有晶状体眼后房型人工晶状体放置轴向对术后早期拱高变化的影响  

Effect of the axial position of posterior chamber phakic intraocular lens on the early postoperative vault changes

作　　者：徐伊琳 蹇骞 陈珣 蒋寅婕 牛凌凌 王晓瑛 XU Yi-lin;JIAN Qian;CHEN Xun;JIANG Yin-jie;NIU Ling-ling;WANG Xiao-ying(Department of Ophthalmology,Eye and ENT Hospital,Fudan University,Shanghai 200031,China;Department of Refractive Surgery,Chongqing Nanping Aier Eye Hospital,Aier Eye Hospital Group,Chongqing 400060,China)

机构地区：[1]复旦大学附属眼耳鼻喉科医院眼科,上海200031 [2]爱尔眼科医院集团重庆南坪爱尔眼科医院屈光科,重庆400060

出　　处：《复旦学报(医学版)》2025年第1期83-90,共8页Fudan University Journal of Medical Sciences

基　　金：国家自然科学基金(82171095);上海市科委优秀学术带头人项目(23XD1400500);重庆市南岸区科卫联合医学科研项目(2021-25);爱尔眼科医院集团科研基金自由探索计划(AF2116D6)。

摘　　要：目的探讨有晶状体眼后房型人工晶状体中的可植入式眼内镜(implantable collamer lens,ICL)植入术后,患者早期拱高的变化特点及人工晶状体不同放置轴向对早期拱高变化的影响。方法采用前瞻性平行队列研究,共纳入屈光门诊ICL(V4c)手术患者124眼,通过角膜地形图眼前节分析仪(Pentacam)和眼前节光学相干断层扫描仪(CASIA2)等设备观察术后1天、1周、1个月拱高等指标变化。结果ICL植入术后1周时,拱高较术后1天下降(108.2±82.4)μm,下降比例为16.6%±12.1%,差异有统计学意义(P<0.01),随后保持稳定。在术后1个月内,排除术后1天拱高基线的差异,中拱高组(250~749μm)和高拱高组(≥750μm)拱高下降比例相似,差异无统计学意义。而在不同ICL放置轴向组观察发现,水平位ICL拱高的下降在术后1周时很快稳定,垂直位ICL在术后1个月内拱高下降比例更明显(P<0.05)。结论ICL植入术后早期拱高呈现下降趋势,中拱高和水平位放置的ICL稳定较快,高拱高或垂直位ICL下降趋势更明显。Objective To observe the early changes of vault after implantation of posterior chamber phakic intraocular lens implantable collamer lens(ICL),and investigate the effect of different implantation axes on the early vault changes.Methods A prospective,parallel cohort study was performed,enrolling a total of 124 eyes of who underwent ICL(V4c)implantation in the refractive clinic.The changes of vault were observed by scheimpflug tomography(Pentacam)and anterior segment optical coherence tomography(CASIA2)at 1 day,1 week and 1 month after surgery.Results The ICL vault declined significantly by approximately(108.2±82.4)μm 1 week after surgery with the proportion of 16.6%±12.1%compared with the values 1 day after surgery(P<0.001),and then remained stable.Within 1 month after surgery,excluding the difference in vault baseline at 1 day after surgery,the proportion of vault decline in the middle vault group(250-749μm)and the high vault group(≥750μm)was similar,and there was no statistically significant difference.We analyzed the relationship between ICL axial directions and vault and found that the vault decline of the horizontal ICL group stabilized quickly at 1 week after surgery,and the vault decline of the vertical ICL group was more significant within 1 month after surgery(P<0.05).Conclusion The vault of the ICL shows a downward trend in the early stage after implantation.The middle vault group and ICL in the horizontal position stabilizes faster,and the downward trend of the high vault group or ICL in the vertical position is more obvious.

关 键 词：可植入式眼内镜(ICL) 拱高 人工晶状体轴位 角膜地形图眼前节分析仪 眼前节光学相干断层扫描仪 

分 类 号：R778.1[医药卫生—眼科]