高度近视并发白内障超声乳化手术的临床体会

The Clinical Study on Phacoemulsification for Cataract with High Myopia

摘要: 目的：探讨高度近视眼白内障在超声乳化这种微小切口的手术方式下的手术效果。方法：回顾性分析我院2009年4月至2014年5月高度近视眼白内障145例178眼，实施了白内障超声乳化手术，术后随访均在半年以上，分别观察术后角膜反应、眼压及最终视力恢复情况。结果：术后1个月裸眼及矫正视力0.1~0.4者79眼(44.38%)，裸眼及矫正视力0.5~0.9者80眼(44.94%)，裸眼及矫正视力达到1.0者19眼(10.67%)；术后3个月裸眼及矫正视力0.1~0.4者65眼(36.52%)，裸眼及矫正视力0.5~0.9者89眼(50%)，裸眼及矫正视力达到1.0者24眼(13.48%)；术后6个月裸眼及矫正视力0.1~0.4者67眼(37.64%)，裸眼及矫正视力0.5~0.9者90眼(50.56%)，裸眼及矫正视力达到1.0者21眼(11.80%)，术后3个月及6个月无明显差异。结论：手术方式选择超声乳化联合人工晶体植入手术能有效的提高患者视力，同时低度数或负值后房型人工晶体又可进行屈光矫正，手术安全，疗效满意。

Abstract: Objectives: To investigate the treatment effect of micro incision phacoemulsification for cataract with high myopia. Methods: 145 cases (178 eyes) of cataract with high myopia who were performed phacoemulsification during April 2009 and May 2014 were retrospectively analyzed, and all patients were followed up for half a year at least. Results: One month after operation, the un-corrected visual acuity and corrected visual acuity of 79 eyes ranged 0.1 to 0.4 which accounted for 44.38 percent; the uncorrected visual acuity and corrected visual acuity of 80 eyes ranged 0.5 to 0.9 (44.94%); the uncorrected visual acuity and corrected visual acuity of 19 eyes were 1.0 (10.67%). Three months after operation, the uncorrected visual acuity and corrected visual acuity of 65 eyes ranged 0.1 to 0.4 (36.52%); the uncorrected visual acuity and corrected visual acuity of 89 eyes ranged 0.5 to 0.9 (50%); the uncorrected visual acuity and corrected visual acuity of 24 eyes were 1.0 (13.48%). Six months after operation, the uncorrected visual acuity and corrected visual acuity of 67 eyes ranged 0.1 to 0.4 (37.64%); the uncorrected visual acuity and corrected visual acuity of 90 eyes ranged 0.5 to 0.9 (50.56%); the uncorrected visual acuity and corrected visual acuity of 21 eyes were 1.0 (11.80%). There was no significant difference between three months and six months after operation. Conclusions: The method of Phacoemulsification combined with IOL implantation could effectively improve visual acuity, low degree IOL and negative posterior chamber IOL could be better for correction of refractive errors. Phacoemulsification for cataract with high myopia is safe and effective.