Pentacam评估高度近视有晶状体眼人工晶状体植入术前后眼前节形态的改变

Quantitative changes of anterior segment before and after implantable collamer lens implantation for high myopia with Pentacamanterior segment system

目的：通过眼前节全景分析仪（ Pentacam）量化分析高度近视患者行ICL植入术手术前后眼前节形态的改变,评估手术的安全性、有效性。 方法：收集我院2011-09/2013-02高度近视眼行ICL植入手术的患者21例39眼,术后随访6-12mo。通过Pentacam分别测量术前；术后1wk；1,6mo的中央前房深度（ ACD）、前房角度（ACA）、前房容积（ACV）；记录术后1wk；1,6mo的ICL拱高（ICL-vault）；记录术前裸眼视力（pre-UCVA）、最佳矫正视力（ BCVA）、术后裸眼视力（ post-UCVA）以及眼压值。使用SPSS18.0统计软件分析各项指标,术前、术后的资料均采用配对t检验进行统计学分析。 结果：术前；术后1wk；1,6mo 的ACD分别是3.27±0.22,3.02±0.33,2.98±0.31,2.98±0.32mm, ACA分别是（40.39±5.40）°,（26.70±4.47）°,（26.96±4.48）°,（26.95±4.45）°, ACV分别是207.74±25.43,122.87±17.58,128.05±17.84,＆amp;nbsp；128.64±17.50mm 3。术后1wk；1,6mo的拱高分别是0.49±0.13,0.46±0.13,0.46±0.14mm。术前与术后3个不同时段的ACD,ACA,ACV的值相比,其均存在统计学差异（ P〈0.05）；术后1 wk拱高与术后1,6 mo拱高相比,均存在统计学差异（ P〈0.05）。 BCVA手术前后比较,亦存在统计学差异（ P〈0.05）。 ICL与透明晶状体没有任何接触,没有引起房角关闭。术后随诊未发现白内障、青光眼、黄斑囊样水肿、视网膜脱离等术后并发症。 结论：通过眼前节全景分析仪（ Pentacam）分析发现ICL术后前房变浅,房角变窄,前房容积变小,但人工晶状体与透明晶状体之间仍拥有安全的间隙,ICL植入术治疗高度近视眼安全、有效,但远期疗效有待进一步观察。

AIM： To analyze the quantitative changes of anterior segment by Pentacam anterior segment system and to evaluate the safety and effectiveness after implantable collamer lens （ lCL） implantation for high myopia. METHODS：Twenty- one patients with 39 eyes were implanted lCL in our hospital from September 2011 to February 2013. The follow-up was 6 - 12mo. Central anterior chamber depth （ ACD ） , anterior chamber angle （ ACA） , anterior chamber volume （ ACV） were measured by Pentacam preoperatively, 1wk, 1 and 6mo postoperatively. The distance between crystal lens and lOL （ lCL- vault ） were measured at 1wk, 1 and 6mo postoperatively. Preoperative uncollected visual activity （ pre - UCVA ） , best corrected visual acuity （ BCVA ） , postoperative uncorrected visual acuity （ post-UCVA） and intraocular pressure （ IOP） were recorded. The paired t-test was used to access the data preoperatively and postoperatively in the statistical way by using SPSS 18. 0 statistical software. RESULTS： Preoperatively, at 1wk, 1 and 6mo postoperatively, ACD were 3. 27±0. 22, 3. 02±0. 33, 2. 98±0. 31, and 2. 98±0. 32mm. ACA were （40. 39±5. 40）o, （26.＆amp;nbsp;70±4. 47）o, （26. 96±4. 48）o, and （26. 95±4. 45）o. ACV were 207. 74±25. 43, 122. 87±17. 58, 128. 05±17. 84, and 128. 64±17. 50mm3 , respectively. There were statistically significant differences between preoperative and postoperative data in ACD, ACA, ACV （P〈0. 05）. The distances between crystal lens and lOL （ lCL-vault） were 0. 49±0. 13, 0. 46±0. 13, and 0. 46±0. 14 at 1wk, 1 and 6mo postoperatively. There were statistically significant difference between 1wk and the others （P〈0. 05）. There were statistically significant different between the preoperative BCVA and postoperative BCVA（P〈0. 05）. There was no contact between lOL and the crystal len. The anterior chamber angle was all open. There were no serious complications such as cataract, glaucoma, cystoid macular edema, retinal detachment, etc. CONCLUSION：ACD, ACA, ACV by Pentacam anterior segment system are found to be decreased after the operation, but there is still a relative safe distance between lOL and the crystal len. lCL implantation is a safe, efficacy method in correcting high myopia, but the long-term effects will require further observation.