角膜基质透镜散光标记器在角膜基质透镜植入术矫正远视及散光中的应用  

Application of corneal stromal lens astigmatism marker in corneal stroma lens implantation for correcting hyperopia and astigmatism

作　　者：凌玲[1] 陈敬旺 姚玲 柯慧敏 周文天[1] LING Ling;CHEN Jingwang;YAO Ling;KE Huimin;ZHOU Wentian(The Affiliated Eye Hospital of Nanchang University,Nanchang 330006,Jiangxi Province,China)

机构地区：[1]南昌大学附属眼科医院,江西省南昌市330006

出　　处：《眼科新进展》2021年第9期861-864,共4页Recent Advances in Ophthalmology

基　　金：江西省重点研发计划项目(编号20171BBG70098);江西省卫生健康委科技计划项目(编号20201074)。

摘　　要：目的探讨角膜基质透镜散光标记器(简称散光标记器)在角膜基质透镜植入术矫正远视及散光中的应用。方法前瞻性病例研究。选取2019年12月至2020年12月在南昌大学附属眼科医院屈光科就诊的满足手术要求的远视及散光患者6例6眼,年龄20~36(27.50±6.72)岁,所有患者均行飞秒激光辅助的瓣下角膜基质透镜植入术(FS-LIKE)。供体角膜取自同期行飞秒激光小切口角膜基质透镜取出术(SMILE)的近视患者,术中利用散光标记器标记角膜基质透镜散光轴位并植入到事先标记好轴位的植床以矫正远视和散光。术后随访6个月,观察所有术眼的裸眼视力(UCVA)、裸眼近视力(UNVA)、最佳矫正视力(BCVA)、等效球镜度、手术安全性及有效性。采用标准矢量分析法对手术前后散光相关指标进行评估。结果所有术眼术后1 d、1周、1个月、3个月、6个月UCVA、UNVA较术前均明显提高(F=5.503、2.968,P=0.002、0.031),术后不同时间点UCVA、UNVA两两比较差异均无统计学意义(均为P>0.05)。术后安全性指数及有效性指数分别为1.17±0.26、0.96±0.25。所有术眼术后BCVA较术前均未见丢失,4眼无变化,2眼提高2行。所有患者术后6个月手术矫正散光量及角度误差分别为(2.24±0.98)D、(5.33±5.79)°。结论散光标记器在FS-LIKE术中能有效标记散光轴位和受体角膜定位,能够有效安全地矫正患者术前远视及散光,为远视散光患者提供了新的、有效的一体式手术方式。Objective To explore the clinical application of corneal stromal lens astigmatism marker(astigmatism marker in the following text)in the correction of hyperopia and astigmatism after corneal stroma lens implantation.Methods It was a prospective study involving 6 patients(6 eyes)with hyperopia and astigmatism who met the surgical requirements in the Department of Ophthalmology,Affiliated Eye Hospital of Nanchang University from December 2019 to December 2020.Their age was 20-36(27.50±6.72)years.All patients were treated with femtosecond laser-assisted subvalvular corneal stromal lens implantation(FS-LIKE).The donor cornea was taken from myopic patients who underwent small incision lenticular extraction(SMILE)during the same period.During the operation,astigmatism markers were used to mark the astigmatism axis of corneal stroma lens and implanted into the previously marked implant bed to correct hyperopia and astigmatism.The uncorrected visual acuity(UCVA),near visual acuity(UNVA),best corrected visual acuity(BCVA),equivalent spherical diopter,surgical safety and effectiveness were observed during the 6 months of postoperative follow-up.The astigmatism-related indexes before and after operation were evaluated by the standard vector analysis.Results Patient’s UCVA and UNVA levels at 1 day,1 week,1 month,3 months and 6 months postoperatively were significantly higher than preoperative levels(F=5.503 and 2.968,P=0.002 and 0.031,respectively).There were no significant differences in UCVA and UNVA at each time point after operation(all P>0.05).The postoperative safety index and effectiveness index were 1.17±0.26 and 0.96±0.25,respectively.There was no loss of BCVA in all patients postoperatively.In addition,4 eyes did not have the improvement of UNVA,and 2 eyes increased by 2 lines.Six months after operation,the amount of astigmatism corrected by surgery for all patients and the angle error were(2.24±0.98)D and(5.33±5.79)°,respectively.Conclusion The astigmatism marker can effectively mark the axis of astigmatis

关 键 词：角膜基质透镜散光标记器 飞秒激光辅助的瓣下角膜基质透镜植入术 小切口飞秒激光角膜基质透镜取出术 远视 散光 

分 类 号：R772[医药卫生—眼科]