ICLV4与ICLV4c治疗高度近视临床对比研究

Comparative clinical study of ICL V4 and ICL V4c in correcting high myopia

目的比较两种植入式眼内镜（implantable collamer lens）ICLV4和ICLV4c治疗高度近视眼视觉质量差异。方法前瞻牲病例对照研究。选取2015年2～12月在郑州市第二人民医院眼科就诊近视度数为-6．00—14．00D患者63例（126只眼），其中26例（52只眼）行ICLV4植入术，37例（74只眼）行ICLV4c植入术，对两组术后视力、高阶像差均方根值（RMS）和对比敏感度（CSF）进行对比分析。结果两组术后10d、1个月和3个月的裸眼视力、最佳矫正视力（LogMAR）以及残留的屈光度（等值球镜、球镜和柱镜）均无统计学意义（P〉0．05）。术后10d、1个月和3个月两组之间总体高阶像差、3阶像差、4阶像差和5阶像差差异无统计学意义（P〉0．05）。术后10d、1个月和3个月两组球差（Z4^0）、水平彗差（Z3^1）、垂直彗差（Z3^-1）、水平三叶草（Z3^3）和垂直三叶草（Z3^-3，）均方根值之间的差异均无统计学意义（．P〉0．05）。术后3个月时在明、暗视对比敏感度各频段之间差异无统计学意义（P〉0．05）。结论ICLV4与ICLV4c均能使高度近视患者获得良好的预期的矫正效果，两者术后总体光学质量结果相似，但ICLV4c临床应用更方便。

Objective To compare the visual quality after implantable collamer lens ICL V4 and ICL V4c for high myopia. Methods Prospective observational study in department of ophthalmology, Zhengzhou Second People＇s Hospital from February 2015 to December 2015, 63 patients （126 eyes） with high myopia between-6--14 D were randomly divided into 2 groups, 26 patients （52 eyes） ICL V4 were implanted, and 37 patients （74 eyes） ICL V4c were implanted. The postoperative visual acuity, residual refraction, the RMS of higher-order aberrations and contrast sensitivity of two groups were analyzed comparatively. Results There was no statistical significant differences between two groups of the uncorrected visual acuity, best corrected visual acuity （LogMAR）, and residual re- fraction （spherical equivalent, spherical and cylinder） at postoperative 10 days, 1 month and 3 months （P 〉0.05）. At 10 days, 1 month and 3 months after surgery, there were no statistically signif- icant differences in the general higher-order aberrations, 3-order aberrations, 4-order aberrations, and 5-order aberrations root mean square value between two groups （P 〉0.05）. There were no significant differences at Z04, Z13, Z-13, Z33, Z-33 at postoperative 10 days, 1 month and 3 months between two groups （P 〉0.05）. Three months after surgery, there were no significant differences between two groups at all spatial frequencies of CSF （P 〉0.05）. Conclusions Both ICL V4 and ICL V4c achieve the anticipated effect for high myopia, the overall results of postoperative optical quality are similar, but the clinical application of ICL V4c is more convenient.