精准选择ICL晶状体型号和置放位置的临床探讨  

A clinical exploration on assessing the accuracy of ICL size selection and implanting orientation

作　　者：乐红华 李琳[1] 王浩 孙琳 周旭霞 方曙姿 张琼芳[1] 刘益慧 Le Honghua;Li Lin;Wang Hao;Sun Lin;Zhou Xuxia;Fang Shuzi;Zhang Qiongfang;Liu Yihui(Aier Ophthalmology Hospital of Zhuzhou,Zhuzhou 412000,China)

机构地区：[1]株洲爱尔眼科医院,湖南412000

出　　处：《临床眼科杂志》2025年第1期24-29,共6页Journal of Clinical Ophthalmology

摘　　要：目的精准选择有晶状体眼人工晶状体(ICL)的型号和置放位置,获取更理想的拱高,减少ICL术后调位率及置换率,探讨个性化ICL手术的可行性。方法回顾性病例对照研究。按选择ICL型号和置放位置的不同分成A、B两组:A组随机选取2020年7~11月行ICL手术患者118例(236只眼),按照STARR公司在线计算和订购系统(OCOS)表选择ICL型号,水平轴置放ICL。B组随机选取2020年12月至2021年3月行ICL手术患者97例(193只眼),通过制作改良OCOS表,结合精确测量不同轴位睫状沟间距(STS),精准选择ICL型号和置放位置。对比A、B两组术后6个月拱高、术后调位率及置换率。结果比较入组A、B两组术前白到白(WTW)、前房深度(ACD)、晶状体厚度(LT)差异均无计学意义(均P>0.05)。A、B两组术后6个月拱高<250μm及拱高>750μm的眼数,差异均有统计学意义(均P<0.05);A、B两组术后6个月250μm≤拱高≤750μm的眼数,差异无统计学意义(P>0.05);术后6个月拱高均值(μm):A组为(427.23±171.98)μm;B组为(464.41±170.50)μm,差异有统计学意义(P<0.05)。A组拱高异常行二次手术共18只眼(7.63%),其中ICL调位11只眼(4.67%),ICL置换7只眼(2.97%)。B组拱高异常行二次手术共3只眼(1.55%),其中ICL调位2只眼(1.03%),ICL置换1只眼(0.51%)。A、B两组二次手术率比较,差异有统计学意义(P<0.05)。结论通过制作改良OCOS表,结合精确测量不同轴位STS,均衡多种影响ICL术后拱高的因素,术前精准选择ICL晶体型号,确定ICL放置位置,获得更理想拱高,减少了ICL植入手术调位率及置换率,获得了良好的临床效果,为个性化ICL手术探索一条新途径。Objective To accurately select the model and placement position of implantable collamer lens(ICL),obtain more ideal vault,reduce the base note rate and replacement rate ofICL surgery,and to explore the feasibil ity of personalized ICL surgery.Methods A retrospective case-control study.According to the different ICL models and placement locations,they were divided into A group and B group.Group A randomly selected 118 patients(236 eyes)who underwent ICL surgery from July to November 2020.ICL models were selected according to the STARR company's OCOS table,and ICL were placed horizontally.The B group randomly selected 97 patients(193 eyes)who underwent ICL sur-gery from December 2020 to March 2021.Through the production of an improved OCOS table and precise measurement of sulcus to sulcus(STS)at different axial positions,the ICL artificial lens model and placement position were accurately se-lected.The vault,base note rate and replacement rate of A group and B group were compared.Results There was no sta-tistically significant difference in preoperative white-to-white(WTW),anterior chamber distance(ACD),and lens thick-ness(LT)between two groups(P>0.05).There was a statistically significant differencein the number of eyes with vault<250μm and vault>750μm between the two groups at 6 months after the surgery(P<0.05).There was no statistically sig-nificant difference in the number of eyes with a height of 250μm≤vault≤750μm between the two groups at 6 months af-ter the surgery(P>0.05).The mean vault(μm)at 6 months after the surgery was(427.23±171.98)μm in A group and 464.41±170.50μm in B group,and the difference was statistically significant(P<0.05).A total of 18 eyes(7.63%)un-derwent secondary surgery for abnormal vault in A group,including 1l eyes(4.67%)with ICL repositioning and 7 eyes(2.97%)with ICL replacement.A total of 3 eyes(1.55%)in B group underwent secondary surgery for abnormal vault,in-cluding 2 eyes(1.03%)with ICL repositioning and 1 eye(0.51%)with ICL replacement.There was a statistically sig

关 键 词：ICL人工晶状体型号 改良OCOS表 ICL置放位置 拱高 个性化ICL手术 

分 类 号：R779.66[医药卫生—眼科]