有晶状体眼人工晶状体植入术后拱高及其影响因素研究

目的:探讨有晶状体眼人工晶状体(V4c型ICL)植入术后拱高的变化及其影响因素。方法:回顾性分析山西省眼科医院2015年7月至2018年12月中度及高度近视行V4c型ICL植入术60例(118只眼)的临床资料。术眼屈光状态为等效球镜度(-11.26±3.87)D。观察术后拱高随时间的变化趋势及可能的影响因素,并对比由Orbscan、IOLMaster、Pentacam及UBM所测得的角膜直径及前房深度的一致性。结果:眼前段OCT测量术后1 d、1、3、6及12个月拱高依次为:(0.635±0.201)mm、(0.608±0.194)mm、(0.581±0.195)mm、(0.597±0.171)mm及(0.495±0.158)mm。术后拱高与年龄呈负相关(r=-0.266,P=0.004),与角膜厚度呈负相关(r=-0.241,P=0.009),与前房深度、ICL直径、角膜直径及眼轴长度呈正相关(r=0.529、0.583、0.405及0.314,均P<0.05),与性别、术前眼的屈光状态、是否植入散光矫正型ICL、角膜曲率及是否伴随睫状体囊肿均无相关(P>0.05)。OrbscanⅡ及Pentacam术前测量角膜直径的一致性好,OrbscanⅡ、Pentacam及UBM术前测量前房深度可互相参考。结论:V4c型ICL植入术矫正中度及高度近视效果良好,拱高是术后安全的重要因素,术前精确的生物测量及术后定期的随访观察是关键。

Study on the vault measurement and influencing factors after V4c ICL implantation in phakic eyes

Objective To investigate the vault measurement and influencing factors after implantation of V4c implantable collamer lens(ICL)with central hole in phakic eyes.Methods The clinical data of 118 eyes of 60 patients with moderate to high myopia from Jul.2015 to Dec.2018 in Shanxi Eye Hospital were analyzed retrospectively.The status of the eye was spherical equivalent diopter of(-11.26±3.87)D.The vaults measurement and influencing factors after ICL V4c implantation were observed after operation with anterior segment OCT.The consistency of anterior chamber depth(ACD)and corneal diameter(white to white)measured with OrbscanⅡ,IOLMaster 500,Pentacam and ultrasound biomicroscopy(UBM)were compared.Results The mean vaults were(0.635±0.201)mm,(0.608±0.194)mm,(0.581±0.195)mm,(0.597±0.171)mm and(0.495±0.158)mm at 1 day,1,3,6 and 12 months successively after operation.There was a negative correlation between vault and age(r=-0.266,P=0.004),a negative correlation between vault and corneal thickness(r=-0.241,P=0.009),whereas a positive correlation with ACD,ICL diameters,corneal diameter and ocular axial length(r=0.529,0.583,0.405,0.314;P<0.05).There was no correlation between the vault and the gender,preoperative spherical equivalent(SE),toric ICL implantation,keratometric power and ciliary cyst(P>0.05).There was an excellent performance of consistency for preoperative corneal diameter measurement between OrbscanⅡand Pentacam.And the preoperative ACD measured with OrbscanⅡ,Pentacam and UBM could be used for reference with each other.Conclusion The V4c ICL implantation has good efficacy for the correction of moderate to high myopia.The vault plays an critical role in postoperative safety.Preoperative biological measurements and a long-term follow-up shall be performed.