两种不同类型眼内接触镜(ICL)矫正高度近视术后视觉质量的比较

Comparsion of corrected visual quality of two types of intraocular contact lens for high myopia

目的对比中央带孔型及传统眼内接触镜(intraocular contact lens,ICL)矫正高度近视术后视觉质量。方法选择行传统ICL植入术的高度近视患者11例(21眼)作为传统组,另外选择行带孔型ICL植入术的高度近视患者12例(20眼)作为带孔型组。术后6个月分别行裂隙灯显微镜检查眼前节,标准对数视力表检查裸眼视力(uncorrected visual acuity,UCVA)、最佳矫正视力(best corrected visual acuity,BCVA),自动验光仪测量手术前后等效球镜度数(spherical equivalent,SE)、散光度数。OQAS视觉质量检查包括客观散射指数(objective scattering index,OSI)、调制传递函数(modulation transfer function,MTF)、斯特列尔比(stryrby,SR)、不同对比度下OQAS值(OV_(100%)、OV_(20%)、OV_(9%))。结果两组患者UCVA(log MAR)、BCVA(log MAR)、SE及散光度数术后6个月均较术前减小,差异均有统计学意义(均为P<0.05);术前及术后6个月两组间UCVA、BCVA、SE及散光度数比较,差异均无统计学意义(均为P>0.05)。带孔型组和传统组患者植入术后6个月OQAS视觉质量参数MTFcutoff、SR、和OV_(100%)、OV_(20%)、OV_(9%)值均较术前增高,差异均有统计学意义(均为P<0.05)。带孔型组和传统组患者植入术后6个月OSI均较术前略降低,但差异均无统计学意义(均为P>0.05)。对比术后6个月带孔型组和传统组患者OQAS视觉质量参数OSI、MTFcutoff、SR、和OV_(100%)、OV_(20%)、OV_(9%)值两组间差异均无统计学意义(均为P>0.05)。结论两种类型ICL矫正高度近视均是安全有效的,中央带孔型ICL可以提供和传统ICL接近的视觉质量。

Objective To assess the optical quality after implantation of the in- traocular contact lens with and without a central hole for high myopia. Methods A total of 23 patients （41eyes） ,including II patients （21 eyes） implanted with V4 ICL （V4 ICL group） and 12 patients （20 eyes） with V4 c ICL implantation （V4 c ICL group） were enrolled in this research. Six months after operation, slit lamp microscope was used to check the anterior segment, and LogMAR chart was to test uncorrected visual a- cuity （UCVA） and best corrected visual acuity （BCVA）. Moreover, automatic refrac- tometer was to measure the spherical equivalent （SE） and astigmatic diopter before and after the operation. OQAS parameters included objective scattering index （OSI）, modu- lation transfer function （ MTF）, Stryrby （ SR）, OQAS values （ OVl00% , OV20% , OV9% ） at different contrast level were examined. Results In both groups, the parameters of UCVA （logMAR）, BCVA （logMAR）, SE and astigmatic diopter at 6 months after opera- tion were significantly improved compared with before operation, with significant differ- ence （ all P 〈 0.05 ）. There was no significant difference in the UCVA, BCVA, SE and as- tigmatic diopter between the two groups before operation and 6 months after operation （all P 〉 0. 05 ）. Moreover, the values of MTFcuton, SR, and OQAS visual parameters （OV100% , OV20% and OV9% ） at 6 months after operation were significantly higher thanthose before operation between the two groups, and the difference was statistically significant （ all P 〈 0.05 ） ,while OSI was lower than preoperative data,but there was no significant difference in OSI between the two groups （P 〈0.05）. There was no significant difference in OQAS visual quality parameters, including OSI, MTFcutoff, SR, and OV100% , OV20% and OV9% , be- tween the two groups （ all P 〉 0.05 ）. Conclusion It is safe and effective of the two types of intraocular contact lens im- plantation for correction of high myopia, and V4 c ICL can achieve the similar visual quality to the traditional V4 ICL.