国际眼科纵览 ›› 2025, Vol. 49 ›› Issue (3): 213-217.doi: 10. 3760/cma.j.cn115500-20250106-25309

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高度近视眼ICL植入术后发生孔源性视网膜脱离的危险因素及临床特征

潘丽朵1  邓健1  李永浩2   

  1. 1暨南大学附属爱尔眼科医院,广州 510071;2深圳市眼科医院 南方医科大学深圳眼科医学中心,深圳 518040

  • 收稿日期:2025-01-06 出版日期:2025-06-22 发布日期:2025-06-12
  • 通讯作者: 李永浩,Email:liyhao486@163.com

Risk factors and clinical characteristics of rhegmatogenous retinal detachment after ICL implantation in high myopia

Pan Liduo1, Deng Jian1, Li Yonghao2   

  1. 1 Aier Eye Hospital, Jinan University, Guangzhou 510071, China; 2 Shenzhen Eye Hospital, Shenzhen Ophthalmic Medical Centre of Southern Medical University, Shenzhen 518040,China

  • Received:2025-01-06 Online:2025-06-22 Published:2025-06-12
  • Contact: Li Yonghao, Email: liyhao486@163.com

摘要: 有晶状体眼后房型人工晶状体(implantable collamer lens,ICL)植入术已成为高度近视患者屈光手术的首要选择。但随着手术量增加,术后并发症尤其是孔源性视网膜脱离(rhegmatogenous retinal detachment,RRD)的潜在风险也增加。目前高度近视眼ICL植入术后RRD的10年发病率为1.71%,与未手术的高度近视眼的1.25%相比并无显著差异。ICL植入术后RRD的发生可能与高度近视眼玻璃体视网膜的改变、手术源性因素(如黏弹剂残留、眼内炎症等)以及两者的协同作用有关。ICL植入术后前6个月内出现的RRD被认为是手术源性因素所致,而较长时间间隔之后出现则被更多地归因于高度近视的自然进展。此外,ICL植入术后一旦出现RRD,及时的手术干预可成功复位视网膜并挽救患者视力,并且大多数情况下无需取出ICL。


关键词: 高度近视, 有晶状体眼后房型人工晶状体, 孔源性视网膜脱离

Abstract: Posterior chamber phakic implantable collamer lens (ICL) implantation has become the primary refractive surgery option for patients with high myopia. However, with the increasing number of procedures performed, postoperative complications-particularly the potential risk of rhegmatogenous retinal detachment (RRD)-have also risen. Current evidence shows that the 10-year incidence rate of RRD following ICL implantation in highly myopic eyes is 1.71%, demonstrating no significant difference compared to the 1.25% incidence in unoperated highly myopic eyes. The pathogenesis of RRD after ICL implantation may be associated with vitreoretinal alterations in high myopia, surgery-related factors (such as residual viscoelastic agents and intraocular inflammation), and the synergistic effects of both. RRD occurring within the first 6 months postoperatively is generally attributed to surgical factors, whereas cases emerging after longer intervals are more likely associated with the natural progression of high myopia. Furthermore, when RRD does occur following ICL implantation, timely surgical intervention can successfully reattach the retina and preserve visual acuity, with the ICL typically remaining in situ as explantation is usually unnecessary.


Key words: High myopia, Phakic implantable collamer lens, Rhegmatogenous retinal detachment