应用Sirius眼前节分析系统选择ICL直径的临床观察  

Clinical Observation of ICL Diameter Selection by Using Sirius Anterior Segment Analysis System

作　　者：曾文慧 罗栋强[2] 钟定娟 王华[2] Wenhui Zeng;Dongqiang Luo;Dingjuan Zhong;Hua Wang(Department of Ophthalmology,People's Hospital of Changsha County,Hunan Provincial People's Hospital Xingsha Branch,Changsha 410100,China;Center of Ophthalmology and Optometric,Hunan Provincial People's Hospital,the First Affiliated Hospital of Hunan Normal University,Changsha 410000,China)

机构地区：[1]长沙县人民医院湖南省人民医院星沙院区眼科,长沙410100 [2]湖南省人民医院,湖南师范大学附属第一医院眼视光中心,长沙410000

出　　处：《中华眼视光学与视觉科学杂志》2022年第5期337-342,共6页Chinese Journal Of Optometry Ophthalmology And Visual Science

基　　金：湖南创新型省份建设项目专项任务书(2020SK2118)。

摘　　要：目的:分析和评价应用Sirius眼前节分析系统选择有晶状体眼后房型人工晶状体(ICL)直径的可行性。方法:回顾性病例对照研究。收集2016年1月至2017年8月在湖南省人民医院行ICL植入术的高度近视患者73例(146眼)。所有患者均通过术前Sirius眼前节分析系统测量各项眼前节指标,如水平可见虹膜直径(HVID)、水平前房直径(HACD)、前房深度(ACD)等,综合这些指标应用STAAR公司提供的ICL计算软件结果来选择ICL直径。术后随访3个月至1年。采用FriedmanM检验、重复测量方差分析、配对t检验和多元线性回归分析对手术前后的数据进行分析。结果:所有患者术后裸眼远视力(UDVA)较术前提高(Χ^(2)=156.08,P<0.001)。术后各时期有效指数、安全指数均大于1。术前和随访期间眼压差异无统计学意义(P=0.054);角膜内皮细胞计数(ECD)、ACD、房角宽度(ACA)术后均较术前减少(t=4.63、31.17、23.57,均P<0.001)。术后拱高为(483±231)μm,其中理想拱高眼数占比83.6%;将理想拱高眼的指标纳入回归分析,得到公式:ICL直径(mm)=6.474+0.43×HVID(mm)+0.299×ACD(mm)(R2=0.44,F=36.23,P<0.001)。所有患者未出现白内障及房角粘连、青光眼等并发症。结论:应用Sirius眼前节分析系统选择的ICL直径在治疗高度近视方面安全、有效。通过Sirius眼前节分析系统获得的HVID、ACD值可作为ICL直径选择的重要参数。Objective:To evaluate the reference value of selecting implantable collamer lens(ICL)size by Sirius anterior segment analysis system.Methods:We retrospectively collected 146 eyes of 73 patients with high myopia who underwent ICL implantation in Hunan Provincial People's Hospital from January 2016 to August 2017.All ICL diameters were selected by the anterior segment indicators such as horizontal visible iris diameter(HVID),horizontal anterior chamber diameter(HACD),anterior chamber depth(ACD),which was measured by Sirius anterior segment analysis system.ICL calculation software provided by STAAR company is used to select ICL diameter based on these indicators.All patients were followed 3 months to 1 year.The data before and after surgery were analyzed using Friedman M test,repeated measures ANOVA,paired t test and multiple linear regression equation.Results:The postoperative uncorrected distance visual acuity(UDVA)of all patients was improved compare with preoperative value(Χ^(2)=156.08,P<0.001).The effective index and safety index were greater than 1 at each postoperative period.There was no significant difference in intraocular pressure(IOP)during the preoperative and postoperative follow-up(P=0.054).The endothelial cell density(ECD),anterior chamber depth(ACD)and anterior chamber angle(ACA)were decreased after surgery(t=4.63,31.17,23.57,all P<0.001).The postoperative mean vault was(483±231)μm and the ideal vault eyes accounted for 83.6%.ICL diameter(mm)=6.474+0.43×HVID(mm)+0.299×ACD(mm)(R2=0.44,F=36.23,P<0.001).No complications such as cataract,goniosynechia and glaucoma occurred in all patients.Conclusions:The ICL selected by Sirius anterior segment analysis system is safe and effective in the treatment of high myopia;the HVID,HACD,and ACD obtained by Sirius can be used as important parameters for ICL diameter selection.

关 键 词：后房型人工晶状体直径 拱高 Sirius眼前节分析仪 

分 类 号：R779.66[医药卫生—眼科]