ICL植入术后黄斑区节细胞-内丛状层及视网膜厚度的变化

Changes of ganglion cell-inner plexiform layer and retinal thickness in macular region after ICL implantation

目的:应用OCT观察ICL植入术后黄斑区节细胞-内丛状层及中央区视网膜厚度的改变,明确ICL植入术对于眼后节的影响。方法:前瞻性研究。最终纳入行ICL植入术患者26例41眼,平均年龄28.19±6.48岁。所有受试者均行眼轴长度(AL)、裸眼视力(UCVA)、综合验光、最佳矫正视力(BCVA)、眼压(IOP)及OCT检查。观察术前及术后的中央区视网膜厚度(CRT)和节细胞-内丛状层厚度(GCT),以及UCVA、BCVA和IOP的变化。结果:ICL植入术后UCVA和BCVA较术前均有提高(P<0.05),而眼压无变化。术前,术后1wk,1、3mo CRT分别为273.20±25.48、274.07±27.64、277.85±25.49、275.99±24.68μm,而GCT分别为85.31±5.19、88.95±6.87、87.73±4.23、87.45±4.59μm(均P<0.05),其中CRT在术后1mo较术前有增加(P<0.01),GCT在术后1wk,1、3mo均比术前有增加(P<0.05)。GCT在术后1wk的变化与AL呈正相关(r s=0.529,P=0.001)。结论:ICL植入术具有良好的有效性及一定的安全性,但术后也会发生一定的黄斑区改变,需给予一定的重视。

AIM: To investigate the changes of ganglion cell-inner plexiform layer and retina thickness in myopic eyes after intraocular collamer lens(ICL) implantation using quantitative optical coherence tomography (OCT). METHODS:A prospective study enrolled 41 myopic eyes of 26 patients which underwent ICL implantation (average age: 28.19±6.28 years). Aaxial length (AL), uncorrected visual acuity (UCVA), refractive diopter (RD), best corrected visual acuity (BCVA), intraocular pressure (IOP) and OCT were measured and compared in all patients before and after surgery. Optical coherence tomography (OCT) was used to image central retinal thickness (CRT) and ganglion cell-inner plexiform layer thickness (GCT). The changes between pre-and postoperative were analyzed by repeated measures analysis of variance (ANOVA). Least significant difference test was used to compare the specific time points after operation with those before operation. RESULTS: Compared with the preoperative data, all the patients showed significant improvements in the postoperative UCVA and BCVA ( P <0.05). However, there was no statistical significance in IOP. CRT were 273.20 ±25.48, 274.07±27.64, 277.85 ±25.49, and 275.99 ±24.68μm before and after surgery, respectively, while GCT were 85.31 ±5.19, 88.95±6.87, 87.73±4.23, and 87.45±4.59μm, respectively, with statistically significant changes (all P <0.05). Among them, CRT increased in one month after operation, with statistical significance ( P < 0.01). GCT increased in 1wk, 1mo and 3mo after operation, with statistical significance ( P <0.05). The changes of GCT in 1wk after operation was positively correlated with AL( r s=0.529, P =0.001). CONCLUSION:ICL implantation for myopic eyes has good efficacy and safety, but macular area changes will occur after surgery, which need to be paid attention to.