Menezo J L, Aviño J A, Cisneros A, Rodriguez-Salvador V, Martinez-Costa R
La Fe University Hospital, University of Valencia School of Medicine, Department of Ophthalmology, Spain.
J Refract Surg. 1997 Sep-Oct;13(6):545-55. doi: 10.3928/1081-597X-19970901-11.
The implantation of a Worst-Fechner iris claw intraocular lens (IOL) is one of the surgical procedures used for the correction of high myopia. This technique reduces myopia with stable refractive results; however, its potential long-term risks have not been evaluated. We report results in 94 eyes with a minimum follow-up of 3 years.
We studied 94 eyes of 62 patients with myopia > or = -7.00 diopters (D) who underwent Worst-Fechner IOL implantation. Lens decentration, permeability of the blood-aqueous barrier by iris angiography, and changes in corneal endothelial density were analyzed.
Mean follow-up time was 48.9 months (range 36 to 72 mo). Three years after surgery, 58 eyes (61%) had an uncorrected visual acuity > or = 20/40, and 77 eyes (82%) gained two or more lines of spectacle-corrected visual acuity with respect to the preoperative value; 75 eyes (79%) were within +/- 1.00 D of emmetropia and 46 eyes (48%) were within +/- 0.50 D of emmetropia. The mean endothelial cell loss was 17.9% at 5 years after surgery, while the percentage of hexagonality and the coefficient of cell variation tended toward preoperative levels. No vision threatening complications were seen.
The implantation of a Worst-Fechner iris claw phakic IOL reduced high myopia with a stable refractive outcome. Endothelial cell damage was within acceptable limits. The absence of major complications makes this procedure an acceptable method for correcting high myopia.
植入 Worst-Fechner 虹膜爪型人工晶状体（IOL）是用于矫正高度近视的手术方法之一。该技术可降低近视度数，屈光结果稳定；然而，其潜在的长期风险尚未得到评估。我们报告了 94 只眼至少随访 3 年的结果。
我们研究了 62 例近视度数≥-7.00 屈光度（D）的患者的 94 只眼，这些患者接受了 Worst-Fechner IOL 植入术。分析了晶状体偏心、虹膜血管造影显示的血-房水屏障通透性以及角膜内皮细胞密度的变化。
平均随访时间为 48.9 个月（范围 36 至 72 个月）。术后 3 年，58 只眼（61%）的未矫正视力≥20/40，77 只眼（82%）相对于术前值获得了两行或更多行的眼镜矫正视力提高；75 只眼（79%）的屈光不正度数在正视眼±1.00 D 以内，46 只眼（48%）的屈光不正度数在正视眼±0.50 D 以内。术后 5 年平均内皮细胞丢失率为 17.9%，而六边形细胞百分比和细胞变异系数趋于术前水平。未观察到威胁视力的并发症。
植入 Worst-Fechner 虹膜爪型有晶状体眼 IOL 可降低高度近视，屈光结果稳定。内皮细胞损伤在可接受范围内。无严重并发症使得该手术成为矫正高度近视的一种可接受的方法。
