有晶状体眼后房型散光人工晶状体植入术后二次调位手术的适应证及其有效性和稳定性  

A retrospective study on indication, effectiveness and stability of toric implantable collamer lens reposition

作　　者：熊洁[1] 张辰星[1] 罗启惠[1] 周青青[1] 汪辉[1] 

机构地区：[1]第三军医大学西南医院眼科,重庆400038

出　　处：《中华眼视光学与视觉科学杂志》2015年第8期463-467,共5页Chinese Journal Of Optometry Ophthalmology And Visual Science

摘　　要：目的探讨有晶状体眼后房型散光人工晶状体（PPC—TICL）二次调位手术的适应证及其有效性和稳定性。方法回顾性研究。纳入PPC—TICL植入术后旋转角度≥10°患者26例（33眼），其中12眼在植入术后3个月内进行了二次调位术作为调位组，21服未进行二次调位术作为对照组。随访12个月以上测量2组logMAR视力、屈光状态、PPC—TICL旋转角度、拱高、角膜内皮细胞数量、眼压以及视觉质量问卷调查评分等指标，采用独立样本t检验比较2组间各指标值，采用重复测量的方差分析比较调位组二次调位术前、术后3个月、术后12个月各指标值。结果二次调位术前及术后12个月调位组与对照组比较：裸眼视力（UCVA）、柱镜度、PPC—TICL旋转角度及问卷调查评分2组间差异具有统计学意义（t=2．569、-5．789、6．297、13．061、-2．063、3．162、-12．973、-2．065，P〈0．05），最佳矫正视力（BCVA）、等效球镜度（SE）、拱高、角膜内皮细胞计数及眼压差异无统计学意义。调位组调位术前、术后3个月及12个月比较：UCVA、柱镜度、SE、PPC．TICL旋转角度及问卷调查评分差异均具有统计学意义（F=30．839、51．118、5．127、117．320、62．347，P〈0．05），进一步两两比较，调位术前较术后3个月、12个月差异均具有统计学意义（P〈0．05），而术后3个月与12个月比较差异均无统计学意义。结论针对PPC-TICL散光轴位大角度旋转的二次调位术是有效和稳定的，术后PPC—TICL未再出现大角度旋转，早期进行二期调位手术可获得良好的预后。Objective To assess the indication, effectiveness and stability of phakic posterior chamber toric implantable collamer lens （PPC-TICL） repositioning operation on PPC-TICL axis rotation. Methods A retrospective study on 33 PPC-TICL eyes with PPC-TICL axis rotation more than 10~ has been performed, 12 eyes have been operated PPC-TICL repositioning in three months postoperation was operation group and 21 eyes only have been performed follow-up examination was control group. The observation indices was studied including LogMAR vision, refractive, PPC-TICL axis rotation, vault value, corneal endothelium, intraocular pressure and subject vision assessment scales. The indices of pre-reposition in operation group and control group post-implantation 3 months follow-up were compared with independent-samples t test. To determine the effect of reposition, the indices of pre-reposition, post-reposition 3 months follow-up and 12 months follow-up in operation group have also been compared through repeat measured ANOVA. Results To compare pre-reposition, post-reposition on 12 months follow-up and control group, the indices including： UCVA, mean manifest refractive cylinder, PPC-TICL axis rotation and subject vision assessment scales have significant difference （t=2.569, -5.789, 6.297, 13.061, -2.063, 3.162, -12.973, -2.065, P〈O.05）, nevertheless, BCVA,mean manifest refractive spherical equivalent, vault value, intraocular pressure and corneal endothelium have no significant difference. To compare pre-reposition, 3 months post-reposition and 12 months post-reposition, there were significant difference on visual outcome, mean manifest refractive cylinder, mean manifest refractive spherical equivalent, PPC-TICL axis rotation and subject vision assessment scales （F=30.839, 51.118, 5.127, 117.320, 62.347, P〈0.05）. Meanwhile, there was also significant difference between pre-reposition and 3 months post-reposition or between pre-reposition and 12 months post-reposition in reposition group. Conclusion The retrospectiv

关 键 词：有晶状体眼人工晶状体植入术 近视 退行性 散光 调位手术 

分 类 号：R779.6[医药卫生—眼科]