高度近视患者ICL V4c植入术后早期双眼视觉功能评估  

Evaluation of early binocular visual function after implantable collamer lens V4c implantation in patients with high myopia

作　　者：唐凯莉 王静[1,2,3] 赵振波 韩冬 丁雨溪 张劲松 马立威 Tang Kaili;Wang Jing;Zhao Zhenbo;Han Dong;Ding Yuxi;Zhang Jinsong;Ma Liwei(Aier Eye Hospital Affiliated to Anhui Medical University,Hefei 230031,Anhui Province,China;Shenyang Aier Excellence Eye Hospital,Shenyang 110000,Liaoning Province,China;Aier Eye Institute of Cataract and Intraocular Lens,Shenyang 110000,Liaoning Province,China)

机构地区：[1]安徽医科大学附属爱尔眼科医院,安徽省合肥市230031 [2]沈阳爱尔卓越眼科医院,辽宁省沈阳市110000 [3]爱尔眼科白内障与人工晶状体研究所,辽宁省沈阳市110000

出　　处：《国际眼科杂志》2024年第4期634-640,共7页International Eye Science

基　　金：湖南省自然科学基金企业联合基金项目(No.2023JJ70040);爱尔眼科医院集团中青年科技创新孵化培育专项计划项目(No.AC2214D01);爱尔眼科医院集团临床研究所科研基金项目(No.AR2002D8)。

摘　　要：目的:评估高度近视患者有晶状体眼后房型人工晶状体(ICL V4c)植入术后早期双眼视觉功能。方法:前瞻性研究。观察2019-05/2021-05在我院行双眼ICL植入术的高度近视患者35例70眼。术前和术后1 mo评估双眼全程视力、双眼对比度敏感度、双眼立体视、双眼中间视觉及眩光敏感度、单眼波前像差及视觉质量调查问卷。结果:术后1 mo双眼裸眼远视力(UDVA)≤0.00(LogMAR)者35例(100%),双眼UDVA≥术前最佳矫正视力(CDVA)者16例(46%)。术后双眼裸眼远视力(UDVA)、中视力(UIVA,80 cm)较术前CDVA、最佳矫正远视力下中视力(DCIVA,80 cm)均有所提升(均P<0.05);双眼术后UIVA(60 cm)与术前DCIVA(60 cm)、双眼术后裸眼近视力(UNVA,40 cm)较术前最佳矫正远视力下近视力(40 cm),均无差异(均P>0.05)。术后双眼对比度敏感度较术前好转(P=0.001)。术后双眼中间视觉及眩光敏感度(无眩光)、中间视觉及眩光敏感度(眩光),较术前均无差异(均P>0.05)。手术前后双眼5 m和40 cm立体视比较均无差异(均P>0.05)。除在瞳孔直径3.0 mm下右眼全眼彗差术后较术前中位数减小,余全眼总高阶像差、三叶草像差、彗差及球面像差术后较术前中位数均有所增加。患者术前及术后的主观视觉质量量表评分总分均值由54.87分显著提升至80.92分(P<0.05),患者术后满意度高、无明确视觉干扰症状。结论:高度近视患者双眼植入ICL V4c术后早期单眼全眼高阶像差虽有所增加,但双眼视觉功能得到改善。AIM:To evaluate the binocular visual function in high myopia patients after the implantation of implantable collamer lens(ICL)V4c.METHODS:A total of 35 cases(70 eyes)that received binocular ICL implantation at our hospital from May 2019 to May 2021 were enrolled in this prospective study.Binocular full-range visual acuity,contrast sensitivity,stereopsis,mesopic vision and glare sensitivity,and monocular wavefront and the quality of vision questionnaire were assessed before the surgery and at 1 mo postoperatively.RESULTS:At 1 mo postoperatively,35 cases(100%)had binocular uncorrected distance visual acuity(UDVA)≤0.00(LogMAR),16 cases(46%)had binocular UDVA≥preoperative corrected distance visual acuity(CDVA).Binocular UDVA and uncorrected intermediate visual acuity(UIVA,80 cm)were improved compared to preoperative CDVA and distance-corrected intermediate visual acuity(DCIVA,80 cm)(all P<0.05).While there were no differences in the binocular postoperative UIVA(60 cm)and preoperative DCIVA(60 cm),and uncorrected near visual acuity(UNVA,40 cm)and preoperative distance-corrected near visual acuity(DCNVA,40 cm)(all P>0.05).The binocular contrast sensitivity was significantly improved postoperatively(P=0.001),and the postoperative binocular mesopic vision,glare sensitivity(no glare/glare)and binocular stereopsis(5 m/40 cm)had no differences(all P>0.05).The postoperative total higher-order aberration,trefoil aberration,coma and spherical aberration were increased,besides the median of total coma in the right eye with a pupil diameter of 3.0 mm was decreased after surgery.The mean total score of quality of vision questionnaire was significantly increased from 54.87 preoperatively to 80.92 after implantation(P<0.05),with high satisfaction and no obvious visual disturbance in patients.CONCLUSION:Although the monocular high-order aberrations increased in the early stage after ICL V4c binocular implantation in patients with high myopia,the binocular visual function was improved.

关 键 词：高度近视 有晶状体眼后房型人工晶状体(ICL V4c) 双眼视觉功能 

分 类 号：R779.6[医药卫生—眼科]