有晶状体眼后房型人工晶状体植入术后早期拱高变化的影响因素分析  

Analysis of pre-operative factors affecting vault after posterior chamber phakic intraocular lens implantation

作　　者：李晓莉 谢怡 林丽勉 冯绮婷 刘泉[1] Li Xiaoli;Xie Yi;Lin Limian;Feng Qiting;Liu Quan(Zhongshan Ophthalmic Center,Sun Yat-sen University,State Key Laboratory of Ophthalmology,Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science,Guangdong Provincial Clinical Research Center for Ocular Diseases,Guangzhou 510060,China;Guangzhou Bright Eye Hospital,Guangzhou 510060,China)

机构地区：[1]中山大学中山眼科中心、眼科学国家重点实验室、广东省眼科视觉科学重点实验室、广东省眼部疾病临床医学研究中心,广州510060 [2]广州普瑞眼科医院,广州510060

出　　处：《中华眼科杂志》2024年第2期168-175,共8页Chinese Journal of Ophthalmology

摘　　要：目的分析有晶状体眼后房型人工晶状体(pIOL)植入术后早期拱高的变化及其影响因素。方法回顾性病例系列研究。连续收集2020年9月至2021年8月于中山大学中山眼科中心行pIOL植入术并完成3个月随访的近视眼或近视眼合并散光患者的资料。收集所有患者的术前眼部检查结果,包括Pentacam眼前节分析系统、Sirius眼前节分析系统、超声生物显微镜和IOL Master光学生物测量仪检测的屈光度数、角膜曲率、角膜水平径、前房容积、前房深度、瞳孔直径、睫状沟直径(STS)、晶状体厚度等参数;记录植入pIOL的度数和植入后位置,以及术后1 d、1周、1个月和3个月的视力和眼前节相干光层析成像术(AS-OCT)测量得到的拱高。并按术后1 d拱高范围及植入pIOL的尺寸分别对拱高进行分析。采用重复测量方差分析、Pearson相关性分析和多元线性回归分析对数据进行统计学分析。结果共纳入患者314例(314只眼),其中男性52例(16.56%),女性262例(83.44%);年龄为(26.44±4.60)岁;术前等效球镜度数为(-8.09±2.41)D。术后1 d、1周、1个月和3个月拱高分别为(671.88±273.02)、(652.26±272.21)、(615.08±259.69)和(591.14±250.71)μm,差异有统计学意义(P<0.001)。拱高>750μm者术后早期拱高下降幅度更大(P<0.001);植入12.1 mm尺寸pIOL的术眼术后拱高最低,13.2 mm者最高(P>0.05)。与术后1 d拱高相关的因素分别为角膜水平径、前房深度、术前柱镜度数、房角度数、晶状体厚度、pIOL柱镜度数;和术后3个月拱高相关的因素分别为角膜水平径、前房深度、术前柱镜度数、前房容积、房角度数、晶状体厚度、眼轴长度、pIOL球镜和柱镜度数;与术后早期拱高变化值相关的因素分别为角膜曲率K2、前房深度、前房容积、瞳孔直径、水平STS、垂直STS、眼轴长度和术前球镜度数(均P<0.05)。多元线性回归分析结果显示,晶状体厚度对术后1 d的拱高有显�Objective To analyze the early changes in vault height and its influencing factors after implantation of posterior chamber phakic intraocular lenses(pIOL).Methods A retrospective case series study was conducted,including patients who underwent pIOL implantation at Zhongshan Ophthalmic Center,Sun Yat-sen University,from September 2020 to August 2021,and completed a 3-month follow-up.Data were collected from myopic or myopic astigmatism patients.Preoperative ocular examinations,including Pentacam anterior segment analysis system,Sirius anterior segment analysis system,ultrasound biomicroscopy(UBM),and IOLMaster optical biometry,were performed to measure parameters such as refractive power,corneal curvature,corneal horizontal diameter,anterior chamber volume,anterior chamber depth,pupil diameter,sulcus-to-sulcus diameter(STS),and lens thickness.The degree and position of implanted pIOL,as well as vault height measured by anterior segment optical coherence tomography(AS-OCT)at 1 day,1 week,1 month,and 3 months postoperatively,were recorded.Statistical analyses were conducted using repeated measures analysis of variance,Pearson correlation analysis,and multiple linear regression analysis.Results A total of 314 patients(314 eyes)were included,with 52 male(16.56%)and 262 female(83.44%)patients,and an average age of(26.44±4.60)years.The preoperative equivalent spherical power was(-8.09±2.41)D.Postoperative vault heights at 1 day,1 week,1 month,and 3 months were(671.88±273.02)μm,(652.26±272.21)μm,(615.08±259.69)μm,and(591.14±250.71)μm,respectively,with statistically significant differences among groups(P<0.001).Eyes with vault height>750μm showed a greater decrease in early postoperative vault height(P<0.001).The eyes implanted with 12.1 mm pIOL had the lowest postoperative vault height,while those with 13.2 mm had the highest(P>0.05).Factors correlated with vault height at 1 day postoperatively included corneal horizontal diameter,anterior chamber depth,preoperative cylinder power,angle degree,lens thickness,a

关 键 词：有晶状体眼人工晶状体植入术 晶体植入 眼内 眼前半段 体层摄影术 光学相干 影响因素分析 屈光 眼 

分 类 号：R779.6[医药卫生—眼科]