应用新一代AS-OCT观察高度近视白内障术后人工晶状体与后囊膜贴附的研究  

Observation of intraocular lens and posterior capsular attachment after high myopia cataract operation by new generation of AS-OCT

作　　者：郑磊[1] 张国明[1] 孙良南[1] 赵燕华 余斯民 甘润[1] 刘欣华[1] Lei Zheng;Guo-Ming Zhang;Liang-Nan Sun;Yan-Hua Zhao;Si-Min Yu;Run Gan;Xin-Hua Liu(Shenzhen Eye Hospital,Affiliated Hospital of Jinan University, Shenzhen 518040, Guangdong Province, China)

机构地区：[1]暨南大学附属深圳市眼科医院,中国广东省深圳市518040

出　　处：《国际眼科杂志》2021年第7期1266-1270,共5页International Eye Science

基　　金：深圳医疗卫生三名工程(No.SZSM201812091)。

摘　　要：目的:利用新一代眼前节OCT(AS-OCT)定量检测和分析高度近视长眼轴患者白内障术后人工晶状体与后囊膜贴附情况。方法:采用回顾性病例观察研究设计。纳入2019-10/12于深圳市眼科医院接受晶状体囊外摘除,经超声乳化吸出联合人工晶状体植入术的白内障患者60例60眼,根据眼轴长度(axial length,AL)分为两组:高度近视长眼轴组(AL>26.00mm)和正常眼轴组(AL:22.00~24.5mm)各30例30眼。分别于术后1、7、30d用AS-OCT测量两组白内障术后人工晶状体光学面与后囊膜之间围成的空间平面面积(AREAP)和未贴附残留后囊膜的边长。采用Kaplan-Meier生存分析法分析两组术后不同时间点的人工晶状体与后囊膜贴附率,Log-Rank检验法比较贴附率。结果:正常眼轴组术后1、7、30d的AREAP分别为0.81±0.37、0.33±0.19、0.14±0.06mm2,未贴附后囊膜边长分别为7.93±3.03、3.95±2.44、1.26±0.08mm,人工晶状体光学面与后囊膜贴附率分别为33%、67%、83%;高度近视长眼轴组术后1、7、30d的AREAP分别为3.29±0.43、1.54±0.66、0.62±0.28mm2,未贴附后囊膜的边长分别为13.56±4.02、8.13±3.90、3.78±2.51mm,人工晶状体光学面与后囊膜贴附率分别为0、7%、23%。两组术后各时间点AREAP、未贴附后囊膜边长、人工晶状体光学面与后囊膜贴附率均有差异(P<0.05)。结论:高度近视长眼轴患者白内障术后人工晶状体与后囊膜之间残留更大的空间,贴附需要更长时间。新一代AS-OCT可以清晰地显示晶状体后囊膜的影像,有望成为研究晶状体相关疾病的有效检查设备。AIM:To quantify and evaluate the capsular adhesion to intraocular lens(IOL)in subjects with high myopia by the latest anterior segment optical coherence tomography(AS-OCT).METHODS:Retrospective case observation study was designed.Sixty eyes of 60 patients who received extra-capsular extraction combined with IOL implantation in Shenzhen Eye Hospital from October 2019 to December 2019 were divided into two groups by axial length(AL),of which 30 eyes were highly myopic(AL>26mm)and 30 eyes were emmetropic(22mm<AL<24.5mm).All eyes were examinated by AS-OCT at 1,7,and 30d after operation.The area between IOL and posterior capsule(AREAP)and residual side length of posterior capsule not adhesion were evaluated.Kaplan-Meier survival analyses of attachment rates were studied.The ratios of posterior capsule attached IOL of the two groups at different postoperative times were compared by Log-Rank.RESULTS:In the emmetropic group,the AREAP was(0.81±0.37),(0.33±0.19)and(0.14±0.06)mm2 at 1,7,and 30d after operation,respectively.The residual side lengths of posterior capsule not adhesion were(7.93±3.03),(3.95±2.44)and(1.26±0.08)mm.The ratios of posterior capsule attached to IOL were 33%,67%and 83%.In the highly myopic group,the AREAP were(3.29±0.43),(1.54±0.66)and(0.62±0.28)mm2 at 1,7,and 30d postoperatively,respectively.The residual side lengths of posterior capsule not adhesion were(13.56±4.02),(8.13±3.90)and(3.78±2.51)mm.The ratios of posterior capsule attached to IOL were 0,7%and 23%.There were statistically significant differences between the two groups in AREAP,residual side lengths of posterior capsule not adhesion and the ratios of posterior capsule attached to IOL(P<0.05).CONCLUSION:There is more space between posterior capsule and IOL after cataract surgery in highly myopic patients.The new generation of AS-OCT can clearly display the image of the posterior capsule of the lens,which is expected to be an effective examination device for the study of lens-related diseases.

关 键 词：眼前节光学相干断层扫描 人工晶状体 后囊膜 空间 后发性白内障 

分 类 号：R779.66[医药卫生—眼科]