山东大学耳鼻喉眼学报 ›› 2020, Vol. 34 ›› Issue (2): 36-41.doi: 10.6040/j.issn.1673-3770.1.2020.008

• 临床研究 • 上一篇    下一篇

中心孔型有晶状体眼后房型人工晶体植入术后拱高变化及相关因素分析

万博1,2,李东辉1,罗岩1,李莹1   

  1. 1. 中国医学科学院/北京协和医院 眼科, 北京 100730;
    2. 首都医科大学附属北京潞河医院 眼科, 北京 101149
  • 发布日期:2020-04-07
  • 通讯作者: 罗岩. E-mail:lawyan@sina.com

Lens vault changes and associated factors after implantation of implantable collamer lenses with central flow

WAN Bo1,2, LI Donghui1, LUO Yan1, LI Ying1   

  1. 1. Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China;
    2. Beijing Luhe Hospital, Capital University of Medical Sciences, Beijing 101149, China
  • Published:2020-04-07

RichHTML

40

PDF (PC)

1089

摘要： 目的 分析中心孔型有晶状体眼后房型人工晶体(ICL)植入术后拱高的变化及相关因素。 方法 回顾性病例研究。观察2015年1个月至2017年1个月行ICL植入术72例(140只眼)近视患者术前、术后1周、1个月、3个月和1年的视力、眼压(IOP)、角膜内皮细胞计数(ECD)、屈光度数、拱高(LV)及前房结构的变化,并比较手术前后各观察指标的差异,分析LV与术前指标及术后前房结构的关系。 结果 术后1年73%只眼最佳矫正远视力较术前提高;术后裸眼视力≥20/20的术眼比例随时间延长逐渐降低;术后1年超过63%只眼的等效球镜度数(MRSE)在±0.5 D预期范围内,超过86%在±1.0 D预期范围内;术后各时间点MRSE、IOP和ECD差异无统计学意义(P>0.05);且无手术并发症;LV在术后1个月及3个月差异无统计学意义(P>0.05),而在术后1年下降(P<0.05);LV与年龄、角膜曲率、距离巩膜突500 μm处的房角开放距离、距离巩膜突500 μm处的小梁网虹膜间面积和前房角度呈负相关,与白对白距离、角对角距离、前房深度、眼轴及ICL长度呈正相关,眼轴长度和ICL长度是LV的独立影响因素。 结论 中心孔型ICL植入术后1年有较好的安全性、稳定性、有效性及预测性,术后1年LV减低且与术前及术后多个因素相关。

关键词: 近视, 中心孔型有晶状体眼后房型人工晶体植入术, 拱高, 前房结构, 光学相干断层影像

Abstract: Objective To investigate the changes to the lens vault(LV)and anterior chamber structures after implantation of implantable collamer lenses(ICL)with central flow in patients with myopia. The relationship between LV and its associated factors, both preoperatively and postoperatively, will also be analyzed. Methods One hundred and forty eyes of 72 patients who underwent ICL implantations were enrolled between January 2015 and January 2017. Visual acuity, intraocular pressure(IOP), corneal endothelial cell count(ECD), refractive outcomes, LV, and other anterior chamber structures were evaluated and compared after 1 week, 1 month, 3 months and 1 year, postoperatively. We analyzed the relationship between LV and other anterior chamber structures. Results After 1 year, 73% of eyes had gained 1 or more lines of corrected distance visual acuity, progressively fewer eyes had gained an uncorrected distance visual acuity above 20/20, more than 63% were within±0.5 D of the prospective mean refractive spherical equivalent(MRSE), and more than 86% were within±0.1 D of the prospective MRSE. There were no significant differences in MRSE, IOP, and ECD, postoperatively(p>0.05). No complications occurred during the postoperative time. There were no significant LV differences at 1 month and 3 months postoperatively. Meanwhile, LV had decreased significantly in the first postoperative year and was negatively correlated with age, keratometric power, 500 μm angle open distance, 500 μm trabecular iris space area, and the anterior chamber angle. LV was positively correlated with the white-to-white distance, angle-to-angle distance, anterior chamber depth, axial length, and ICL length. Axial length and ICL length were independent factors of LV. Conclusion Implantations of phakic ICL with center flow are safe, effective, and predictable in correcting myopia. LV decreased significantly at 1 year postoperatively, which correlated with multiple factors, both preoperatively and postoperatively.

Key words: Myopia, Implantations of implantable collamer lens with central flow, Lens vault, Anterior chamber structures, Optical coherence tomography of anterior segment

中图分类号: 

  • R772.2
[1] Sun J, Zhou JB, Zhao PQ, et al. High prevalence of myopia and high myopia in 5060 Chinese university students in Shanghai[J]. Invest Ophthalmol Vis Sci, 2012, 53(12): 7504-7509. doi:10.1167/iovs.11-8343.
[2] Alfonso JF, Fernández-Vega-Cueto L, Alfonso-Bartolozzi B, et al. Five-year follow-up of correction of myopia: posterior chamber phakic intraocular Lens with a central port design[J]. J Refract Surg, 2019, 35(3): 169-176. doi:10.3928/1081597X-20190118-01.
[3] 中华医学会眼科学分会眼视光学组. 中国有晶状体眼后房型人工晶状体植入术专家共识(2019年)[J]. 中华眼科杂志, 2019, 55(9): 652-657. doi:10.3760/cma.j.issn.0412-4081.2019.09.005.
[4] Yan ZP, Miao HM, Zhao F, et al. Two-year outcomes of visian implantable collamer Lens with a central hole for correcting high myopia[J]. J Ophthalmol, 2018, 2018: 8678352. doi:10.1155/2018/8678352.
[5] Lisa C, Naveiras M, Alfonso-Bartolozzi B, et al. Posterior chamber collagen copolymer phakic intraocular Lens with a central hole to correct myopia: One-year follow-up[J]. J Cataract Refract Surg, 2015, 41(6): 1153-1159. doi:10.1016/j.jcrs.2014.10.030.
[6] 李茜, 郦舒伊, 徐雯. 人工晶体反装1例诊断与治疗[J]. 山东大学耳鼻喉眼学报, 2017, 31(4): 40-42. doi:10.6040/j.issn.1673-3770.1.2017.023. LI Xi, LI Shuyi, XU Wen. Diagnosis and treatment of reverse implantable collamer Lens orientation: a case report[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2017, 31(4): 40-42. doi:10.6040/j.issn.1673-3770.1.2017.023.
[7] Alfonso JF, Fernández-Vega-Cueto L, Alfonso-Bartolozzi B, et al. Five-year follow-up of correction of myopia: posterior chamber phakic intraocular Lens with a central port design[J]. J Refract Surg, 2019, 35(3): 169-176. doi:10.3928/1081597X-20190118-01.
[8] Higueras-Esteban A, Ortiz-Gomariz A, Gutiérrez-Ortega R, et al. Intraocular pressure after implantation of the visian implantable collamer Lens with CentraFLOW without iridotomy[J]. Am J Ophthalmol, 2013, 156(4): 800-805. doi:10.1016/j.ajo.2013.05.018.
[9] Shimizu K, Kamiya K, Igarashi A, et al. Long-term comparison of posterior chamber phakic intraocular Lens with and without a central hole(hole ICL and conventional ICL)implantation for moderate to high myopia and myopic astigmatism[J]. Medicine, 2016, 95(14): e3270. doi:10.1097/md.0000000000003270.
[10] Eissa SA, Sadek SH, El-Deeb MW. Anterior chamber angle evaluation following phakic posterior chamber collamer Lens with CentraFLOW and its correlation with ICL vault and intraocular pressure[J]. J Ophthalmol, 2016, 2016: 1383289. doi:10.1155/2016/1383289.
[11] Sachdev G, Ramamurthy D. Long-term safety of posterior chamber implantable phakic contact Lens for the correction of myopia[J]. Clin Ophthalmol, 2019, 13: 137-142. doi:10.2147/OPTH.S185304.
[12] Kamiya K, Shimizu K, Komatsu M. Factors affecting vaulting after implantable collamer Lens implantation[J]. J Refract Surg, 2009, 25(3): 259-264. doi:10.3928/1081597X-20090301-04.
[13] Gonvers M, Bornet C, Othenin-Girard P. Implantable contact Lens for moderate to high myopia: relationship of vaulting to cataract formation[J]. J Cataract Refract Surg, 2003, 29(5): 918-924. doi:10.1016/s0886-3350(03)00065-8.
[14] Dougherty PJ, Rivera RP, Schneider D, et al. Improving accuracy of phakic intraocular Lens sizing using high-frequency ultrasound biomicroscopy[J]. J Cataract Refract Surg, 2011, 37(1): 13-18. doi:10.1016/j.jcrs.2010.07.014.
[15] Kawamorita T, Shimizu K, Shoji N. Effect of hole size on fluid dynamics of a posterior-chamber phakic intraocular Lens with a central perforation by using computational fluid dynamics[J]. Albrecht Von Graefes Arch Fur Klinische Und Exp Ophthalmol, 2016, 254(4): 739-744. doi:10.1007/s00417-016-3304-3.
[16] Huang JH, Savini G, Su BB, et al. Comparison of keratometry and white-to-white measurements obtained by Lenstar with those obtained by autokeratometry and corneal topography[J]. Cont Lens Anterior Eye, 2015, 38(5): 363-367. doi:10.1016/j.clae.2015.04.003.
[17] Lim DH, Lee MG, Chung ES, et al. Clinical results of posterior chamber phakic intraocular Lens implantation in eyes with low anterior chamber depth[J]. Am J Ophthalmol, 2014, 158(3): 447-454.e1. doi:10.1016/j.ajo.2014.06.005.
[18] Igarashi A, Shimizu K, Kato S, et al. Predictability of the vault after posterior chamber phakic intraocular Lens implantation using anterior segment optical coherence tomography[J]. J Cataract Refract Surg, 2019, 45(8): 1099-1104. doi:10.1016/j.jcrs.2019.02.020.
[19] 曲海燕, 张浩润, 邵文鹏, 等. 高度近视患者行ICL植入术后拱高变化的影响因素分析[J]. 国际眼科杂志, 2019, 19(3): 514-516. doi:10.3980/j.issn.1672-5123.2019.3.41. QU Haiyan, ZHANG Haorun, SHAO Wenpeng, et al. Study on influencing factors of arch height change in patients with high myopia undergoing ICL implantation[J]. International Eye Science, 2019, 19(3): 514-516. doi:10.3980/j.issn.1672-5123.2019.3.41.
[20] Qi MY, Chen Q, Zeng QY. The effect of the crystalline Lens on central vault after implantable collamer Lens implantation[J]. J Refract Surg, 2017, 33(8): 519-523. doi:10.3928/1081597X-20170602-02.
[21] Lee H, Kang DS, Ha BJ, et al. Effect of accommodation on vaulting and movement of posterior chamber phakic lenses in eyes with implantable collamer lenses[J]. Am J Ophthalmol, 2015, 160(4): 710-716.e1. doi:10.1016/j.ajo.2015.07.014.
[22] Petternel V, Köppl CM, Dejaco-Ruhswurm I, et al. Effect of accommodation and pupil size on the movement of a posterior chamber Lens in the phakic eye[J]. Ophthalmology, 2004, 111(2): 325-331. doi:10.1016/j.ophtha.2003.05.013.
[23] 徐婧, 罗岩, 林燕楠, 等. 有晶状体眼后房型人工晶状体植入术后LV的变化及相关影响因素[J]. 中华眼视光学与视觉科学杂志,2016,18(12):714-718. doi:10.3760/cma.j.issn.1674-845X.2016.12.003. XU Jing,LUO Yan,LIN Yannan,et al. Changes in the central vault after collamer lens implantation and its impact[J]. Chinese Journal of Optometry Ophthalmology and Visual Science,2016,18(12):714-718. doi:10.3760/cma.j.issn.1674-845X.2016.12.003.
[24] Lee H, Kang SY, Seo KY, et al. Dynamic vaulting changes in V4c versus V4 posterior chamber phakic lenses under differing lighting conditions[J]. Am J Ophthalmol, 2014, 158(6): 1199-1204.e1. doi:10.1016/j.ajo.2014.08.020.
[25] Du CX, Wang JH, Wang XY, et al. Ultrasound biomicroscopy of anterior segment accommodative changes with posterior chamber phakic intraocular Lens in high myopia[J]. Ophthalmology, 2012, 119(1): 99-105. doi:10.1016/j.ophtha.2011.07.001.
[26] Lu YY, Yang N, Li XD, et al. Four-year follow-up of the changes in anterior segment after phakic collamer Lens implantation[J]. Am J Ophthalmol, 2017, 178: 140-149. doi:10.1016/j.ajo.2017.03.020.
[27] 李彩红, 赵宏, 赵晓金, 等. 有晶状体眼人工晶状体植入术后前房形态观察[J]. 中华眼外伤职业眼病杂志, 2017, 39(7): 485-490. doi:10.3760/cma.j.issn.2095-1477.2017.07.002. LI Caihong, ZHAO Hong, ZHAO Xiaojin, et al. Observation on morphology of anterior chamber with Pentacam after implantation of posterior chamber phakic intraocular Lens[J]. Chinese Journal of Ocular Trauma and Occupational Eye Disease, 2017, 39(7): 485-490. doi:10.3760/cma.j.issn.2095-1477.2017.07.002.
[28] 刘磊, 栗静, 王恒, 等. 前房深度对有晶状体眼后房型人工晶状体植入术后前房形态的影响[J]. 中华眼视光学与视觉科学杂志, 2016, 18(12): 719-723. doi:10.3760/cma.j.issn.1674-845X.2016.12.004. LIU Lei, LI Jing, WANG Heng, et al. Impact of anterior chamber depth on anterior chamber angle morphology after phakic posterior chamber implantable collamer Lens implantation[J]. Chinese Journal of Optometry & Ophthalmology, 2016, 18(12): 719-723. doi:10.3760/cma.j.issn.1674-845X.2016.12.004.
[29] Wang XY, Shen Y, Du CX, et al. Observation on changes of anterior chamber and chamber angle structures after posterior chamber phakic intraocular Lens implantation by ultrasound biomicroscopy[J]. Zhonghua Yan Ke Za Zhi, 2009, 45(10): 908-912.
[1] 代诚李宾中. 多焦点软性角膜接触镜应用研究进展[J]. 山东大学耳鼻喉眼学报, 2022, 36(5): 100-105.
[2] 张陶然,王薇,李明铭,黄映湘. IVR治疗mCNV患者黄斑中心凹下脉络膜厚度分析[J]. 山东大学耳鼻喉眼学报, 2022, 36(2): 68-71.
[3] 彭娇,钟定娟,陈蛟,左筠,王华. 光学区直径与暗瞳直径的关系对不同程度近视患者SMILE术后视觉质量的影响[J]. 山东大学耳鼻喉眼学报, 2022, 36(2): 100-107.
[4] 李莹. 重视角膜屈光手术操作规范及并发症防治[J]. 山东大学耳鼻喉眼学报, 2021, 35(6): 1-6.
[5] 厉斌,方学军,吴德,黄敏. 基于NK公式和KS公式预测ICL术后早期拱高的一致性研究[J]. 山东大学耳鼻喉眼学报, 2021, 35(6): 33-41.
[6] 张颖,雷玉琳,马志兴,杨星花,张静,侯杰. SMILE联合快速角膜交联术后角膜光密度的早期临床观察[J]. 山东大学耳鼻喉眼学报, 2021, 35(6): 52-58.
[7] 刘艺,于明坤,孙伟,邵震,胡媛媛,毕宏生. 角膜塑形术控制儿童近视有效性与安全性的Meta分析[J]. 山东大学耳鼻喉眼学报, 2021, 35(6): 92-100.
[8] 冉宏运,蒋可可，张杰. 早产儿视网膜病变患儿屈光影响因素研究进展[J]. 山东大学耳鼻喉眼学报, 2021, 35(5): 118-124.
[9] 岳鹏程,杜秋萱,孔玲,乔镇涛. 未矫正近视性屈光参差患者双眼间调节力对照研究[J]. 山东大学耳鼻喉眼学报, 2021, 35(4): 76-80.
[10] 刘凌,张美霞. 近视的药物治疗[J]. 山东大学耳鼻喉眼学报, 2021, 35(4): 123-128.
[11] 任雨馨赵博军. 病理性近视脉络膜新生血管的诊断与治疗[J]. 山东大学耳鼻喉眼学报, 2020, 34(5): 157-162.
[12] 李莹,姜洋. 惟论近视矫正眼外与眼内手术方式的选择[J]. 山东大学耳鼻喉眼学报, 2020, 34(2): 1-6.
[13] 王暄琪. 可植入式眼内镜术后拱高及相关因素[J]. 山东大学耳鼻喉眼学报, 2020, 34(2): 72-78.
[14] 张丹凤. 青少年近视散瞳前后眼球生物参数变化的分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(5): 121-124.
[15] 宋森,李莹,丁欣,金玉梅. 飞秒激光小切口基质透镜取出术后早期视力恢复的相关因素分析[J]. 山东大学耳鼻喉眼学报, 2018, 32(4): 77-79.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
[1] 邓基波,孙奉乾,许安廷 . 大前庭导水管综合征[J]. 山东大学耳鼻喉眼学报, 2006, 20(2): 116 -118 .
[2] 周子宁,金国威 . 喉气管狭窄的预防和治疗进展[J]. 山东大学耳鼻喉眼学报, 2006, 20(5): 462 -465 .
[3] 周斌,李滨 . 鼻内窥镜下鼻窦鼻息肉手术75例疗效观察[J]. 山东大学耳鼻喉眼学报, 2006, 20(1): 24 -26 .
[4] 徐赛男,杨雷 . 红霉素促进鼻息肉上皮细胞凋亡的实验研究[J]. 山东大学耳鼻喉眼学报, 2006, 20(1): 27 -29 .
[5] 张玉光,韩旭光,张华,王旭,徐湘辉 . 改良穿透性角膜移植术治疗真菌性角膜炎[J]. 山东大学耳鼻喉眼学报, 2006, 20(1): 94 -95 .
[6] 刘联合 . 颈深部脓肿37例[J]. 山东大学耳鼻喉眼学报, 2008, 22(2): 180 -181 .
[7] 谢治年 ,姬长友 . RNA干扰及其在喉鳞癌研究中的应用[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 200 -203 .
[8] 乔 艺,倪关森,陈文文 . 改良悬雍垂腭咽成形术联合鼻腔手术治疗阻塞性睡眠呼吸暂停综合征38例[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 206 -208 .
[9] 汪晓锋,林 昶,程金妹 . 不同龄小鼠内耳中ABAD的表达及临床意义[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 207 -211 .
[10] 凡启军,黄治物,梅 玲,肖伯奎 . 荧光定量PCR测定水杨酸钠作用后大鼠耳蜗基因的表达[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 212 -214 .
网站版权所有 © 2018 《山东大学耳鼻喉眼学报》编辑部　
地址：山东省济南市山大南路27号（250100）电话：+86-0531-88366912 E-mail: ebhxb@sdu.edu.cn
本系统由北京玛格泰克科技发展有限公司设计开发