空中乘务员有晶体眼后房型人工晶体植入术后的临床观察及航空医学鉴定  

Clinical observation and aviation medical identification of posterior chamber phakic implantable collamer lens implantation for flying attendants

作　　者：张亚辉[1] 高丽[2] Yahui Zhang;Li Gao(Aviation Health Center of China Southern Airlines Co.Ltd.,Guangzhou 510405,China;Department of Organ Transplantation of the First Affiliated Hospital of Sun Yat-sen,Guangzhou 510080,China)

机构地区：[1]中国南方航空股份有限公司航空卫生中心,广州510405 [2]中山大学附属第一医院器官移植科,广州510080

出　　处：《中华航空航天医学杂志》2022年第2期99-105,共7页Chinese Journal of Aerospace Medicine

摘　　要：目的观察分析空中乘务员有晶体眼后房型人工晶体(implantable collamer lens,ICL)植入术后的临床效果及航空医学鉴定结果。方法采用回顾性病例研究。收集2017年9月至2021年7月在中国南方航空股份有限公司航空医学鉴定中心首次行航空医学体检鉴定的21例(38眼)ICL植入术后空乘人员的临床及体检鉴定资料。研究观察指标包括裸眼视力(uncorrected visual acuity,UCVA)、最佳矫正视力(best corrected visual acuity,BCVA)、等效球镜度(spherical equivalent,SE)、眼压(intraocular pressure,IOP)、角膜内皮细胞计数(endothelial cell density,ECD)等,并分析比较上述观察指标手术前后的变化情况及原因。统计分析空中乘务员ICL术后并发症的发生情况及航空医学鉴定结果。结果21例(38眼)空乘人员ICL植入术后UCVA(4.98±0.06)较术前BCVA(4.91±0.07)显著提高(t=6.95,P<0.001);术后SE(-0.21±0.71)较术前(-11.81±3.52)明显下降(t=19.57,P<0.001);手术前后IOP差异无统计学意义(P>0.05);术后ECD较术前轻微减少,丢失率为2.27%,但差异无统计学意义(P>0.05)。空中乘务员ICL植入术后均未出现明显或严重的并发症,因眼压升高、周边视网膜格子样变性伴一圆形小裂孔各1例航空医学鉴定给予不合格结论,其余19例均合格。结论ICL植入术后视力可以满足空中乘务员航空医学鉴定标准要求,可作为空中乘务员矫正高度近视的可靠选择。考虑到ICL植入术的术后风险及航空安全,建议航空体检医师体检鉴定时重点观察ICL术后常见并发症的发生可能,做到早发现、早干预,保障空中乘务员拥有安全、舒适的视觉效果。Objective To observe and analyze the clinical effect and aviation medical identification results of the flight attendants after phakic posterior chamber implantable collamer lens(ICL)implantation.Methods Retrospective case study was used.The clinical and physical examination identification data of 21 flying attendants(38 eyes)after phakic posterior chamber ICL implantation collected from the first physical examination conducted in the aviation medical identification center of China Southern Airlines Co.Ltd.from September 2017 to July 2021 were analyzed.The observation indicators included uncorrected visual acuity(UCVA),best corrected visual acuity(BCVA),spherical equivalent(SE),intraocular pressure(IOP),endothelial cell density(ECD),etc..The changes of the above observation indicators and causes were analyzed and compared between the states before and after operation.The postoperative complications and the results of aviation medical identification in flight attendants were statistically analyzed.Results UCVA(4.98±0.06)of 21 flight attendants(38 eyes)after ICL implantation was significantly higher than BCVA(4.91±0.07)before ICL implantation(t=6.95,P<0.001).SE(-0.21±0.71)after ICL implantation was significantly lower than that before ICL implantation(-11.81±3.52)(t=19.57,P<0.001).The difference on IOP before and after ICL implantation was not statistically significant(P>0.05).ECD after ICL implantation was slightly lower than that before ICL implantation,and the loss rate was 2.27%,but the difference was not statistically significant(P>0.05).There were no obvious or serious complications after ICL implantation in flight attendants.Because of elevated intraocular pressure(1 case)and peripheral retinal lattice degeneration with a small circular hole(1 case),the conclusion of aviation medical identification for these 2 cases was unqualified,and the other 19 cases were qualified.Conclusions The visual acuity corrected by ICL implantation can meet the requirements of aviation medical identification standards for fl

关 键 词：晶体 人工 视觉 双眼 合格鉴定 空中乘务员 

分 类 号：R856.77[医药卫生—航空、航天与航海医学]