有晶体眼房角支撑型前房人工晶体植入治疗高度近视

发布时间：2018-02-16 17:25

本文关键词： 有晶体眼前房人工晶体房角支撑近视　出处：《福建医科大学》2010年硕士论文　论文类型：学位论文

【摘要】： 目的:探讨有晶体眼房角支撑型前房人工晶体植入治疗高度近视的有效性、预测性和安全性。方法:2004年6月至2007年4月在本院接受前房晶状体植入术治疗高度近视的患眼共15只。手术前后观察患眼的视力、屈光状态、眼压、房角、角膜内皮计数及精确测量生物参数,裂隙灯观察角膜、瞳孔、透明晶状体、人工晶体情况,检眼镜观察眼底情况,并进行比较分析。术后随访2.7~5.6年,中位数3年。结果:15只眼均成功植入前房型人工晶状体。术前平均裸眼视力0.06±0.03,术后3年平均裸眼视力0.58±0.26,与术前平均裸眼视力相比(t=--7.602,P0.01)有统计学意义;术前平均最佳矫正视力0.54±0.18,术后3年平均最佳矫正视力0.74±0.26,相比(Z=-2.214,P0.05)有统计学意义;术前平均等效球镜度数(-16.75±3.66)D,术后3年残余屈光度为(-1.75～1.25)D,平均等效球镜度数(-0.38±0.87)D,与术前平均等效球镜度数相比(t=-16.840 ,P0.01)有统计学意义;术前平均角膜内皮细胞计数(2934±455)个/mm2,术后3年角膜内皮计数为(2485±812)个/mm2,相比(t=1.869,P0.05)无统计学意义,平均下降15.3%。1只眼(6.7%)术后有眩光,瞳孔直径大于人工晶状体光学部,其晶体有1攀入虹膜周切口,晶状体光学中心稍偏移;1只眼(6.7%)晶体后表面周边条带状虹膜色素播散,其1攀入虹膜周切口,晶状体光学中心稍偏移;2只眼(13.3%)瞳孔稍变形呈椭圆形。但对视力均无明显影响。手术的安全性指数为1.37,有效性指数为1.08,预测性指数为-0.023。所有病人对术后视力表示满意。结论:本组有晶体眼房角支撑型前房人工晶体植入治疗超高度近视的病人术后随访示对术后裸眼视力满意度较高,生活质量明显改善,术后3年手术的预测性指数-0.023,有效性指数为1.08,安全性指数为1.37,并发症相对较少,但术后3年角膜内皮计数有一定的丢失,未发生角膜内皮失代偿,术后角膜内皮细胞自然丢失率情况有待进一步观察。该术简单易行,具有良好的可预测性,确切的有效性,安全性较好,是高度近视矫正可供选择的方法之一。
[Abstract]:Objective: to evaluate the efficacy, predictability and safety of anterior chamber intraocular lens implantation with lens angle support in the treatment of high myopia. Methods: from June 2004 to April 2007, 15 eyes with high myopia were treated with anterior chamber lens implantation. The visual acuity, refractive state, intraocular pressure, angle of atrium, corneal endothelium count and biological parameters were observed before and after operation. The cornea, pupil, transparent lens, intraocular lens and ocular fundus were observed by slit lamp and compared and analyzed. The follow-up was 2.7 ~ 5.6 years (median 3 years). Results all 15 eyes were successfully implanted with anterior chamber intraocular lens. The mean uncorrected visual acuity was 0.06 卤0.03 before operation and 0.58 卤0.26 in 3 years postoperatively. The mean BCVA was 0.54 卤0.18 before operation and 0.74 卤0.26 after 3 years. The mean preoperative equivalent spherical degree was -16.75 卤3.66 d, the postoperative residual refraction was -1.75 卤1.25 Dand the mean equivalent spherical degree was -0.38 卤0.87 d, which was significantly higher than that of preoperative mean equivalent spherical degree (t = -16.840 vs P 0.01). The mean corneal endothelial cell count was 2934 卤455 / m2 before operation and 2485 卤812 / s / mm-2 in 3 years postoperatively. There was no significant difference in corneal endothelial cell count compared with 1.869 (P0.05). The mean decrease of corneal endothelial cell count was 15.3.1 eyes (6.7mm). The pupil diameter was larger than that of intraocular lens (IOL), and the diameter of pupil was larger than that of intraocular lens (IOL). Its crystal has 1 incision around the iris, and the optical center of the lens is slightly deviated from the center of the lens. One of the crystals has a band of iris pigment spread around the posterior surface of the crystal, and one of the crystals climbs into the incision around the iris. The pupil was slightly deformed in oval shape, but had no obvious effect on the visual acuity. The safety index, effectiveness index and predictive index were 1.37, 1.08 and -0.023 respectively. All the patients were satisfied with the postoperative visual acuity. Conclusion: the follow-up of the patients with angle support anterior chamber intraocular lens implantation for ultra-high myopia showed that the patients were satisfied with the naked eyesight and the quality of life was improved obviously. The predictive index (-0.023), the effectiveness index (1.08), the safety index (1.37), the complications were relatively few, but the corneal endothelium count was lost and no corneal endothelium decompensation occurred 3 years after operation. The rate of spontaneous loss of corneal endothelial cells remains to be further observed. The procedure is simple, predictable, effective and safe. It is one of the alternative methods for correction of high myopia.
【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R779.6

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