作者：张虹，龚永强 作者单位：650021）中国云南省昆明市，云南省第二人民医院眼科
【摘要】 目的：探讨超声乳化透明晶状体摘除联合人工晶状体植入治疗高度近视的临床疗效。
【关键词】 高度近视；超声乳化；人工晶状体
Clinical efficacy of transparent lens phacoemulsification combined with intraocular lens implantation for correcting high myopia Hong Zhang，YongQiang GongDepartment of Ophthalmology, the Second Peoples Hospital of Yunnan Province, Kunming 650021, Yunnan Province , China Abstract AIM: To investigate the clinical efficacy and safety of transparent lens phacoemulsification combined with intraocular lens (IOL) implantation in correcting high myopia。
METHODS: Thirth patients (49 eyes) with high myopia underwent transparent lens phacoemulsification combined with IOL implantation. We investigated the patient's visual acuity before and after the surgery and observed the postoperative complications which lasted for 612 months, average 8.5 months.
RESULTS: The best corrected vision of 49 eyes after surgery were better than that before surgery. Postoperative uncorrected vision was above 0.5 in 28 eyes (57%); the best corrected vision was above 0.5 in 41 eyes (84%); posterior capsule opacification occured in 5 eyes(10%), and all the above were performed YAG laser treatment. Retinal detachment occured only in 1 eye(2%). Complications such as cystoid macular edema, fundus hemorrhage, glaucoma, and IOL deviation didnt occur in the followup period.
CONCLUSION: It can be concluded that the therapy of transparent lens phacoemulsification combined with IOL embedding as refractive surgery to correct high myopia seems to be very effective and safe.
KEYWORDS: high myopia; phacoemulsification; intraocular lens
方法：对30例49眼高度近视眼患者，经透明角膜切口行超声乳化透明晶状体吸除联合后房型折叠人工晶状体植入术，对比患眼手术前后视力，观察术后并发症，术后随访6～12（平均8.5）mo。
结果：术后49眼矫正视力均超过术前最佳矫正视力，其中术后裸眼视力≥0.5者28眼（57%），术后最佳矫正视力≥0.5者41眼（84%）；术后发生后囊混浊5眼（10%），均行YAG激光治疗；1例发生视网膜脱离（2%）。随访期内未发现黄斑囊样水肿、眼底出血、青光眼、人工晶状体偏位等并发症。
结论:超声乳化透明晶状体摘除联合折叠式人工晶状体植入术，作为一种屈光手术治疗高度近视是安全有效的方法。
0引言
目前，近视的手术矫治主要是通过准分子激光原位角膜磨镶术（laser in situ keratomileusis, LASIK）来完成，然而，角膜屈光手术要受到年龄、近视程度和角膜厚度等因素的限制。尽管角膜屈光状态是相对稳定的，而晶状体会随着年龄的增长出现相关性改变：如调节力逐渐下降、晶状体纤维吸收水分而膨胀及晶状体混浊等，最终还是要解决晶状体问题[1，2]。随着人工晶状体（IOL）的改善和手术方法的改进,利用人工晶状体植入治疗高度近视获得了满意的效果，现报告如下。
1对象和方法 1.1对象 高度近视患者30例49眼，男18例28眼，女12例21眼；平均年龄（38±2.2）岁；术前裸眼视力0.01～0.3，屈光度数平均为13.3±0.42D,矫正视力0.2～0.7，平均眼轴长度28.2±1.37mm。所有病例均排除了糖尿病性视网膜病变、视神经萎缩，视网膜色素上皮病等眼底病变。
1.2方法 术前检查：均查血常规、血糖、ECG，胸片、光定位、视力、验光、裂隙灯、前房角镜、三面镜、间接眼底镜、双眼A，B超、角膜曲率、视野等。手术方法：常规消毒、铺巾、开睑后，倍诺喜表面麻醉，上方透明角膜作3.0mm切口，前房注入黏弹剂，3∶00方位做角膜辅助切口，用撕囊镊连续环形撕囊，水分离，超声乳化碎核，吸出皮质，抛光后囊，黏弹剂维持前房，囊袋内植入折叠晶状体，冲洗晶状体前后黏弹剂，调整人工晶状体于正位。BSS液重建前房，角膜切口层间注水封闭切口，结膜下注射抗菌药物，术毕，包扎术眼1d。术后典必殊眼液点眼2wk，随访6～12mo。
表1 超声乳化晶状体摘除联合人工晶状体植入术后视力变化（略）
统计学分析：采用χ2检验。
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