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

doi:10.6040/j.issn.1673-3770.1.2020.008

摘要/Abstract

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

万博,李东辉,罗岩,李莹. 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[J]. 山东大学耳鼻喉眼学报, 2020, 34(2): 36-41.

WAN Bo, LI Donghui, LUO Yan, LI Ying. Lens vault changes and associated factors after implantation of implantable collamer lenses with central flow[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(2): 36-41.

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