基于CASIA2评价白内障术后3种非球面人工晶状体囊袋内倾斜和偏心的研究

doi:10.6040/j.issn.1673-3770.0.2023.138

摘要/Abstract

摘要： 目的应用新型眼前节扫频光相干断层扫描仪CASIA2比较白内障术后3种不同非球面人工晶状体(intraocular lens, IOL)倾斜和偏心。方法回顾2020年10月至2021年3月于山东省千佛山医院行白内障超声乳化摘除联合IOL植入术的患者资料,其中包括患者的年龄、性别、术前及术后1 d最佳矫正视力(best corrected visual acuity, BCVA)、眼轴长度(axial length, AL)、IOL类型及度数等资料,并分别于术后1 d、7 d、30 d应用CASIA2测量IOL在2D图像中水平和垂直方向的倾斜度和偏心量以及3D图像中的倾斜度、偏心量及其方向。结果患者134例(157眼),其中男52例,女82例,年龄45~86岁,平均(67.86±8.26)岁。分为A(HOYA250)组56眼(右眼31只,左眼25只)、B(RS60A)组63眼(右眼34只,左眼29只)、C(ZCB00)组38眼(右眼15只,左眼23只)。右眼结果显示,术后7 d在2D图像中A组水平倾斜度大于B组IOL的水平倾斜度;术后1 d、7 d,A组的水平偏心量均小于B组IOL的水平偏心量。术后1 d和7 d,A组的垂直倾斜度均大于C组IOL的垂直倾斜度,以上差异均有统计学意义。在3D图像中术后1 d、7 d,A组的倾斜方向与C组IOL的倾斜方向差异均有统计学意义。A组术后7 d的倾斜度大于术后30 d的倾斜度,差异有统计学意义。术后1 d、7 d和30 d,A组的偏心量均分别小于B组IOL的偏心量,差异均有统计学意义。A组和C组术后1 d的偏心量均分别小于术后30 d,差异均有统计学意义。左眼结果显示:在3D图像中,术后7 d、30 d,A组的偏心量均小于B组IOL的偏心量,差异均有统计学意义。C组术后1 d的倾斜度小于术后30 d的倾斜度,差异有统计学意义。术后1 d、7 d和30 d,IOL均出现向颞侧和颞下倾斜趋势,偏心未表现出有偏向的趋势。结论 3种IOL在囊袋内存在不同程度的倾斜和偏心,均出现向颞侧和颞下倾斜趋势,偏心未表现出有偏向的趋势。

关键词: 白内障, 非球面人工晶体, 扫频源光学相干层析成像, 倾斜, 偏心

Abstract: Objective Evaluation of tilt and decentration of 3 kinds of aspheric intraocular lens(IOL)after cataract surgery based on a new anterior segment swept-source optical coherence tomography CASIA2. Methods Retrospective case series. Clinical data of patients with cataracts who underwent phacoemulsification and IOL implantation between October 2020 and March 2021 were collected. Moreover, clinical data such as age, sex, best-corrected visual acuity(BCVA)before and on the first day after surgery, axial length(AL), and type and power of the IOL used were collected from all patients. CASIA2 was used to obtain clear images at 1, 7, and 30 days postoperatively. Horizontal and vertical tilt and decentration in two-dimensional(2D)images, and tilt, decentration, and orientation in three-dimensional(3D)images were assessed. SPSS26.0 software was used for statistical analysis. Additionally, P<0.05 was considered statistically significant. Results In total, 134 patients(157 eyes)were enrolled. The patients comprised 52 males and 82 females, with an age range of 45-86 years and an average age of 67.86±8.26 years. The eyes were divided into groups A(HOYA250), B(RS60A), and C(ZCB00). The study included 31, 34, and 15 right eyes, and 25, 29, and 23 left eyes. No significant differences were observed in ocular AL, IOL power, or frequency of BCVA improvement on day 1 after surgery among the three groups. On day 7 postoperatively, the horizontal tilt degree of group A was greater than that of group B in 2D images. On days 1 and 7 postoperatively, the horizontal decentration of group A was smaller than that of group B in 2D images; and on days 1 and 7 postoperatively, the vertical tilt degree of group A was larger than that of group C in 2D images, with a significant difference between the two groups. On days 1 and 7 postoperatively, significant differences in the orientation of the tilt between groups A and C group in 3D images were observed. The vertical decentration of group A 1 day postoperatively was significantly greater than that at 30 days postoperatively. On 1, 7, and 30 days postoperatively, the decentration of group A was significantly smaller than that of group B in the 3D images. No significant differences in the remaining intergroup and intragroup results were observed. Left eye results: on days 7 and 30 postoperatively, the decentration of group A was significantly lower than that of group B in 3D images. The tilt of group C 1 day postoperatively was significantly smaller than that at 30 days postoperatively. No significant differences in the remaining intergroup and intragroup results were identified. On days 1, 7, and 30 postoperatively, the three IOL groups demonstrated temporal and infratemporal trends; however, the tilt trend displayed no bias. Conclusion Different degrees of tilt and decentration of the three types of IOLs in the capsular bags were identified. The three types of IOLs demonstrated a tendency to tilt to the temporal and infratemporal sides, and decentration did not display a biased tendency.

Key words: Cataract, Aspheric intraocular lens, Optical coherence tomography, Tilt, Decentration

中图分类号:

R776.1

马继玲,王晓明,李琰,穆延潇,靳琳,孔慧,杨乃甫,党光福. 基于CASIA2评价白内障术后3种非球面人工晶状体囊袋内倾斜和偏心的研究[J]. 山东大学耳鼻喉眼学报, 2024, 38(4): 76-85.

MA Jiling, WANG Xiaoming, LI Yan, MU Yanxiao, JIN Lin, KONG Hui, YANG Naifu, DANG Guangfu. Evaluation of three different aspheric intraocular lens tilts and decentrations in capsular bags after cataract surgery based on CASIA2[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(4): 76-85.

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