有晶状体眼后房型人工晶状体术与SMART术矫治中低度近视术后效果及视觉质量的比较  

Comparison and analysis of the postoperative effect and visual quality of ICL surgery and SMART surgery for moderate and low myopia

作　　者：邓娅 楼永倞 余璐 李艳玲 余脉雯 DENG Ya;LOU Yongliang;YU Lu;LI Yanling;YU Maiwen(Department of Refractive Surgery,Eyegood Ophthalmic Hanyang Hospital,Wuhan,Hubei 430000,China)

机构地区：[1]武汉汉阳艾格眼科医院屈光手术科,湖北武汉430000

出　　处：《安徽医药》2022年第8期1602-1607,共6页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探究中低度近视有晶状体眼后房型人工晶状体(ICL)手术矫治与SMART手术矫治术后效果及视觉质量的变化。方法选取2019年1月至2020年1月武汉汉阳艾格眼科医院中低度近视病人148例(148眼),随机数字表法分为ICL组(74例,74眼)和SMART组(74例,74眼)。ICL组施行ICL,SMART组施行SMART。统计两组并发症及术前、术后1周、1个月、6个月最佳矫正视力(BVCA)、裸眼视力(UCVA)、安全指数、有效指数、视觉质量[客观散射指数(OSI)、MTF截止频率(MTF cutoff)、斯特列尔比(SR)]、对比敏感度[低频段(3 cpd)、中频段(6 cpd)、中频段(12 cpd)]、全眼像差(垂直彗差、球差、总高阶像差)、眼血流动力学参数[眼动脉(OA)、睫状后动脉(PCA)舒张末期流速(Vd)、收缩期血流速度峰值(Vs)]。结果术前、术后1周、1个月、6个月两组BVCA、UCVA、安全指数、有效指数比较,差异无统计学意义(P>0.05),术后1个月、6个月两组BVCA[ICL组(−0.77±0.06)、(−0.84±0.07)比(0.49±0.05),SMART组(−0.76±0.09)、(−0.82±0.08)比(0.50±0.03)]、UCVA[ICL组(0.72±0.08)、(0.65±0.10)比(0.95±0.22),SMART组(0.70±0.10)、(0.67±0.12)比(0.93±0.25)]优于其术前(P<0.017);术后1周、1个月、6个月ICL组OSI低于SMART组,MTF cutoff、SR高于SMART组(P<0.05);术后1周、1个月、6个月ICL组明光无眩光状态下3 cpd、6 cpd、12 cpd对比敏感度高于SMART组(P<0.05);术后1周、1个月、6个月ICL组总高阶像差低于SMART组(P<0.05);术前、术后1周、术后1个月、6个月两组眼血流动力学指标比较,差异无统计学意义(P>0.05);术后6个月内,两组haze、光晕、眼压升高等并发症发生率比较,差异无统计学意义(P>0.05)。结论ICL术、SMART均对中低度近视具有良好矫正作用,特别是ICL,有助于增加对比敏感度,提高视觉质量。Objective To explore the effects and visual quality of implantable contact lens(ICL)surgery and SMART surgery for phakic eyes with moderate to low myopia.Methods A total of 148 patients(148 eyes)with moderate to low myopia in Wuhan PRI Ophthalmic Hospital from January 2019 to January 2020 were selected.They were divided into ICL group(n=74,74 eyes)and SMART group(n=74,74 eyes)according to the random number table.The ICL group was given ICL,and the SMART group was given SMART.The complications and best corrected visual acuity(BVCA),uncorrected visual acuity(UCVA),safety index,effective index,and visual quality[Objective Scattering Index(OSI),MTF cutoff(MTF cutoff),Strehl ratio(SR)]and contrast sensitivity[low frequency range(3 cpd),mid frequency range(6 cpd),mid frequency range(12 cpd)],aberrations of the whole eye(vertical coma,spherical aberration,total high-order aberration),ocular hemodynamic parameters[end diastolic flow velocity(Vd)of ophthalmic artery(OA),posterior ciliary artery(PCA),peak systolic blood flow velocity(Vs)]before operation,1 week,1 month,and 6 months after operation of the two groups were counted.Results There was no significant difference between the two groups in BVCA,UCVA,safety index and effective index before operation,1 week,1 month,and 6 months after operation(P>0.05).The BVCA[ICL(−0.77±0.06),(−0.84±0.07)vs.(0.49±0.05),SMART(−0.76±0.09),(−0.82±0.08)vs.(0.50±0.03)]and UCVA[ICL(0.72±0.08),(0.65±0.10)vs.(0.95±0.22),SMART(0.70±0.10),(0.67±0.12)vs.(0.93±0.25)]at 1 month and 6 months after operation in the two groups were better than those before the operation(P<0.017);the OSI of the ICL group was lower than that of the SMART group at 1 week,1 month,and 6 months after operation,and the MTF cutoff and SR were higher than the SMART group(P<0.05);the contrast sensitivity of 3 cpd,6 cpd,and 12 cpd under bright light and no glare in the ICL group at 1 week,1 month,and 6 months after operation was higher than that of the SMART group(P<0.05);the total high-order aberrations in

关 键 词：近视 ICL手术 SMART手术 视觉质量 全眼像差 眼血流动力学 

分 类 号：R779.6[医药卫生—眼科]