TICL植入术治疗高度近视合并散光的临床观察

Clinical research of the implantation of Toric implantable collamer lens for high myopia with astigmatism

摘要:

目的：研究后房型有晶状体眼散光型人工晶状体(toric implantabIe collamer lens，TICL)矫正高度近视合并散光的有效性、安全性。

方法：回顾性系列病历研究。收集我院2010-02/2011-06经手术治疗高度近视合并散光22例40眼的病历资料，该手术均在局部麻醉下通过3mm透明角膜切口植入TICL。随访12mo，随访内容包括术前及术后1d； 1wk； 1，3，12mo的裸眼视力、术前最佳矫正视力、眼压、裂隙灯显微镜检查、屈光度数、角膜内皮细胞分析、人工晶状体柱镜轴位等。

结果：术后3mo 40眼裸眼视力均等于或高于术前最佳矫正视力，球镜度数均在-0.5～+0.5D，柱镜度数均在-0.75～0D。术后1mo TICL轴向偏差在10°以内者占95.0%(38/40)， TICL轴向偏差在10°～15°者占2.5%(1/40)， 偏差大于30°者1眼(2.5%)； TICL旋转大于30°的1眼行人工晶状体调位术，术后TICL轴向偏差在10°以内。术后7眼眼压一过性升高，经降眼压治疗，1wk内恢复正常。未发现继发性青光眼、晶状体混浊等病例。

结论：TICL植入术矫治高度近视合并散光具有有效性和安全性。

Abstract:

AIM: To evaluate the efficacy and safety of Toric implantable collamer lens(TICL)for high myopia with astigmatism.

METHODS: This retrospective case series included 40 eyes of 22 patients from February 2010 to June 2011. A TICL was intraocularly implanted via a 3mm clear corneal incision after local anesthesia.Patients were examined preoperatively and followed-up 1 day, 1 week, 1 month, 3, 12 months postoperatively for uncorrected visual acuity. The examinations also included best-corrected visual acuity(BCVA)preoperatively, slit-lamp examination, refraction, intraocular pressure, endothelial cell morphometry, cylinder axis of the TICL, etc.

RESULTS: The uncorrected visual acuity in 40 eyes was equal or improved after 3 months of the operation in comparison with BCVA of preoperation. The spherical refraction after operation was within(-0.5- +0.5)D. The cylinder refraction was within(-0.75-0)D. The axial deviation of TICL after 1 month postoperatively within 10° was 95.0%(38/40). The axial deviation of TICL between 10 ° and 15° was 2.5%(1/40). The axial deviation of TICL above 30° was 2.5%(1/40)whose astigmatic axial rotation was changed after surgical intervention. As a result, the axial deviation of TICL was within 10 degrees. 7 eyes had increased intraocular pressure shortly after surgery and after treatment the intraocular pressure became normal in 1 week. No severe complications including secondary glaucoma and cataract and etc occurred.

CONCLUSION: TICL implantation appears to be an effective, safe method for high myopia with astigmatism.