高度近视后房型有晶状体眼人工晶状体植入术后拱高对眼前节结构及视觉质量的影响  

Effect of postoperative vaulting on anterior segment structure and visual quality after EVO ICL implantation for high myopia

作　　者：张波[1] 庞辰久[1] 任胜卫 顾宇伟 王树林 代丽娟 范棋 ZHANG Bo;PANG Chenjiu;REN Shengwei;GU Yuwei;WANG Shulin;DAI Lijuan;FAN Qi(Department of Ophthalmology,Henan Province People′s Hospital,Henan Eye Hospital,Zhengzhou 450003,China)

机构地区：[1]河南省人民医院眼科河南省立眼科医院,郑州450003

出　　处：《中国眼耳鼻喉科杂志》2021年第6期406-412,共7页Chinese Journal of Ophthalmology and Otorhinolaryngology

摘　　要：目的对比高度近视有晶状体眼后房型人工晶状体(ICL)V4c植入术后不同拱高对前房深度(ACD)、房角以及视觉质量的影响。方法2017年7月~2018年7月,39例(76眼)高度近视眼行ICL V4c植入术,用CASIA SS-1000频域眼前节光学相干层析成像(AS-OCT)测量术前、术后中央ACD、小梁与虹膜夹角(TIA)及术后中央拱高;术后用双通道视觉质量分析系统(OQASTMⅡ)分别测量客观散射指数(OSI)、调制传递函数截止频率、斯特列尔比;术后1年按照中央拱高不同分组,组1:拱高<500μm;组2:拱高为500~750μm;组3:拱高>750μm,对比3组间数据的差别。术后中央拱高采用One-way ANOVA处理,余手术前后数据采用重复测量的单因素方差分析及Bonferroni检验处理。结果术后1年,各组间裸眼视力(UCVA)、等效球镜度(MRSE)、眼压、中央角膜内皮细胞密度(ECD)相比,差异均无统计学意义(P值均>0.05);各组ACD分别减小24.20%、30.46%、31.27%,组3与前2组相比,术后ACD减小值及百分比差异均有统计学意义(P值均<0.05);组3 TIA750μm(3点、9点、12点、6点位及四方位均值)分别较术前减小52.16%、53.90%、51.03%、50.07%及52.26%,与其他2组相比,差异均有统计学意义(P值均<0.05);各组间OSI、调制传递函数截止频率、斯特列尔比差异均无统计学意义(P值均>0.05)。结论应用频域AS-OCT观察ICL V4c植入后的位置及ACD、房角相关结构有很好的临床前景。术后1年,中央拱高在750μm以内者,ACD变浅,房角变窄,各方位房角开放,对中央角膜ECD、眼压及术后视觉质量无明显影响。拱高>750μm者,甚至稍>1000μm的,也能保持大部分房角开放,眼压及角膜中央ECD正常;关于远期的影响,还需长期临床随访观察。Objective To compare the effects of different vaulting on anterior chamber depth(ACD),trabecular-iris angle(TIA)and visual quality after implantation of ICL V4c for high myopia.Methods The study recruited 39 high myopia patients(76 eyes)who were treated with posterior chamber phakic ICL(V4c)implant and had follow-up period of 1 year postoperatively from July 2017 to July 2018.The preoperative and postoperative central ACD,TIA,and postoperative central vaulting were measured using CASIA SS-1000 anterior segment optical coherence tomography(AS-OCT).Meanwhile,the postoperative objective scattering index(OSI),modulation transfer function cutoff frequency(MTF)and Strehl ratio were measured by double-pass optical quality analysis system(OQASTMⅡ).The patients were divided into three groups according to the central vaulting at 1 year postoperatively,Group 1:vaulting<500μm;Group 2:vaulting ranging from 500 to 750μm;Group 3:vaulting>750μm.The differences of measurements among three groups were analyzed.One-way analysis of variance(ANOVA)was used to analyze the postoperative central vaulting,and One-way repeated measurements ANOVA and Bonferroni test were used to analyze the measurements pre-and postoperatively.Results One year after the operation,there was no significant difference in UCVA,MRSE,intraocular pressure(IOP)and central cornea ECD among three groups(all P>0.05).The postoperative ACD of each group decreased by 24.20%,30.46%and 31.27%compare to the preoperative value respectively,and the reduced value and percentage of ACD were significantly different between the group with the vaulting>750μm and another two groups(all P<0.05).The TIA750μm(3,9,12,6 o’clock and the mean of 4 positions)in the group with the postoperative vaulting over 750μm decreased by 52.16%,53.90%,51.03%,50.07%and 52.26%compared with the preoperative data respectively.The difference in the reduced percentage of TIA750μm in all positions between the group with the vaulting>750μm and another two groups was statistically significant(all

关 键 词：近视 有晶状体眼人工晶状体 光学相干层析成像 眼前节 光学质量 眼内散射 双通道技术 

分 类 号：R779.6[医药卫生—眼科]