1800-Degree Myopia? Implantable Lenses Offer a Solution
- Topics on Ophthalmology
- Article
- HKSH Article
- 22 Apr 2026
植入式隱形眼鏡（Implantable Contact Lens，簡稱ICL），又稱「眼內透鏡」，透過手術將由塑膠或矽膠製成的鏡片植入眼球內，以矯正近視、遠視及散光。此技術經過多年的演進，現時採用「後房鏡」手術，將長方形鏡片置於虹膜與晶體之間，不單更為安全，對角膜損害也較少。
深近視亦可矯視
ICL為深度近視患者的矯視選擇，因為激光矯視最多矯正約1400度近視；ICL則可矯正高達1800度近視、1000度遠視及600度散光。最近亦有一種新型ICL鏡片適用於早期老花患者。進行ICL手術前，患者需接受角膜內皮細胞密度及前房深度檢查，以確保符合ICL手術的條件。角膜是一層透明組織，覆蓋虹膜前方，共分5層，最內層的內皮細胞負責吸收水分而保持角膜透明。正常的角膜內皮細胞密度需為每平方毫米約2400個；若低於800個，角膜會變得混濁，不符合手術要求。一般而言，年約20歲的年輕人角膜內皮細胞數量介乎2000至3000個，普遍符合要求。至於前房深度則需大於2.8毫米，若空間過淺，鏡片可能會壓迫角膜，損害細胞。遠視患者因眼球較短和前房較淺，通常並不適合進行ICL手術。
鏡片改良助疏通房水 副作用大減
ICL植入後毋須定期取出清潔，可長期穩定留在眼內。患者術後需每年覆診，如發現角膜內皮細胞過少，可移除鏡片以確保內皮細胞不會進一步減少。最早期第一、二代ICL，約有十分之一患者於術後出現白內障，原因是鏡片阻礙房水流動，導致晶體缺氧。隨着新一代ICL鏡片的改良，在中央加小孔，既讓房水自然流通，毋須再在虹膜上開孔；亦令鏡片浮起，避免貼近晶體，確保氧氣和養分供應。現時ICL手術後的白內障風險，已大幅降至約二千分之一，能夠揮別佩戴隱形眼鏡需每天清潔、消毒、更換，或引致眼睛乾澀等情况，有效幫助患者解決視力問題帶來的不便。
撰文：養和視力矯正中心主任張叔銘醫生
（文章於2026年4月22日刊於《明報》「養和醫道百科」專欄
About Dr. CHANG So Min, John
Hong Kong Sanatorium & Hospital
Director, Refractive Surgery
Honorary Consultant in Ophthalmology
Specialist in Ophthalmology
Honorary Clinical Associate Professor, Department of Ophthalmology (HKU)
Clinical Associate Professor (Honorary), Department of Ophthalmology and Visual Sciences (CUHK)
- MBBCh (N U Irel)
- LLM RCP Irel
- LLM RCS Irel
- FCSHK
- FCOphthHK
- DABOph
- FHKAM (Ophthalmology)
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