目的:评估角膜移植术(KP)后植入后房型人工晶状体(ICL)的安全性、屈光效果和视力.方法:单中心回顾性研究.包括32例35眼接受后房型人工晶状体植入以矫正角膜移植术后近视和散光.患者在无法配戴眼镜、隐形眼镜或准分子激光术治疗不当的情况下接受后房型人工晶状体植入术.观察患者裸眼远视力(UDVA)、最佳矫正远视力(CDVA),屈光度及并发症.对术前术后随访资料进行分析(16.7±13mo) (P＜0.05).结果:术前,患者等效球镜和柱镜分别为-4.00～-20.00 D和-2.00～-9.00 D.平均等效球镜由术前-11.41±3.62 D显著下降至术后-1.95±1.78 D(P＜0.0001).平均UDVA由术前20/400显著增加至术后20/25(P＜0.0001).与术前相比,术后CDVA平均提高1.5行,其中37％提高2行或更多.1眼(2.8％)CDVA降低≥1行.术中或术后无并发症.结论:后房型人工晶状体植入对于无法配戴眼镜、隐形眼镜或准分子激光术治疗不当的患者是一种安全有效的治疗手段.%· AIM:To evaluate the safety,refractive outcomes and vision after phakic posterior chamber implantable collamer lens (ICL) after keratoplasty (KP).· METHODS:This retrospective single center study evaluated 32 (35 eyes) patients who received an ICL for myopia and/or astigmatism after keratoplasty.Patients underwent ICL surgery if they were unable to wear glasses or contact lenses and excimer laser surgery was contraindicated.Data were collected on uncorrected distance visual acuity (UDVA),corrected distance visual acuity (CDVA),refraction and complications.Data were analyzed for the preoperative and last postoperative visits (16.7±13mo) (P＜0.05).· RESULTS:Preoperatively,spherical equivalent (SE) ranged from-4.00 to-20.00 D and cylinder from-2.00 to -9.00 D.The mean SE decreased statistically significantly from-11.41± 3.62 D preoperatively to-1.95±1.78 D postoperatively (P ＜ 0.0001).Mean UDVA increased statistically significantly from 20/400 preoperatively to 20/ 25 postoperatively (P＜ 0.0001).There was a mean improvement in postoperative CDVA of 1.5 lines compared to preoperatively,37％ of eyes had an increase of 2 or more lines.One eye (2.8％) lost ≥ 1 line of CDVA.There were no intraoperative or postoperative complications.· CONCLUSION:Posterior chamber phakic intraocular lens implantation is a safe and effective treatment for post-keratoplasty myopia and astigmatism in patients who are unable to wear spectacles or contact lenses and where corneal refractive surgery is contraindicated.
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