中央孔型有晶状体眼后房型人工晶状体矫正高度近视性屈光不正的疗效

Visual and refractive out comes of implant able collamer lens with a central hole for high myopia

目的:评估中央孔型有晶状体眼后房型人工晶状体(implantable collamer lens,ICL)——V4c植入术矫正高度近视性屈光不正的疗效。方法:选取2016-09/12间在四川大学华西医院眼科近视手术中心行ICL/TICL植入术的高度近视性屈光不正患者25例43眼,常规检查裸眼视力(uncorrected visual acuity,UCVA)、最佳矫正视力(best corrected visual acuity,BCVA)、屈光度、眼压、角膜内皮细胞计数、对比敏感度和屈光矫正对生活质量的影响问卷(the quality of life impact of refractive correction questionnaire,QIRC)评分,收集术后1d,1wk,1、3mo随访数据,采用重复测量方差分析、LSD-t检验和配对样本t检验进行数据处理。结果:术后UCVA和BCVA较术前提高,且各个时间点差异均有统计学意义(均P<0.01);术后各个时间点等效球镜较术前降低,差异有统计学意义(均P<0.01),且术后各个时间点两两比较差异无统计学意义(均P>0.05)。术后3mo安全指数为1.38±0.24,有效指数为1.22±0.15。术前和术后各个时间点眼压的比较,差异无统计学意义(F=1.464,P=0.215),术后3mo内皮细胞密度较术前差异无统计学意义(t=-0.544,P=0.586)。术后高频对比敏感度优于术前水平,差异有统计学意义(12.0c/d:F=4.347,P=0.010;18.0c/d:F=4.539,P=0.005);低频变化差异无统计学意义(3.0c/d:F=1.094,P=0.354;6.0c/d:F=1.325,P=0.271)。术后QIRC问卷评分与术前比较差异无统计学意义(F=2.669,P=0.094)。结论:ICL V4c植入术是一种安全、有效地矫正高度近视性屈光不正的手术方式。

AIM:To evaluate the efficacy of implantable collamer lens(ICL)-V4c implantation in the correction for high myopia.METHODS:This retrospective analysis collected twenty-five patients(43 eyes)with high myopia treated with ICL/TICL implantation from September to December 2016 at Department of Ophthalmology,West China Hospital.Routine ophthalmic examinations were performed.The patients were followed 3mo to monitor uncorrected visual acuity(UCVA),best corrected visual acuity(BCVA),refractive error,intraocular pressure,corneal endothelial cell count,contrast sensitivity and scores for Quality of Life Impact of Refractive Correction Questionnaire(QIRC).Statistical analyses were performed using repeated measures ANOVA,LSD-t test and paired-samples T test.RESULTS:Postoperative UCVA and BCVA were significantly higher than before surgery(all P<0.01).Postoperative spherical mirrors at all time points were lower than before surgery(all P<0.01),and there was no significant difference between the different time point postoperative(all P>0.05).The safety index in 3mo postoperatively was 1.38±0.24 and the effective index was 1.22±0.15.There was no statistical difference in intraocular pressure between preoperative and postoperative time points(F=1.464,P=0.215).There was no statistical difference in endothelial cell density at 3mo after surgery compared to preoperative(t=-0.544,P=0.586).The postoperative Log contrast sensitivity(LogCS)of 12.0 cycles per degree(c/d)and 18.0 c/d were significantly higher compared to the preoperative(F=4.347,P=0.010;F=4.539,P=0.005;respectively),but other(the postoperative LogCS of 3.0 c/d and 6.0 c/d)differences were statistically insignificant(F=1.094,P=0.354;F=1.325,P=0.271;respectively).There was no significant difference in the amount of change in the QIRC scores between preoperative and postoperative(F=2.669,P=0.094).CONCLUSION:ICL V4c implantation is a safe and effective method for the correction of high myopia.