单眼高度近视合并白内障的超声乳化手术疗效分析

Effects of phalcoemulsification on unilateral high myopia with cataract

摘要:

目的：探讨单眼高度近视合并年龄相关性白内障行超声乳化白内障摘除联合后房型人工晶状体植入术的手术疗效。

方法：回顾性病例研究。选择因单眼高度近视合并年龄相关性白内障而实施超声乳化白内障摘除联合后房型人工晶状体植入术的患者为研究对象，手术眼眼轴≥27mm，对侧非手术眼眼轴≤25mm，术后1，7d； 1，3mo随访视力及并发症情况。

结果：单眼高度近视合并年龄相关性白内障33例纳入此次研究，男7例，女26例，平均年龄68.8±9.26(41～87)岁，手术眼平均眼轴29.44±1.80(27.1～32.71)mm，对侧非手术眼平均眼轴23.39±0.92(21.72～24.90)mm，双眼平均眼轴差值6.06±1.97(2.78～9.92)mm。术前33眼平均矫正视力为0.02±0.02(光感～0.12)； 术后3mo，矫正视力显著提高，平均为0.20±0.20(0.02～0.8)，与术前比较差异有统计学意义(t =-5.278，P<0.05)。双眼眼轴差为2.01～5.00mm者10例，60%术后3mo矫正视力>0.3； 双眼眼轴差为5.01～7.00mm者13例，术后3mo矫正视力46.2%>0.3，46.2%位于0.05～0.25； 另有10例双眼眼轴差为7.01～9.99mm，90%术后3mo矫正视力<0.3，其中40%<0.05。术中术后无明显手术并发症发生。

结论：单眼高度近视合并年龄相关性白内障行超声乳化白内障摘除联合后房型人工晶状体植入可有效提高术后视力，手术安全，其视力恢复程度与双眼眼轴差值相关。

Abstract:

AIM: To observe the clinical effect of phacoemulsification and posterior chamber intraocular lens(IOL)implantation in the treatment of unilateral high myopia combined with age-related cataract.

METHODS: A retrospective clinical study was carried out in a single ophthalmology center. All patients diagnosed of unilateral high myopia with age-related cataract were performed phacoemulsification and posterior chamber IOL implantation. The axial length of operation eye was ≥27mm, and the axial length of unoperated fellow eye was≤25mm. Visual acuity and complications were followed up for 1, 7d, 1, 3mo postoperative.

RESULTS: Thirty-three patients with average age 68.8±9.26(41-87)y were enrolled in this study, 7 cases were men, 26 cases were women. The mean axial length of operation eyes was 29.44±1.80(27.1-32.71)mm and the mean axial length of unoperated fellow eyes was 23.39±0.92(21.72-24.90)mm. The average axial length difference of binocular eyes was 6.06±1.97(2.78-9.92)mm. The best corrected visual acuity(BCVA)increased from 0.02±0.02(light perception～0.12)preoperatively to 0.20±0.20(0.02-0.8)at 3mo postoperatively. There was statistically significant difference(t=-5.278, P<0.05). Among the 10 patients whose axial length difference of binocular eyes was 2.01-5.00mm, 60% of their postoperative BCVA were >0.3. Among the 13 patients with binocular axial length difference of 5.01-7.00mm,46.2% of BCVA were >0.3,46.2% achieved 0.05-0.25. Another 10 patients of binocular axial length difference between 7.01-9.99mm, 90% of BCVA were <0.3, of which 40% were <0.05. No complications occurred during operative and postoperative.

CONCLUSION:Phacoemulsification and posterior chamber IOL implantation can effectively improve the postoperative visual acuity and it is safe for unilateral high myopic patients combined with age-related cataract. The recovery of visual acuity is related with binocular axial length difference.