Background With the development of refractive surgery,phakic intraocular lens implantation (PIOL) for high myopia is proving its outstanding merits in short-term treating outcomes.However,its long-term safety and effectiveness were still in more attention.Objective This study was to evaluate and compare the long-term safety,stability and efficacy of Verisyse PIOL implantation with implantable contact lens (ICL) implantation for high myopia.Methods The clinical data of 18 eyes (9 patients) who received Verisyse iris-claw intraocular lens implantation for high myopia and matched 22 eyes (11 patients) who received ICL implantation for high myopia from 2009 to 2011 were retrospectively analyzed.The patients were followed-up for 2 years after surgery.Uncorrected visual acuity (UCVA),best corrected visual acuity (BCVA),spherical equivalence (SE),axial length,corneal endothelial cell density (ECD),contrast sensitivity (CS),wave-front aberrations and postoperative complications were recorded during the following-up.The efficacy index,predictable and safety index were compared between the two groups.Results There was no significant difference in UCVA,BCVA and SE between Verisyse group and ICL group(t =0.92,1.32,4.32;all at P＞0.05).Non-glare CS under the 1.5,3.0,6.0,12.0 and 18.0 c/d spatial frequencies were insignificantly different between the two groups(Z=0.782,0.956,0.495,0.874,0.293;all at P＞0.05),and the similar outcomes were found in glare CS (Z=0.985,1.254,0.896,1.652,0.492;all at P＞0.05) in postoperative 2 years.Root meas square of total high order aberration (RMSh),vertical-trefoil,vertical-coma,horizontal-coma,spherical aberration(SA),were significantly elevated in the Verisyse group compared with the ICL group (Z =4.72,4.24,3.12,3.65,2.16;all at P ＜ 0.05).The mean efficacy index was 108.49 ± 16.62 in the V erisyse group and 106.71±15.88 in the ICL group,showing a significant difference (t =0.54,P＞0.05).The mean safety index was 140.56±33.89 in the Verisyse group and 143.34±34.56 in the ICL group,with a significant difference between them (t=0.29,P＞0.05).The mean predictable index was-0.25(-0.97,4.23)in the Verisyse group and 0.98 (-1.44,1.52) in the ICL group,and the difference was significant (Z =-2.68,P ＜ 0.05).Conclusions Both Verisyse PIOL implantation and ICL implantation for high myopia are safe,predictable and effective.The vusial quality and predictability of ICL implantation are much better than Verisyse PIOL implantation.A long-term effect should be observed for the further evaluation.%背景 随着屈光手术的不断进步,有晶状体眼人工晶状体(PIOL)植入术矫正高度近视逐步体现出其独有的优越性,目前评价其短期疗效和安全性的研究较多,但其远期安全性、有效性在临床上越来越受到关注. 目的 观察和比较Verisyse PIOL和可植入眼内接触镜(ICL)植入术矫正高度近视的远期效果、安全性及可预测性.方法 对2009-2011年行PIOL植入术矫正高度近视的患者资料进行回顾性分析,其中Verisyse PIOL植入术9例18眼(Verisyse组)和ICL植入术11例22眼(ICL组),各组术眼术前裸眼视力(UCVA)、最佳矫正视力(BCVA)、眼轴、眼压、角膜内皮细胞密度(ECD)等基线特征匹配.所有手术均由同一医师完成,随访期2年,评价指标包括术眼UCVA、BCVA、等效球镜度(SE)、眼轴、眼压、ECD、对比敏感度(CS)、波前像差及并发症,比较2种手术的安全性、有效性及可预测性. 结果 术后2年,2个组间术眼UCVA、BCVA、SE的差异均无统计学意义(t=0.92、1.32、4.32,均P＞0.05).Verisyse组术眼无眩光状态下不同空间频率CS值均低于ICL组,但差异均无统计学意义(Z=0.782、0.956、0.495、0.874、0.293,均P＞0.05);术后2年Verisyse组术眼眩光状态下不同空间频率CS值均稍低于ICL组,但差异均无统计学意义(Z=0.985、1.254、0.896、1.652、0.492,均P＞0.05).Verisyse组总高阶像差均方根值、垂直三叶草差、垂直慧差、水平慧差和球差均高于ICL组,差异均有统计学意义(Z=4.72、4.24、3.12、3.65、2.16,均P＜0.05).Verisyse组术眼平均有效性指数为108.49±16.62,ICL组为106.71±15.88,组间差异无统计学意义(t=0.54,P＞0.05).Verisyse组平均安全性指数为140.56±33.89,ICL组为143.34±34.56,差异无统计学意义(t=0.29,P＞0.05).Verisyse组术眼可预测性指数为-0.25(-0.97,4.23),低于ICL组的0.98(-1.44,1.52),差异有统计学意义(Z=-2.68,P＜0.05). 结论 Verisyse PIOL和ICL植入术矫正高度近视的有效性、安全性和可预测性均较好,ICL植入术术后术眼的视觉质量和可预测性均优于Verisyse PIOL植入术.
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