有晶状体眼虹膜固定型人工晶状体植入术后房角宽度的改变

Changes of anterior chamber angle width after implantation of iris-fixated intraocular lens in phakic eyes

目的使用光学相干断层扫描(optical coherence tomography,OCT)评估有晶状体眼虹膜固定型人工晶状体(intraocular lens,IOL)近视患者植入术后患者房角宽度的变化。方法 28眼(14例)近视患者植入虹膜固定型IOL矫正高度近视。观察术前、术后患者的等效球镜、角膜内皮细胞计数、眼压以及2点、3点、4点、8点、9点、10点钟位的房角宽度。结果术前、术后等效球镜分别为(-12.95±0.77)D、(-0.35±0.08)D,差异有显著统计学意义(P<0.001)。术前、术后角膜内皮细胞计数分别为(2859.38±62.27)mm-2、(2783.92±62.67)mm-2,差异有统计学意义(P=0.012)。术前、术后眼压分别为(11.87±0.40)mmHg(1kPa=7.5mmHg)、(11.80±0.40)mmHg,差异无统计学意义(P=0.800)。术后3个月,3点、9点钟位房角较术前变窄,差异均有统计学意义(均为P<0.05),其他方位房角宽度术前、术后差异均无统计学意义(均为P>0.05)。结论植入虹膜固定型IOL后高度近视患者部分房角变窄,术后应对患者前房变化情况进行随访观察。

Objective To evaluate the changes of anterior chamber angle width after the implantation of iris-fLxated intraocular lens（IOL） in phakic eyes by optical co- herence tomography（OCT）. Methods A total of 28 eyes（ 14 cases） with high myopia were treated with the implantation of iris-fixated IOL. Spherical equivalent, corneal en- dothelial density, intraocular pressure, and angles at 2,3,4,8,9 and l0 O＇ clock positions before and after operation were observed. Results The preoperative and postopera- tive spherial equivalent were （ - 12.95 ± 0.77 ） D and （ - 0.35 ± 0.08 ） D, respectively, and there was significant difference between them （P 〈 0. 001 ）. The preoperative and post- operative corneal endothelial density were （ 2859. 38 ± 62.27 ） nun-2 and （ 2783.92 ± 52. 57） mm-2, respectively, and there was significant difference between them （P = 0. 012）. The preoperative and postoperative intraocular pressure were （11.87 ± 0. 40 ） mmHg （ 1 kPa = 7.5 mmHg） and （ 11.80 ± 0.40） mmHg, respectively and there was no difference between them（P = 0. 800 ）. At postoperative 3 months, the angles at ] and 9 O＇ clock positions became lower than those before the operation and there was signifi- cant difference （P 〈 0. 05 ）, but there was no significant difference between others （ all P 〉 0. 05 ）. Conclusion There is partial narrowing of anterior chamber angle after the implantation of iris-fixated IOL, which shows that the follow up after operation is necessary.