高度近视患者植入ICL V4c后眼前节参数的早期结果
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浙江省市共建重点学科项目(No.2017-2023); 衢州市指导性科技计划项目(No.2022083,2022085)


Early outcomes of anterior segment parameters in patients with high myopia after implantable collamer lens V4c implantation
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Jointly Built Key Discipline Project of Zhejiang(No.2017-2023); Instructive Science and Technology Plan Project of Quzhou(No.2022083, 2022085)

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    摘要:

    目的:研究高度近视患者植入带中心孔的植入式collamer晶状体(ICL V4c)后眼前节参数的早期结果。

    方法:纳入2019-02/2022-09在我院行ICL V4c植入术且随访1 a的高度近视患者82例160眼,其中男42例82眼,女40例78眼,年龄26.0±4.6(21-37)岁。术前检测患者的眼前节一般特征:球镜度数、平均角膜水平曲率、水平角膜直径(WTW)和轴向长度(AL); 术前,术后1 d,1 wk,1、3、6 mo测量患者的眼内压(IOP)、内皮细胞密度(ECD)、中央前房深度(CACD)、前房容积(ACV)、前房角(ACA); 术后1 d,1 wk,1、6 mo,1 a测量患者ICL V4c光学区后表面中心到晶状体前表面的距离(拱高)。

    结果:患者术前平均球镜度数为-7.56±2.55 D,平均角膜水平曲率为42.89±1.47 D,WTW为11.64±0.37 mm,AL为26.64±0.93 mm。眼压基线为15.97±2.13 mmHg,ICL V4c植入后各时间点眼压与术前相比无差异(F=0.875,P=0.504); ECD基线为2989.30±140.78 cell/mm2,ICL V4c植入后6 mo的ECD与术前相比无差异(t=1.475,P=0.142); CACD基线为3.19±0.21 mm,ACV基线为210.30±27.7 mm3,术后各时间点CACD、ACV均显著低于术前(F=111.10、288.38,均P<0.001); ACA基线为35.44°±11.27°,ICL V4c植入后各时间点ACA显著低于术前(F=21.23,P<0.001)。术后1 d拱高为665.32±184.03 μm,术后1 wk,1、6 mo,1 a与术后1 d相比,拱高继续显著减少(F=52.10,P<0.001),但在术后6 mo,1 a时保持稳定,与1 mo时相比均无差异(P>0.05)。

    结论:ICL V4c在术后1 a的随访中具有一定安全性和有效性,植入后早期眼前节参数趋于稳定。

    Abstract:

    AIM: To study the early outcomes of anterior segment parameters after implantation of an implantable collamer lens with a central hole(ICL V4c)in patients with high myopia.

    METHODS:A total of 82 cases(160 eyes)with high myopia, including 42 males(82 eyes)and 40 females(78 eyes), aged 26.0±4.6(21 to 37)years, who underwent ICL V4c implantation at our institution from February 2019 to September 2022 and were followed up for 1 a, were included. The general characteristics of the anterior segment of the eye were measured preoperatively: spherical equivalent, mean horizontal corneal curvature, white-to-white(WTW), and axial length(AL); intraocular pressure(IOP), endothelial cell density(ECD), central anterior chamber depth(CACD), anterior chamber volume(ACV)and anterior chamber angle(ACA)were measured preoperatively and at 1 d, 1 wk, 1, 3 and 6 mo postoperatively. Furthermore, the distance from the centre of the posterior surface of the ICL V4c optical zone to the anterior surface of the lens(vault)was measured at 1 d, 1 wk, 1, 6 mo, and 1 a after surgery.

    RESULTS: The mean preoperative spherical equivalent of the patients was -7.56±2.55 D, mean horizontal corneal curvature was 42.89±1.47 D, WTW was 11.64±0.37 mm, and AL was 26.64±0.93 mm. The baseline IOP was 15.97±2.13 mmHg, and the differences in IOP at each time point after ICL V4c implantation compared to preoperative were not statistically significant(F=0.875, P=0.504); ECD was 2 989.30±140.78 cells/mm2 at baseline, and ECD at 6 mo after ICL V4c implantation was not statistically significant compared with preoperative ECD(t=1.475, P=0.142); CACD was 3.19±0.21 mm at baseline, and ACV was 210.30±27.7 mm3, and CACD and ACV were significantly lower than preoperative at all postoperative time points(F=111.10, 288.38, all P<0.001). The baseline ACA was 35.44°±11.27°, and the ACA at each time point after ICL V4c implantation was significantly lower than preoperatively(F=21.23, P<0.001). The vault was 665.32±184.03 μm at 1 d postoperatively, and continued to be significantly reduced at 1 wk, 1, 6 mo, and 1 a postoperatively compared with 1 d(F=52.10, P<0.001). However, it remained stable at 6 mo and 1 a postoperatively, and the difference was not statistically significant compared with vault at 1 mo postoperatively(P>0.05).

    CONCLUSION: ICL V4c has certain safety and efficiency in 1 a postoperative follow-up, and the parameters of the anterior segment of the eye stabilized in the early period.

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潘冰心,吴杰,蒋鹏飞,等.高度近视患者植入ICL V4c后眼前节参数的早期结果.国际眼科杂志, 2024,24(3):491-494.

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  • 收稿日期:2023-10-09
  • 最后修改日期:2024-01-23
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  • 在线发布日期: 2024-02-23
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