有晶体眼后房型人工晶体植入术早期并发症的临床研究

发布时间：2018-06-23 02:28

本文选题：有晶体眼后房型人工晶体 + 高度近视　；参考：《第三军医大学学报》2015年10期

【摘要】：目的观察有晶体眼后房型人工晶体(implantable collamer lens,ICL)植入治疗高度近视的早期并发症以及处理情况,探讨其发生原因。方法观察在大坪医院眼科行有晶体眼人工晶体植入术的患者40例78眼,术后对患者的裸眼视力(UCVA)、最佳的矫正视力(BCVA)、等效球镜(SE)、眼压(IOP)、角膜内皮细胞计数及人工晶体拱高进行3个月随访,评估临床效果并记录并发症、处理方法以及处理后的情况。结果裸眼视力在术后均有显著提高,等效球镜度数与术前比较差异有统计学意义(P0.05);术后各随访期的眼压、裸眼视力、等效球镜、人工晶体拱高、角膜内皮细胞计数差异无统计学意义(P0.05)。早期并发症:激光虹膜周切后有35眼在24 h内出现高眼压,进行降眼压治疗后次日恢复正常,仅1眼高眼压状态22~30 mm Hg持续8 d。2例患者术后发生视网膜黄斑中心凹上皮层脱离,其中1例伴有视网膜黄斑板层裂孔。术后患者的人工晶体表面上都有一定程度的虹膜色素沉着,但无明显视力影响。术后视觉干扰主要表现为夜晚眩光。结论 ICL植入术作为眼内的屈光手术仍具有一定的风险,因此临床上完善术前检查、严格掌握适应证、及时识别及处理早期并发症,能够有效地降低手术带来不良事件的风险,提高手术安全性。
[Abstract]:Objective to observe the early complications and treatment of high myopia with posterior chamber intraocular lens (implantable collamer) implantation, and to explore the causes. Methods A total of 40 patients (78 eyes) with intraocular lens implantation were observed in Daping Hospital. The patients' uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), equivalent spherical lens (SE), intraocular pressure (IOP), corneal endothelial cell count and intraocular lens arch height were followed up for 3 months. Results the uncorrected visual acuity was significantly improved after operation, the degree of equivalent spherical lens was significantly higher than that before operation (P0.05), the intraocular pressure, naked visual acuity, equivalent spherical lens, intraocular lens arch height were significantly higher than those before operation (P0.05). There was no significant difference in corneal endothelial cell count (P0.05). Early complications: 35 eyes had high intraocular pressure within 24 hours after laser iris resection, and recovered to normal the next day after intraocular pressure reduction. Only 1 eye with high intraocular pressure, 2230 mm Hg, lasted 8 days. 2 cases of retinal macular central foveal detachment occurred after operation. One case was associated with retinal macular lamellar hole. Postoperative intraocular lens had a certain degree of iris pigmentation on the surface, but there was no obvious effect of visual acuity. Postoperative visual disturbance was mainly night glare. Conclusion ICL implantation is still at risk as an intraocular refractive surgery. Therefore, it can effectively reduce the risk of adverse events caused by surgery by perfecting preoperative examination, strictly grasping indications, and timely identifying and managing early complications. Improve the safety of operation.
【作者单位】：第三军医大学预防医学院军事流行病学教研室;第三军医大学大坪医院野战外科研究所眼科;
【分类号】：R779.6

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