背驮式人工晶状体植入矫正白内障术后屈光意外的有效性及准确性  

Efficacy and Accuracy of Piggyback Intraocular Lens Implantation for the Correction of Refractive Errors Post-Cataract Surgery

作　　者：曾宗圣 张广斌 贾长凯 欧阳文博 Zongsheng Zeng;Guangbin Zhang;Changkai Jia;Wenbo Ouyang(Eye Institute and Affiliated Xiamen Eye Center of Xiamen University,Fujian Provincial Key Laboratory of Corneal&Ocular Surface Diseases,Xiamen Municipal Key Laboratory of Corneal&Ocular Surface Diseases,Xiamen Research Center for Eye Diseases and Key Laboratory of Ophthalmology,Xiamen 361000,China)

机构地区：[1]厦门大学附属厦门眼科中心,福建省眼表与角膜病重点实验室,厦门市眼表与角膜疾病重点实验室,厦门市眼部疾病重点实验室,厦门市眼部疾病临床医学研究中心,厦门361000

出　　处：《中华眼视光学与视觉科学杂志》2024年第1期17-21,共5页Chinese Journal Of Optometry Ophthalmology And Visual Science

基　　金：厦门市自然科学基金项目(3502Z20227127)

摘　　要：目的:探讨采用背驮式(Piggyback)人工晶状体(IOL)植入矫正白内障术后IOL眼屈光意外的有效性及准确性。方法:回顾性病例对照研究。连续性纳入2018年1月至2021年12月在厦门大学附属厦门眼科中心行睫状沟二期背驮式IOL植入的白内障术后屈光意外患者22例(22眼)。IOL采用三片式折叠式疏水性丙烯酸IOL,屈光力测算分别采用Gayton、Gills公式。对比分析术前与术后视力矫正情况。将患者术后末次随访的屈光度带入Gayton和Gills公式,计算公式预测的IOL屈光力与实际植入IOL屈光力的差异,分析2个公式预测的准确性。术前与术后数据比较采用配对样本t检验。结果:除2例(2眼)由正视过矫为近视,余20例(20眼)术后LogMAR裸眼视力(0.21±0.13)较术前(0.77±0.38)明显提高(t=7.81,P<0.001),术后LogMAR最佳矫正视力(0.07±0.09)较术前(0.14±0.12)明显提高(t=3.18,P=0.005)。术后眼压与术前相比,差异无统计学意义(t=-1.98,P=0.061),无一例发生术后明显并发症。实际植入IOL屈光力与Gayton和Gills公式预测的IOL屈光力差值的绝对值≤0.5 D和≤1.0 D的占比分别为72.7%、81.8%和63.6%、86.4%。在远视屈光意外矫正(植入IOL>0 D)的IOL屈光力预测方面,Gayten公式预测较实际IOL屈光力低估占比为71.4%,而Gills公式高估占比为71.4%;在近视屈光意外矫正(植入IOL<0 D)中,2种公式预测IOL屈光力高估占比分别是66.7%和60.0%。结论:采用三片式IOL睫状沟背驮式植入矫正IOL眼屈光意外是一种安全有效的方法,采用Gayton和Gills公式预测IOL屈光力准确性较高。但对于远视屈光意外,Gayten公式常低估,Gills公式则相反。对于近视屈光意外,2种公式常高估。Objective:To investigate the effectiveness and accuracy of Piggyback intraocular lens(IOL)implantation in correcting refractive errors following cataract surgery.Methods:We conducted a retrospective case-control analysis,and a total of 22 cases(22 eyes)with post-cataract surgery patients who underwent Piggyback IOL implantation using a three-piece foldable hydrophobic acrylic IOL at Xiamen Eye Center,Xiamen University,from January 2018 to December 2021 were collected.The refractive power of the Piggyback IOL was calculated using the formulas introduced by Gayton and Gills.Preoperative and postoperative visual acuity were compared.The difference between the predicted IOL refractive power based on the final postoperative refraction and the actual implanted IOL refractive power was calculated using the Gayton and Gills formulas to assess the accuracy of these prediction formulas.Paired sample t test was used to compare preoperative and postoperative data.Results:Except for 2 cases(2 eyes)that shifted from emmetropia to myopia,the remaining 20 cases(20 eyes)showed a significant improvement in uncorrected distance visual acuity(UDVA)from 0.77±0.38 logMAR preoperatively to 0.21±0.13 logMAR postoperatively(t=7.81,P<0.001),and the best-corrected distance visual acuity improved from 0.14±0.12 logMAR preoperatively to 0.07±0.09 logMAR postoperatively(t=3.18,P=0.005).Postoperative intraocular pressure showed no statistically significant difference compared to preoperative intraocular pressure(t=-1.98,P=0.061),and no significant postoperative complications was observed.The absolute differences between the actual implanted IOL refractive power and the predicted IOL refractive power using Gayton and Gills formulas were≤0.5 D and≤1.0 D in 72.7%,81.82%and 63.6%,86.4%of cases,respectively.Regarding hyperopic refractive error correction(IOL power>0 D),Gayton's formula tended to underestimate the IOL power in 71.4%of cases,while Gills'formula tended to overestimate it in 71.4%.For myopic refractive error correction(IOL powe

关 键 词：人工晶状体 白内障 背驮式 屈光意外 

分 类 号：R779.66[医药卫生—眼科]