高度近视眼ICL手术前后两种固视稳定性分析比较  

Comparison of two types of fixation stability before and after ICL surgery in patients with high myopia

作　　者：何林波 李自杨 姚春莲 宋利兵 王青 杨于力 HE Linbo;LI ZiYang;YAO Chunlian;SONG LiBing;WANG Qing;YANG YuLi(Department of Ophthalmology,the First Affiliated Hospital of Armed Forces Medical University,Chongqing 400038,China)

机构地区：[1]陆军军医大学第一附属医院眼科,重庆400038

出　　处：《检验医学与临床》2024年第S01期39-42,共4页Laboratory Medicine and Clinic

基　　金：重庆市科卫联合医学科研项目面上项目(2022MSXM051)。

摘　　要：目的应用微视野计对比高度近视眼在有晶体眼人工晶体植入术(ICL)术前和术后的固视稳定性,分析微视野两种固视分类方法(临床和二元轮廓椭圆面积)的差异,为临床视功能固视检测提供更精确的评价。方法回顾性分析2019年7月至2021年1月该院做屈光手术的高度近视患者31例48只眼,在术前和术后均进行了微视野检查(MAIA),测量10°范围平均光敏感度和固视稳定性[包括方法1:2°和4°范围内固视点百分比(P1,P2),方法2:63%及95%双曲线轮廓椭圆面积(BCEA)],通过临床分类(方法1)和量化的二元轮廓椭圆面积(方法2)两种方法对固视敏感性进行分析比较,采用配对秩和检验,并对术前术后固视稳定性提升率比较采用χ^(2)检验。结果术前术后固视稳定性比较,方法1中固视稳定性P1、P2值手术前后差异均无统计学意义(Z=-0.611,-0.700,P>0.05);方法2中63%和95%固视点面积差异均有统计学意义(Z=-0.126,-0.773,P>0.05)。术前术后固视稳定性提升率比较,方法1中固视稳定性P1、P2和方法2中63%和95%固视点面积值提升率分别为31.3%,10.4%,39.6%,64.6%,差异有统计学意义(χ^(2)=59.946,P<0.001),不同固视方法与固视稳定性变化之间存在中等相关性(r=0.488,P<0.001)。结论高度近视眼ICL术后固视稳定性没有明显的变化;在高度近视术后固视稳定性评价上,运用95%的二元廓BCEA能够提供更敏感的固视稳定性评价。Objective To compare the quantification of fixation stability using microperimetry in high myopia before and after ICL,by means of 2 available(clinical and bivariate contour ellipse area[BCEA])classification methods.Methods From July 2019 to January 2021,a total of 31 high myopia patients(48 eyes)underwent refractive surgery in the hospital.Microperimetry examination was performed before and after surgery,and All fixation data were analyzed and compared by means of a clinical classification and by means of BCEA quantification.Results According to clinical classification,P1 and P2 values had no clinical significance before and after operation(Z=-0.611,-0.700,P>0.05).According to the quantized ellipse area of binary contour,the areas of 63%and 95%fixations(Z=-0.126,-0.773,P>0.05)were not statistically significant.The variation of fixation stability was highlighted only by BCEA analysis(χ^(2)=59.946,P<0.001).Conclusion The change of fixation stability after ICL in high myopia was improved.BCEA analysis provides more accurate evaluation of fixation stability and may detect minimal quantitative changes of the fixation area.

关 键 词：微视野 固视稳定性 屈光术后 高度近视 人工晶体植入术 

分 类 号：R779.6[医药卫生—眼科]