近视的中长期稳定性和安全性。

方法

这项回顾性研究纳入了1996年6月至2008年12月期间接受ICL植入的498例患者的993只眼。采用多因素分析和方差分析评估结果的稳定性并确定并发症的危险因素。

结果

所有患者均成功植入。术前等效球镜度（SE）为（16.23±4.12，均值±标准差）D，末次检查时为（-0.92±1.22）D。术前眼压为（13.58±2.93）mmHg（1mmHg = 0.133kPa），末次检查时为（13.90±3.01）mmHg。随访期间差异无统计学意义（t = 0.44～1.30，P>0.05）。术前内皮细胞密度为（2858.21±395.13）/mm²，末次检查时为（2567.19±423.45）/mm²。术后2小时发生瞳孔阻滞性青光眼2只眼（0.2%），术后1个月发生1只眼（0.1%）。3只眼在ICL植入后6个月至1年出现前发性白内障，另外2只眼在术后4年出现半周边区域的囊下混浊，且与年龄、SE和房拱高度无关（F = 2.42、1.98、0.81，P>0.05）。术后1年发现黄斑皱襞5只眼（0.5%），其中2只眼发生脉络膜新生血管并接受了光动力疗法（PDT），最佳矫正视力下降超过2行。术后1.5年发生视网膜脱离2只眼。急性虹膜炎发生1只眼（0.1%），慢性虹膜炎发生1只眼（0.1%），伴有轻度瞳孔变形和眼压升高。发现虹膜基质萎缩和瞳孔变形2只眼（0.2%）。