有晶状体眼后房型人工晶状体植入术中拱高与术后拱高的相关性研究  

Study of the correlation between intraoperative and postoperative vault of posterior chamber phakic intraocular lens

作　　者：张帅[1] 吴万民 刘文洁 畅颖 杨李春 樊泽琦 刘杰为 Zhang Shuai;Wu Wanmin;Liu Wenjie;Chang Ying;Yang Lichun;Fan Zeqi;Liu Jiewei(Shanxi Medical University,Taiyuan 030001,China;Department of Cataract,Shanxi Eye Hospital Affiliated to Shanxi Medical University,Taiyuan 030002,China)

机构地区：[1]山西医科大学,太原030001 [2]山西医科大学附属山西省眼科医院白内障科,太原030002

出　　处：《中华眼外伤职业眼病杂志》2024年第4期289-296,共8页Chinese Journal of Ocular Trauma and Occupational Eye Disease

基　　金：山西省卫生健康委员会科研基金项目(2021097)。

摘　　要：目的分析有晶状体眼后房型人工晶状体(pIOL)植入术中拱高与术后拱高的相关性。方法回顾性病例系列研究。纳入山西省眼科医院2022年1月至2022年3月接受V4c型可植入式接触镜(ICL)植入术的屈光不正者36例(67眼),使用术中OCT获得术中黏弹剂去除前后的ICL拱高图像,术后用ImageJ进行分析处理,根据术中去除黏弹剂后的拱高分为3组:低拱高组(<250μm)11眼、正常拱高组(250~750μm)50眼、高拱高组(>750μm)6眼,使用前节OCT测量术后1 d、1个月、3个月的ICL中央厚度及拱高,比较术中黏弹剂去除前后以及术后不同时间段的ICL拱高差异并分析术中与术后拱高的相关性。结果所有受术者术中黏弹剂去除前后以及术后1 d、1个月、3个月的拱高分别为(200.42±120.65)、432.00(310.00,581.00)、(592.99±202.62)、(535.75±158.35)、(509.66±157.92)μm,两两比较不同时间点的拱高差异均有统计学意义(均P<0.05),术后拱高有随时间下降趋势,且下降幅度逐渐减小,拱高逐渐趋于稳定。Spearman相关性分析显示术后不同时间的拱高均与前房深度、ICL型号、术中黏弹剂去除前、黏弹剂去除后的拱高呈正相关(均P<0.05)。术中前房黏弹剂去除前后的拱高相差为(254.13±185.96)μm,二者均与术后3个月的拱高线性相关,R^(2)分别为0.219、0.249(均P<0.001)。Kruskal-Wallis检验结果显示3组间术后1 d、1个月、3个月的拱高差异均有统计学意义(H=9.28、12.78、10.16,P=0.010、0.002、0.006),而前房深度、ICL型号差异无统计学意义(H=1.58、1.02,P=0.453、0.599)。在术后1个月、3个月时,低拱高组、正常拱高组均与高拱高组的术后拱高差异有统计学意义(均P<0.05),而术后1 d时,仅低拱高组与高拱高组的术后拱高差异有统计学意义(P=0.007)。结论PICL植入术后拱高会随时间下降,术中拱高对于预测术后拱高有指导价值,二者具有显著相关性,术中高拱高则术后拱高偏高。ObjectiveTo analyze the correlation between intraoperative and postoperative vault of posterior chamber phakic intraocular lens(pIOL).MethodsThis was a retrospective case series study.The study included 36 cases(67 eyes)diagnosed with ametropia who underwent V4c implantable collamer lens(ICL)implantation in Shanxi Eye Hospital from Jan.to Mar.2022.Intraoperative optical coherence tomography(OCT)was used to obtain ICL vault images before and after the removal of medical sodium hyaluronate ophthalmic viscosurgical device(OVD)and ImageJ was used for analyzing and processing these after surgery.They were divided into three groups based on the vault after the removal of OVD:low vault group(<250μm)included 11 eyes,normal vault group(250-750μm)included 50 eyes and high vault group(>750μm)included 6 eyes.Anterior segment OCT was used to measure the central thickness of the ICL and vault at 1 day,1 month,and 3 months postoperatively.The differences between ICL vault before and after the removal of OVD and all postoperative vaults were compared,and the correlation between intraoperative and postoperative vault was analyzed.ResultsMean ICL vault was(200.42±120.65)μm intraoperatively before the removal of OVD and 432.00(310.00,581.00)μm after the removal of OVD,(592.99±202.62)μm at 1 day,(535.75±158.35)μm at 1 month and(509.66±157.92)μm at 3 months after surgery,respectively.The difference of vaults was statistically significant at each time point(all P<0.05).There was a decreasing trend in postoperative vault over time,with the amplitude gradually decreasing and the vault gradually stabilizing.Spearman correlation analysis showed that the postoperative vault at different time points were positively correlated with anterior chamber depth,ICL size,vault before and after removal of OVD intraoperatively(all P<0.05).There was a(254.13±185.96)μm difference between the vaults before and after the removal of OVD,which were linearly correlated with vault at 3 months with R^(2) at 0.219 and 0.249,respectively(all P<0.00

关 键 词：有晶状体眼后房型人工晶状体 相关性 拱高 术中 术后 光学相干断层扫描 

分 类 号：R779.6[医药卫生—眼科]