| Part oneObjective:To observe the characteristics of cases who received the implantable collamer lens(ICL) implantation and the demand trend to ICL technology.Methods:To collect the medical record data from cases who received the ICL surgery as the treatment for the high myopia in Daping Hospital during 2009-2014. The distribution of these cases has been analyzed.Results:In the past five years, 346 cases with 688 eyes had received the ICL surgery. Male 135 cases(39.02%), female 211 cases(60.98%), the degree of acceptance of the female patients for surgery was higher than men, and the difference was statistically significant(P <0.05). Among the cases, the spherical equivalent of male was-10.28 ± 3.49 D, and women-9.98 ± 4.49 D. From 2009-2014, for each year, the cases number were 54, 60, 67, 80, and 85 respectively. And showing a grow trend. The cases ratios of residence in urban, county and rural areas were 51.16%, 30.64% and 18.20%. 20-30 year-olds is the main crowd ICL surgery, in which the male age group accounted for 57.78 percent, 58.29 percent for females. All cases were mainly composed of six kinds of occupational structure. Which accounts for the ratio is the biggest student was 54.36%, followed by staff 22.54%, civil servants 9.54%, teachers 6.07% and farmers 2.89%. The average operation cost of each eye was 16248.38 + 438.56 yuan.Part twoObjective:To obserbe the early complications of ICL surgery.Methods:Forty patients( 78 eyes) who underwent ICL implantations in our hospital from April to September 2014 were recruited. During 3 month follow-up, the uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), spherical equivalent(SE), intraocular pressure, corneal endothelial cell counts and vaults have been observed to assess the clinical effectiveness and record complications.Results:After operation,there was significant improved in UCVA and SE(P>0.05). But there was no significant difference in IOP, UCVA, SE, vault and corneal endothelial cell count at 1 week,1 month and 3 month after operation(P<0.05). Early complications: After laser iridectomy, 35 case with high intraocular pressure symptoms appear within 24 hours. The next day returned to normal after drug treatment. Only one case with high intraocular pressure(22-30 mm Hg) last for 8 days. Retinal neurepithelium layer detachment was observed in 2 eyes, one of them has accompanied by a lamellar macular holes. All ICL surfaces of postoperative patients have iris pigmentation, but no significant impact on visual. Postoperative visual disturbances mainly were night glare.Part threeObjectiveTo observe the efficacy and safety effects of laser iridectomy operation timing in phakic intraocular lens implantation.Methods:Parallel randomized controlled study with double-blind design method has been used in this study. Ultimately the high myopia 40 patients(80 eyes) were been divided into two groups. Intervention programs: ① preoperative one week(control group: 20 cases 40) 2 hours ago ② surgery(experimental group: 20 cases of 40) laser iridectomy received postoperative posterior chamber implantable artificial crystal(Implantable Collamer lens, ICL) or astigmatism type posterior chamber intraocular lens implantable(Toric-ICL) treatment. ICL patients were followed up for 3 months, outcome measures include: intraocular pressure, UCVA, BCVA, ICL vault, retinal fiber layer(RNFL), corneal endothelial cell count, and pigmentation.Results:1.The two groups of patients with phakic intraocular lens implantation varying degrees of visual acuity had improved after the March uncorrected visual acuity 0.5-1.0(log MAR0.2 ± 0.21), preoperative uncorrected visual acuity 0.01-0.2(log MAR1.15 ± 0.91) difference was statistically significant(P <0.05), but there was no significant difference(P> 0.05).2.The control group had 18 cases of 35(89.7%) cut in half hour weeks after laser iris appears high intraocular pressure(26.06 ± 7.75 mm Hg), within three hours of intraocular pressure continued to increase reach(35.39 ± 10.88 mm Hg). Test group cut iris weeks laser expert ICL 2 hours after implantation, the two groups after ICL implantation of intraocular pressure decreased to normal range(14.73 ± 4.56 mm Hg) before both groups, there was no statistical difference in IOP significance(P <0.05).3.postoperative IOL are located in the center of the pupil; vault in experimental group:(0.547 ± 0.34mm), the control group:(0.517 ± 0.47mm), between the two groups was not statistically significant(P = 0.995).4. After 3 months ago pigment festival on camera inspection IOL calm the experimental group than the control group; pigment four azimuth angle composure same experimental group than the control group.Conclusions:1.ICL implantation as a refractive surgery, carried out with growing trend in recent years. In the analysis of cases, the 20-30 age group, women and students have the highest ratio of surgery. The safety and technical improvement of IGL should be carried out.2.ICL surgery as refractive eye surgery still has certain risks, and therefore improve the clinical preoperative examination, strict indications, prompt recognition and treatment of early complications could effectively reduce the risk of adverse events, improve surgical safety.3.The 2 hours prior to implantation iridectomy program is a prefer plan in ICL surgery, and could be use in clinical practice. |
PDF Full Text Request