探讨矫正高度近视的两种眼内屈光手术的临床效果

目的：探讨超高度近视后房型人工晶体手术与透明晶状体切除联合后房型人工晶状体植入术矫正高度近视的临床效果。方法：系统回顾性研究近一年内在本院接受矫正超高度近视眼患者23例（45只眼）。将所有患者随机分为A、B组，A组8例（15只眼），为晶体眼后房型人工晶体手术植入患者，B组15例（30只眼），为透明晶状体超声乳化摘除及低度数或负度数人工晶状体囊袋内植入患者。分别在术后第3、6、12个月，观察两组患者视力、屈光度、角膜内皮细胞计数、眼压、前房反应、后发性白内障及视网膜并发症等方面的变化情况。结果：所有手术没有医源性事故发生。术后12个月裸眼视力≥0.5：A组11眼（73.3%），B组19眼（63.3%），两组差异无统计学意义（P〉0.05）。手术主要并发症：A组中于术后24h内高眼压2眼，平均角膜内皮细胞丢失率为4.2%。B组术后12个月行YAG激光后囊切开3只眼，未发生视网膜脱离。两组均有主诉夜间眩光症状，B组视近困难者6例。结论：两种手术临床疗效无明显差异，但需充分做好术前沟通及术前全面细致的眼部检查和评估。超高度近视行眼内屈光手术，是一种安全、有效、稳定性好的治疗方法，值得推广。

Clinical Effect of Two Kinds of Intraocular Refractive Operation to Correct High Myopia

Objective：To investigate the clinical effect of super high myopia after posterior chamber intraocular lens operation and transparent lens ectomy combined intraocular shaped body implantation for the correction of high myopia. Method：A system of retrospective study for nearly a year in this hospital for correction of high myopia in 23 cases（45 eyes）,all patients were randomly divided into the group A and the group B：the group A with crystal eyes after intraocular lens implantation operation in 8 cases（15 eyes）,the group B of transparent lens phacoemulsification and low or negative power intraocular lens capsular bag implantation in 15 cases（30 eyes）.The changes were respectively observed after three, six,twelve months in visual acuity,diopter,corneal endothelial cell count,intraocular pressure,anterior chamber reaction,after cataract and retinal complication etc.Result：There were no iatrogenic accident after operation;twelve months after surgery,visual acuity was greater than or equal to 0.5：group A had 11 eyes（73.3%）,group B had 19 eyes（63.3%）, there was no significant difference between the two groups（P〉0.05）.Operation complications：high IOP was observed in 2 eyes after operation 24 hours in group A,the average corneal endothelial cell loss rate was 4.2%.Post-operative YAG laser capsulotomy was done on 3 eyes in group B after twelve months without the occurrence of retinal detachment,two groups have complained glare symptoms,the recent difficulties were occured in 6 cases in group B.Conclusion：There is no significant difference between the two kinds of operation curative effect,but the need to fully eye examination and assessment of preoperative communication and preoperative careful,The super high myopia underwent intraocular refractive operation,is a safe,effective,stable treatment,worthy of promotion.