中央孔型有晶状体眼后房型人工晶状体植入术后近视患者早期视力恢复的影响因素分析  

Analysis of influencing factors for the early visual acuity recovery of patients after implantation of posterior chamber phakic intraocular lens with a central hole

作　　者：汪宇涵 杨珂 李晓霞 辛晨 张熙芳 乔利亚 WANG Yuhan;YANG Ke;LI Xiaoxia;XIN Chen;ZHANG Xifang;QIAO Liya(Beijing Tongren Eye Center,Beijing Tongren Hospital,Capital Medical University,Beijing Institute of ophthalmology,Beijing Key Laboratory of Ophthalmology&Visual Sciences,Beijing 100730,China;Department of Ophthalmology,Beijing Shijitan Hospital,Beijing 100038,China)

机构地区：[1]首都医科大学附属北京同仁医院北京同仁眼科中心北京市眼科研究所北京市眼科学与视觉科学重点实验室,北京市100730 [2]首都医科大学附属北京世纪坛医院眼科,北京市100038

出　　处：《眼科新进展》2022年第10期815-819,共5页Recent Advances in Ophthalmology

基　　金：首都医科大学附属北京同仁医院青年后备人才基金资助(编号:2020-YJJ-ZZL-021)。

摘　　要：目的探讨中央孔型有晶状体眼后房型人工晶状体植入术(ICL)后近视患者早期视力恢复的影响因素。方法回顾性病例对照研究。收集2016年5月至2022年1月在首都医科大学附属北京同仁医院行ICL V4c植入术,且术后1周裸眼视力(UCVA)<术前最佳矫正视力(BCVA),术后1周UCVA(logMAR)≥0的近视患者64例(64眼)为视力恢复较差组;匹配同期在我院行ICL植入术,且术后1周UCVA≥术前BCVA的近视患者160例(160眼)为视力恢复较好组。检查患者术前非接触性眼压(NCT)、球镜度数、柱镜度数、等效球镜度数(SE)、白到白距离(WTW)、角膜曲率(K)、角膜前表面中央扁平子午线曲率(K_(1))、角膜前表面陡峭子午线曲率(K_(2))、角膜内皮细胞计数(ECC)、中央角膜厚度(CCT)、瞳孔直径、前房深度(ACD)、眼轴长度(AL)、晶状体厚度(LT),测量患者术后1周的非接触性眼压(NCT)、球镜度数、柱镜度数、等效球镜度数(SE)、拱高,并记录术中植入ICL的球镜度数、柱镜度数、预期晶状体残留度数和ICL直径。对两组患者手术前后指标进行组间两两比较,并进行相关性分析和多因素回归分析。对视力恢复较差组中37例患者进行术后1个月的指标分析。结果视力恢复较差组患者术前K_(1)、K_(2)均大于视力恢复较好组(P=0.01、0.001),术后UCVA(logMAR)、BCVA(logMAR)均大于视力恢复较好组(均为P<0.001)。两组患者间平均K值、中央平均曲率半径、3 mm区平面中心半径、3 mm区陡中心半径差异均有统计学意义(均为P<0.05)。视力恢复较差组术后球镜度数小于视力恢复较好组(P=0.011)。多因素分析结果显示,较高的K_(2)是影响术后1周视力恢复的危险因素(OR=0.693,P=0.001),较高的术后球镜度数是影响术后1周视力恢复的危险因素(OR=4.131,P=0.003)。视力恢复较差组中37例患者随访至术后1个月,其中25例(67.6%)患者术后UCVA≥术前BCVA,与12例(32.4%)患者术后1个月UCVA<术�Objective To investigate the influencing factors for visual acuity recovery at the early stage after implantation of posterior chamber phakic intraocular lens with a central hole(ICL).Methods A retrospective case-control study was adopted.Totally 64 myopia patients(64 eyes)who underwent ICL V4c in Beijing Tongren Hospital,CMU from May 2016 to January 2022 with uncorrected visual acuity(UCVA)at 1 week after the operation less than the preoperative best corrected visual acuity(BCVA)and UCVA(logMAR)no less than 0 were collected as the poor visual acuity recovery group.A total of 160 myopia patients(160 eyes)who underwent ICL implantation in our hospital in the same period with UCVA no less than preoperative BCVA at 1 week after the operation were collected as the good visual acuity recovery group.The non-contact intraocular pressure,spherical lens,cylindrical lens,spherical equivalent(SE),white-to-white distance(WTW),corneal curvature(K),central flat meridian curvature of the anterior corneal surface(K_(1)),steep meridian curvature of the anterior corneal surface(K_(2)),endothelial cell count(ECC),central corneal thickness(CCT),pupil diameter,anterior chamber depth(ACD),axial length(AL),and lens thickness(LT)were measured before treatment.One week after the operation,the non-contact intraocular pressure,spherical lens,cylindrical lens,SE,and vault were measured again.The spherical lens,cylindrical lens,expected residual diopter,and diameter of the ICL during the operation were recorded.The preoperative and postoperative parameters of the two groups were compared,and correlation analysis and multi-factor regression analysis were conducted.The parameters of 37 patients in the poor visual acuity recovery group were analyzed 1 month after the operation.Results The preoperative K_(1) and K_(2) in the poor visual acuity recovery group were higher than those in the good visual acuity recovery group(P=0.01,0.001),and its postoperative UCVA and BCVA were higher than those in the good visual acuity recovery group(both P<0.001

关 键 词：有晶状体眼后房型人工晶状体植入术 近视 视力 早期 

分 类 号：R779.62[医药卫生—眼科]