眼科学报2023，Vol.38Issue(10)：683-692,10.DOI:10.12419/2308180001
依镜PRL植入术矫正超高度近视的临床疗效观察
Observation the clinical efficacy of PRL implantation for correction of ultra high myopia
摘要
Abstract
Objective:To assess the efficacy and safety of phakic refractive lens(PRL)implantation for the correction of ultra-high myopia.Methods:This self-controlled case series study included 39 eyes of 24 patients with ultra-high myopia who underwent PRL implantation at Shenzhen Eye Hospital between January 2018 and September 2020.The study comprised 13 eyes in 8 males and 26 eyes in 16 females,with a mean age of(31.15±6.33)years.Postoperative parameters,including refraction,visual acuity(UCVA,BCVA),intraocular pressure,corneal endothelial cell count,vault,and surgical complication were observed.Results:The median follow-up time was 5.5(3,11)months.The refraction significantly decreased from preoperative(-22.29±4.96)D to postoperative(-0.28±1.01)D(t=24.421,P＜0.001).Postoperatively,82.4％of eyes achieved a spherical degree within±0.5 D,and 91.2％within±1.0 D.LogMAR UCVA significantly improved from 1.40(1.30,1.70)preoperatively to(0.28±0.20)postoperatively.LogMAR BCVA significantly improved from 0.40(0.22,0.70)preoperatively to 0.15(0.00,0.30)postoperatively(P＜0.001 for all).Postoperative BCVA improved by 3.00(1.00,5.00)lines compared with preoperative BCVA,with no instances of BCVA loss in any patient.Intraocular pressure values showed significant differences among preoperative,1 day postoperative and last follow up(F=8.779,P=0.012).Intraocular pressure increased significantly 1 day after surgery compared to before surgery(Z=-3.401,P=0.001),but decreased significantly at the last follow-up compared to 1 day postoperatively(Z=-2.685,P=0.007),with no significant difference in intraocular pressure between preoperative and last follow-up(Z=-0.894,P=0.371).Corneal endothelial cell count decreased significantly from preoperative(2 782.20± 296.30)/mm2 to postoperative(2 472.54±394.32)/mm2(t=-5.437,P＜0.001),with a mean loss of 11.2％.The average vault at the last follow-up was(379.00±283.27)μm,of which 0～250 μm in 12 eyes(36.4％),250～750 μm in 19 eyes(57.6％),and＞750 μm in 2 eyes(6％).In 21 eyes,the vault at 3 months postoperative(269.81±194.67)μm was significantly lower than that at 1 month postoperative(373.62±195.75)μm(t=-2.917,P=0.009).Postoperative complications included steroid-induced glaucoma(2 eyes in 1 case),PRL optical surface crack(1 eye),macular hemorrhage(1 eye),and PRL decentration(3 eyes in 2 cases).Conclusions:PRL implantation is a safe and effective intraocular refractive surgery for ultra-high myopic patients.Nonetheless,it should be neccessary to observe for long-term efficacy and saff lens;high myopia关键词
有晶状体眼后房屈光晶体/有晶体眼/高度近视Key words
PRL/Phakic intraocular lens/High myopia引用本文复制引用
张静,聂丹瑶,孙良南,贺温玲,胡慧玲,黄茗荃,刘欣华..依镜PRL植入术矫正超高度近视的临床疗效观察[J].眼科学报,2023,38(10):683-692,10.基金项目
广东省基础与应用基础研究基金项目(2021A1515111012) （2021A1515111012）
深圳医疗卫生三名工程(SZSM201812091).This work was supported by the Basic and Applied Basic Research Fund of Guangdong Province(2021A1515111012)and the SanMing Project of Medicine in Shenzhen,China(SZSM201812091). （SZSM201812091）
