Clinical Effects Of Two Kinds Of Different Intraocular Lens Implanting In High Myopia Eyes With Cataract

Objective:To investigate the changes of the structure and the influence of the posterior segment of the eyeball after two different intraocular lens (IOL) implantation in high myopia eyes with cataract.Method:Totally 55 cases (88 eyes) received phacoemulsification combined with two kind of different IOL implantation in our hospital from January 2010 to October 2014.38 cases (66 eyes) in which the A group were Bigbag IOL implantation, and another 17 cases (22 eyes) in the B group implanting MA60MA IOL. The term of Following up is 3 months after the surgery. Preoperative and postoperative uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA) and the changes of intraocular pressure were recorded. Observed the position of intraocular lens and posterior capsular circumstances by the slit-lamp microscope and UBM after fully dilated. Preoperative and postoperative anterior chamber depth (ACD) of the eyeballs and the distance from the central of posterior capsule to retina were measured by A-mode ultrasound, to evaluate the changes of the ACD and the influence of the vitreous chamber after IOL implantation. The occurrence of posterior vitreous detachment(PVD) and retina detachment(RD) were examined by B-scan ultrasonography and Non-contact slit lamp lenses.Results:In 3 months postoperation, the number of eyes with UCVA> 0.3were 47eyes(71.21%) in A group and 16 eyes(72.73%) in B group, there was no statistical significance between the two groups, P>0.5. The mean preoperative ACD in group A and group B, respectively (3.59 ± 0.17) mm and (3.55 ± 0.21) mm, there was no statistically significant between the two groups (t=-2.740, P > 0.05). At 3 months after cataract operation The mean ACD in group A and group B, respectively (4.29±0.31) mm and(3.74±0.12)mm,the depth of the two groups were increased compared with the preoperative (group A t=-9.529, P< 0.05. group B, t=-5.747, P< 0.05),and there was a statistically significant difference between the two groups (t=4.969, P<0.05). The difference of the distance from the central of posterior capsule to retina of preoperative had no statistically significant between the two groups(t=-3.289, P>0.05), The average margin for the distance from the central of posterior capsule to retina of the A group before operation and 3 month after operation is (1.56+0.41) mm, B group (1.67±0.12) mm, both of the two groups had increased compared with the preoperative (group A, t=-7.451, P<0.05; group B, t=-3.800, P< 0.05), and there was a statistically significant difference between them (t=-6.452, P<0.05). Three(3) months after operation,one eye with after-cataract was found in B group and 5 eyes (41.67%) developed PVD postoperatively. in the A group, there was no after-cataract and 4 eyes(19.05%) developed PVD postoperatively. One eye of the B group had severe complications of retina detachment in 1 month after the surgery.Conclusion:The two kinds of IOL can effectively improve visual acuity, due to the particularity design of Bigbag IOL, it has certain advantages than MA60MA IOL in maintaining the anterior chamber depth, weaken the vitreous rush forth so as reduce the influence of the surgery for posterior segment of eyeball.