摘要目的 研究有晶状体眼虹膜夹型人工晶状体(ICPIOL)矫治高度近视眼的长期安全性和有效性.方法 高度近视眼患者49例(86只眼),等效球镜度数(SE)(-15.33±3.81)D,植入ICPIOL.术后随访3年,观察手术前后的视力、屈光状态、眼压、角膜、前房、瞳孔、ICPIOL和晶状体、眼底情况,并采用单因素方差分析进行统计学比较.结果 与术前比较,术后1、2、3年的裸眼视力(UCVA)、最佳矫正视力(BCVA)和SE显著改善(F=513.68,20.88,827.65;P＜0.01).术后3年时,UCVA≥0.5有85%,≥0.8有35%;BCVA未见下降,17%比术前提高1行,59%比术前提高≥2行;81%眼的实际屈光度数稳定在预期的±1.00 D,54%稳定在预期的±0.50 D.术后1、2、3年的角膜内皮细胞累积丢失率分别为3.60%、5.78%、7.74%.除了3只眼术中在抓持虹膜固定ICPIOL时有轻度虹膜脱色素,1只眼ICPIOL脚襻脱位重新手术固定,2只眼黄斑出血外,未见其他并发症发生.结论 ICPIOL矫治高度近视术后3年内安全、有效.

abstractsObjective To investigate long-term efficacy and safety of an iris-claw phakic intraocular lens (ICPIOL) implantation for high myopia. Methods A consecutive group of 86 eyes in 49 patients with -15.33 ±3. 81 diopters (D) of myopia was implanted with the Artisan ICPIOL ( Ophtec), and was evaluated preoperatively and 1,2, 3 years postoperatively. Uncorrected visual acuity ( UCVA ), best corrected visual acuity ( BCVA), manifest refraction, intraocular pressure, and complications were evaluated. Results The implantation was successful in all of 86 eyes. Compared with preoperative data, UCVA, BCVA, and spherical equivalent (SE) were improved significantly ( F = 513. 68,20. 88,827. 65; P ＜ 0. 01 ). At 3-year postoperatively, UCVA in 85% eyes was 0. 5 or better, in 35% was 0. 8 or better; No loss of BCVA was found, 17% gained 1 line, and 59% gained 2 lines or more; SE in 81%, 54% eyes was within ± 1.00 D,±0. 50 D of attempted, respectively. At 1-, 2-, 3-year follow-up, the corneal endothelial loss was 3. 60%,5.78%, 7.74%, respectively. There were 2 macular haemorrhages resulted from CNV, and 1 ICPIOL repositioning due to inappropriate iris capture. No other severe complications occurred. Conclusion At 3-year follow-up, the implantation of the ICPIOL proved to be safe and effective for the correction of myopia in phakic eyes.