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在印度中部人群中,对于不适合激光辅助角膜磨镶术和可植入隐形眼镜的患者,进行透明晶状体切除术。

Clear lens extraction for patients who are unfit for laser-assisted keratomileusis and implantable contact lenses in central Indian population.

机构信息

Department of Ophthalmology, Government Medical College, Nagpur, Maharashtra, India.

出版信息

Indian J Ophthalmol. 2020 Dec;68(12):3002-3005. doi: 10.4103/ijo.IJO_1307_20.

Abstract

PURPOSE

The purpose of this study is to establish the safety of clear lens extraction (CLE) for the correction of high myopia in patients unfit for implantable contact lenses (ICLs) and laser in situ keratomileusis in the central Indian population.

METHODS

In this retrospective observational study performed at a tertiary care centre, medical records of the patients who had undergone CLE with implantation of intraocular lens (IOL) to treat high myopia were retrieved. Details of the demographic profile, surgical procedure, complications, power, and type of IOLs implanted were recorded.

RESULTS

The average postoperative follow-up period was 64.1 ± 4.2 months. The average postoperative spherical power was -1.4 ± 0.6 D, which was much lower than the preoperative spectacle power -15 ± 4.4 D. There was improvement in the postoperative visual acuity (0.4 ± 0.2 logMAR) from the preoperative distant uncorrected visual acuity (0.8 ± 0.2 logMAR). No significant change in intraocular pressure (IOP) was observed. The postoperative average anterior chamber depth (ACD) (2.66 ± 0.1 mm) was significantly deeper than the preoperative ACD (2.61 ± 0.1 mm) P = 0.00. Barrage laser was required for lattice degeneration in one patient before CLE and in two patients during follow-up. Two patients (8.7%) required Nd:YAG capsulotomy for posterior capsular opacification. None of the patients had corneal decompensation, retinal detachment, or endophthalmitis.

CONCLUSION

CLE with implantation of IOL is the safe procedure for correcting high myopia in patients who are unfit for ICL. None of the patient had eye loss in the follow-up period of 5 years. The low incidence of complications can be attributable to the closed chamber lens removal and implantation of IOL and prophylactic retinal treatment.

摘要

目的

本研究旨在确定在印度中部人群中,对于不适合佩戴硬性透气性角膜接触镜(RGP)和准分子激光原位角膜磨镶术(LASIK)的高度近视患者,行晶状体切除术(CLE)联合人工晶状体(IOL)植入术的安全性。

方法

本回顾性观察研究在一家三级护理中心进行,检索了接受 CLE 联合 IOL 植入术治疗高度近视的患者的病历。记录了患者的人口统计学特征、手术过程、并发症、植入的 IOL 类型和屈光力等详细信息。

结果

平均术后随访时间为 64.1 ± 4.2 个月。术后平均球镜屈光度为-1.4 ± 0.6 D,远低于术前的矫正眼镜屈光度-15 ± 4.4 D。术后远视力(0.4 ± 0.2 logMAR)较术前未矫正远视力(0.8 ± 0.2 logMAR)有改善。未观察到眼压(IOP)显著变化。术后平均前房深度(ACD)(2.66 ± 0.1 mm)显著深于术前 ACD(2.61 ± 0.1 mm),P=0.00。1 例患者在 CLE 前和 2 例患者在随访期间需要行格栅状激光治疗格子状视网膜变性。2 例(8.7%)患者需要行 Nd:YAG 后囊切开术治疗后发性白内障。无患者出现角膜失代偿、视网膜脱离或眼内炎。

结论

对于不适合佩戴 ICL 的高度近视患者,行 CLE 联合 IOL 植入术是一种安全的治疗方法。在 5 年的随访期间,没有患者丧失视力。并发症发生率低可归因于闭室晶状体切除术和 IOL 植入术以及预防性视网膜治疗。

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Clear lens extraction for the correction of high myopia.透明晶状体摘除术治疗高度近视。
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Implantable contact lens for high myopia.用于高度近视的可植入隐形眼镜。
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本文引用的文献

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[Complications after refractive lens exchange].[屈光性晶状体置换术后的并发症]
Ophthalmologe. 2008 Nov;105(11):1005-12. doi: 10.1007/s00347-008-1829-5.

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