Zhou J, Ye J
Department of Ophthalmology, Army Medical Center of PLA(Daping Hospital), Chongqing400042, China.
Zhonghua Yan Ke Za Zhi. 2024 Dec 11;60(12):985-990. doi: 10.3760/cma.j.cn112142-20240313-00111.
To assess the surgical outcomes of cataract surgery combined with phakic posterior chamber intraocular lens (ICL) implantation in the contralateral eye for patients with high myopia and monocular cataract. This is a retrospective case series study. Clinical data were collected from 10 patients (20 eyes) with high myopia and monocular cataract who underwent phacoemulsification cataract extraction and intraocular lens implantation in the cataract eye (cataract surgery eye), and implantable Collamer lens (ICL) implantation in the contralateral eye (ICL implantation eye) at the Ophthalmology Department of the Army Characteristic Medical Center from June 2021 to December 2023. Among them, there were 4 males and 6 females, with an average age of (35.60±7.62) years. Uncorrected visual acuity was measured using the international standard visual acuity chart, and spherical equivalent (SE) and best corrected visual acuity (BCVA) were obtained through comprehensive optometry. Visual acuity was recorded in the form of logarithm of the minimum angle of resolution (logMAR). Objective visual quality parameters were obtained using a visual quality analysis system, and subjective visual quality was obtained through questionnaire surveys. Postoperative accommodative function and defocus curve were also examined. Various indicators before and 5 months after surgery were compared between the two eyes. The BCVA in the cataract surgery eye significantly improved postoperatively (<0.05), while no significant change was observed in the ICL implantation eye (>0.05). Postoperative UCVA for the cataract surgery eye was 0.12±0.12 for distance, 0.18±0.18 for intermediate, and 0.28±0.20 for near vision. For the ICL implantation eye, these values were 0.10±0.11, 0.00 (0.00, 0.03), and 0.01 (0.00, 0.06), respectively. Objective scatter indices postoperatively were 2.20±1.82 for the cataract surgery eye and 0.90 (0.48, 1.90) for the ICL implantation eye. All patients became spectacle-independent postoperatively, with 6 experiencing halo phenomena that did not affect their daily life. The average patient satisfaction score was 9.5. The ICL implantation eye showed better accommodative amplitude and facility than the cataract surgery eye, with statistically significant differences (both <0.05). The defocus curve indicated good binocular visual acuity, and no severe intraoperative or postoperative complications were reported. For patients with high myopia and monocular cataract, the combination of cataract surgery and ICL implantation in the contralateral eye effectively enhances postoperative visual acuity and quality, preserves natural accommodation, establishes binocular vision balance, and facilitates spectacle independence. The procedure is safe, reliable, and improves the quality of life and work.
评估高度近视合并单眼白内障患者患眼白内障手术联合对侧眼有晶状体眼后房型人工晶状体（ICL）植入术的手术效果。这是一项回顾性病例系列研究。收集了2021年6月至2023年12月在陆军特色医学中心眼科接受白内障超声乳化吸除及人工晶状体植入术（白内障手术眼），并在对侧眼植入可植入式Collamer晶状体（ICL植入眼）的10例（20眼）高度近视合并单眼白内障患者的临床资料。其中男性4例，女性6例，平均年龄（35.60±7.62）岁。采用国际标准视力表测量未矫正视力，通过综合验光获得等效球镜度（SE）和最佳矫正视力（BCVA）。视力以最小分辨角对数（logMAR）形式记录。使用视觉质量分析系统获得客观视觉质量参数，通过问卷调查获得主观视觉质量。术后还检查了调节功能和散焦曲线。比较了两眼手术前和术后5个月的各项指标。白内障手术眼术后BCVA显著提高（<0.05），而ICL植入眼无显著变化（>0.05）。白内障手术眼术后远视力UCVA为0.12±0.12，中视力为0.18±0.18，近视力为0.28±0.20。ICL植入眼的这些值分别为0.10±0.11、0.00（0.00，0.03）和0.01（0.00，0.06）。白内障手术眼术后客观散射指数为2.20±1.82，ICL植入眼为0.90（0.48，1.90）。所有患者术后均无需佩戴眼镜，6例出现光晕现象，但不影响日常生活。患者平均满意度评分为9.5分。ICL植入眼的调节幅度和调节灵活性优于白内障手术眼，差异有统计学意义（均<0.05）。散焦曲线显示双眼视力良好，未报告严重的术中或术后并发症。对于高度近视合并单眼白内障患者，患眼白内障手术联合对侧眼ICL植入术可有效提高术后视力和视觉质量，保留自然调节功能，建立双眼视觉平衡，促进摆脱眼镜依赖。该手术安全可靠，可提高生活和工作质量。
