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后房型有晶状体眼人工晶状体矫正近视:长期随访。

Posterior chamber phakic intraocular lens to correct myopia: long-term follow-up.

机构信息

Departments of Ophthalmology, University Medicine Charité Berlin, Berlin, Germany.

出版信息

J Cataract Refract Surg. 2013 Jul;39(7):1023-8. doi: 10.1016/j.jcrs.2013.01.041. Epub 2013 May 8.

Abstract

PURPOSE

To evaluate the long-term safety and efficacy of a refractive phakic intraocular lens (pIOL) (PRL) to correct moderate to high myopia.

SETTING

Department of Ophthalmology, University Medicine Charité Berlin, Berlin, Germany.

DESIGN

Retrospective cohort study.

METHODS

Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refraction, intraocular pressure, endothelial cell loss, and adverse events were evaluated.

RESULTS

The study enrolled 53 eyes (mean spherical equivalent [SE] -12.17 diopters [D] ± 4.12 [SD]) of 29 patients. The mean age was 34.6 ± 9.2 years and the mean follow-up, 86 ± 21.2 months. The mean UDVA improved from 1.37 ± 0.28 logMAR preoperatively to 0.14 ± 0.19 logMAR at the last postoperative visit (P<.05). The mean CDVA improved from 0.10 ± 0.18 logMAR to -0.01 ± 0.09 logMAR (P<.05). The overall mean efficacy index and mean safety index were 0.9 and 1.21, respectively, at the last follow-up visit. The mean endothelial cell loss at the last follow-up was 6.4%. The complications were slight posterior chamber (PC) pIOL decentration (5 eyes, 9.4%), severe PC pIOL decentration resulting in pIOL removal (1 eye, 1.8%), glaucoma (4 eyes, 7.5%), clinically significant cortical lens opacification resulting in cataract surgery (4 eyes, 7.5%), clinically asymptomatic anterior subcapsular cataract formation (6 eyes, 11.3%), and retinal detachment (2 eyes, 3.8%).

CONCLUSIONS

Posterior chamber phakic pIOL implantation to correct moderate to high myopia provided predictable and stable refractive results but with a high rate of serious complications over the long term.

FINANCIAL DISCLOSURE

No author has a financial or proprietary interest in any material or method mentioned.

摘要

目的

评估矫正中高度近视的屈光性有晶状体眼人工晶状体(pIOL)(PRL)的长期安全性和有效性。

地点

德国柏林夏里特大学医学系眼科。

设计

回顾性队列研究。

方法

评估未矫正(UDVA)和矫正(CDVA)远距视力、屈光度、眼压、内皮细胞丢失和不良事件。

结果

本研究共纳入 29 名患者的 53 只眼(平均等效球镜度数[SE] -12.17 屈光度[D] ± 4.12 [SD])。平均年龄为 34.6 ± 9.2 岁,平均随访时间为 86 ± 21.2 个月。平均 UDVA 从术前的 1.37 ± 0.28 logMAR 提高到最后一次术后访视的 0.14 ± 0.19 logMAR(P<.05)。平均 CDVA 从 0.10 ± 0.18 logMAR 提高到-0.01 ± 0.09 logMAR(P<.05)。最后一次随访时,总有效指数和总安全指数分别为 0.9 和 1.21。最后一次随访时平均内皮细胞丢失率为 6.4%。并发症包括轻微的后房(PC)pIOL 偏心(5 只眼,9.4%)、严重的 PC pIOL 偏心导致 pIOL 取出(1 只眼,1.8%)、青光眼(4 只眼,7.5%)、临床显著皮质晶状体混浊导致白内障手术(4 只眼,7.5%)、临床无症状的前囊下白内障形成(6 只眼,11.3%)和视网膜脱离(2 只眼,3.8%)。

结论

矫正中高度近视的后房型有晶状体眼人工晶状体植入术可提供可预测且稳定的屈光效果,但长期来看并发症发生率较高。

利益冲突

没有作者在任何材料或方法上有财务或专有利益。

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