Lam Jasmine K M, Chan Tommy C Y, Ng Alex L K, Chow Vanissa W S, Wong Victoria W Y, Jhanji Vishal
Hong Kong Eye Hospital, 147K Argyle street, Kowloon, Hong Kong.
Department of Ophthalmology and Visual Sciences, Chinese University of Hong Kong, Kowloon, Hong Kong.
Graefes Arch Clin Exp Ophthalmol. 2016 Sep;254(9):1811-7. doi: 10.1007/s00417-016-3414-y. Epub 2016 Jun 16.
To analyse the outcomes of phacoemulsification in extreme axial myopia
Consecutive cases of phacoemulsification in eyes with axial length ≥ 30.0 mm from January 1, 2010 to Dec 31, 2013 in a tertiary referral eye hospital were retrospectively reviewed. A single intraocular lens (IOL) type was used for all cases. Main outcome measures included perioperative complications and refractive outcome.
Two hundred and twenty-one eyes were identified. Intraoperatively, two eyes (0.9 %) had unstable capsular bag and three (1.4 %) had posterior capsular rupture. At a mean follow-up duration was 27.4 ± 14.6 months, three eyes (1.5 % of 198 eyes with no history of retinal detachment or macular hole) developed retinal detachment. There was an overall hyperopic shift with a mean biometry error of 0.45 ± 1.21 D in all eyes. The mean absolute biometry prediction error was 0.98 ± 0.83 D in all eyes, 1.11 ± 0.86 D and 0.85 ± 0.82 D in eyes receiving negative- and positive-power IOL, respectively (p = 0.042). A total of 61.2 % of eyes had refractive outcome within ± 1.0 D of target spherical equivalent. Regression analysis showed low IOL power as an independent predictor for greater postoperative absolute biometry error (p = 0.014).
We showed no increase in perioperative complications in eyes with extreme high axial myopia. In eyes with long axial length, implantation of IOL with lower power was associated with more hyperopic shift, which was more pronounced with negative-power IOL.
分析超高度轴性近视患者白内障超声乳化手术的效果
回顾性分析2010年1月1日至2013年12月31日在一家三级转诊眼科医院接受白内障超声乳化手术且眼轴长度≥30.0mm的连续病例。所有病例均使用单一类型的人工晶状体（IOL）。主要观察指标包括围手术期并发症和屈光结果。
共纳入221只眼。术中，2只眼（0.9%）囊袋不稳定，3只眼（1.4%）发生后囊膜破裂。平均随访时间为27.4±14.6个月，3只眼（198只无视网膜脱离或黄斑裂孔病史的眼中的1.5%）发生视网膜脱离。所有眼均出现总体远视漂移，平均生物测量误差为0.45±1.21D。所有眼的平均绝对生物测量预测误差为0.98±0.83D，接受负屈光度和正屈光度IOL的眼中分别为1.11±0.86D和0.85±0.82D（p=0.042）。共有61.2%的眼屈光结果在目标球镜等效值±1.0D范围内。回归分析显示，低IOL屈光度是术后绝对生物测量误差增大的独立预测因素（p=0.014）。
我们发现超高度轴性近视患者围手术期并发症并未增加。在眼轴长度较长的眼中，植入较低屈光度的IOL与更多的远视漂移相关，负屈光度IOL的这种情况更为明显。
