| ObjectiveTo observe and analyze the clinical effect after implantation of phakic posterior chamber intraocular lens in high myopiaMethodThe total 142 cases(269 eyes) with high myopia were followed up who have acceptted the implantation of phakic posterior chamber intraocular lens in the departments of ophthalmology,the first Hospital Afflicated to Anhui medical University and Shenzhen Humanity hospital from April 2005 to September 2009, including 57 cases (100 eyes) of Toric Implantable Collamer Lens(Toric ICL),male 57(109 eyes)and female 85(160 eyes),127 cases in both eyes and 15 cases in a simple eye; The average age was 28.41±6.90 years(range 18～46 years);Preoperative refraction ranged from -6.00～-23.00 diopters(D),refraction averaged (-11.48±3.70 )D, Astigmatism ranged from 0～-6.50D,mean(-1.48±0.07 D) ;The uncorrected visual acuity (UCVA) was from 0.02 to 0.3 (mean 0.05±0.03) and best corrected visual acuity (BCVA) was from 0.1 to 1.2(mean 0.75±0.23) preoperatively; Preoperative corneal endothelial density ranged from 2000 to 3961个/mm2(mean 2735.13±464.50个/mm2).According to degree of mean refraetive spherieal equivalent(MRSE) preoperatively,all patients were divided into Group A(-6.00～-12.00D)and Group B (≥-12.00D).Before and after refractive surgery, The refraction,uncorrected visual acuity,best corrected visual acuity,intraocular pressure and corneal endothelial density were compared and analyzed. The ultrasound biomicroscopy was usded to observe the lens and the ICL. The operative complications were observed and managed. The visual quality of patients was assessed. All cases were followed up for 12 to 36 months.ResultUCVA was significantly improved at postoperative 1 day,There were no significant difference in the postoperative UCVA among 1 day,1week,1month,3month,6month(P﹥0.05);The proportion which BCVA of preoperation reach or exceed 0.5 was 87.36%and 1.0 was 25.28%; postoperative UCVA≥0.5 ratio is 95.91%,≥1.0 ratio is 68.77%. UCVA and BCVA of Group A were both better than Group B, and there were statistically significance (P﹤0.05)。95.53% of UCVA and 99.26% of BCVA postoperatively was same or better than preoperative BCVA. The safety index and effective index of Group B was higher than Group A, and it was statistically significant different. 83.08% of the difference between postoperative refraction and target refraction was within±0.50D, 96.41% was within±1.00D. In 1 year postoperatively the ultrasound biomicroscopy(UBM)was usded to observe the distance from corneal endothelium to ICL and the distance from ICL to the lens with 40 eyes, the distance from corneal endothelium to ICL before and after constriction of the pupils was 2.38±0.21mm and 2.43±0.16mm respectively (P=0.16,t=1.45), the distance from ICL to the lens before and after constriction of the pupils was 0.54±0.19mm and 0.41±0.23mm respectively(P=0.002,t=-3.567)。Before and after surgery, corneal endothelial density and intraocular pressure was no statistically significant different. Postoperative complications are as follows: the vision decent at night and dazzling sensation occurred in 7 cases of patients with 13 eyes,the ability of close vision was fatigued in 6 cases of patients with 10 eyes;19 eye of 10 patients had increased intraocular pressure;anterior subcapsular of limitation and ICL removal occurred1 in 1 eye of 1 patient; Toric ICL axial movement in 4 eye of 3 patient;ICL of the surface and the surface had pigmentation to the different degree. In addition to the above complications, no other serious complications have happened.Group B(95.83%)was more satisfied with the surgery than Group A(91.55%)at the latest follow-up.ConclusionIn areas with high myopia, PPC IOL implantation have an exact effect, and the operation is especially suitable for those who can not choose corneal refractive surgery, but Its long-term complications needs further observation. |
