带中心孔植入式透镜(V4c-ICL)矫正高度近视的视觉质量研究

Quality of vision after implantation of implantable collamer lens with a central hole (V4c-ICL) for high myopia

目的观察高度近视患者植入带中心孔植入式透镜(implantable collamer lens,ICL)后的临床疗效和视觉相关的生活质量。方法前瞻性病例研究。选取我院诊断为高度近视,并植入V4c-ICL患者25例(50眼)为研究对象。术前及术后1个月、3个月、6个月分别检查患者屈光状态,裸眼远、中、近视力,最佳矫正远视力,远视力矫正下中、近视力,双眼视力,眼压,角膜内皮细胞密度(corneal endothelial cell density,ECD),并进行国家眼科研究所视功能问卷-25(national eye institute-visual function questionnaire,NEI-VFQ-25)调查及评分。结果高度近视患者植入V4c-ICL后不同时间球镜、柱镜、等效球镜(spherical equivalent,SE)度较术前均明显降低(F=884.35、17.15、810.25,均为P<0.05);术后不同时间裸眼远、中、近视力,最佳矫正远视力,远视力矫正下中、近视力和双眼视力较术前均明显改善(F=604.47、878.13、713.92、22.25、5.33、6.90、16.51,均为P<0.05)。术前及术后随访期间眼压、ECD无明显变化(F=0.07、1.53,均为P>0.05);术后NEI-VFQ-25评分较术前明显提高(F=21.76,P<0.05)。结论高度近视患者植入V4c-ICL后屈光不正得到矫正、短期内屈光稳定,随访期间远、中、近视力明显提高,视觉相关的生活质量明显改善。V4c-ICL植入术治疗高度近视安全、有效。

Objective To observe the clinical effect and vision related quality of life after implantation of V4 c-ICL for high myopia.Methods Prospective case study.We observed 25 high myopia patients(50 eyes) with V4 c-ICL as the research objects.Patients’ refractive status,the uncorrected distant vision acuity(UDVA),uncorrected intermediate vision acuity(UIVA) and uncorrected near vision acuity(UNVA),the best corrected distant vision acuities(CDVA),distance-corrected intermediate visual acuity and distance-corrected near visual acuity(DCNVA),binocular visual acuities(BVA),intraocular pressure,corneal endothelial cell density(ECD) were examined preoperatively and one month,three months and six months after the implantation respectively,and the national eye institute-visual function questionnaire-25(NEI-VFQ-25) was conducted and evaluated.Results Diopter(D) of sphere power,cylinder power and spherical equivalent(SE) after implantation of V4 c-ICL for high myopia were decreased significantly during the follow-up period(F=884.35,17.15,810.25,respectively;all P<0.05).UDVA,UIVA,UNVA,CDVA,DCIVA,DCNVA and BVA were increased significantly after implantation of V4 c-ICL(F=604.47,878.13,713.92,22.25,5.33,6.90,16.51,respectively;all P<0.05).Intraocular pressure and ECD had no obvious change before the operation and during the post-operation follow-up period(F=0.07,1.53,respectively;all P>0.05).After the implantation,scored in the NEI-VFQ-25 were remarkably higher compared with the preoperative ones,(F=21.76,P<0.05).Conclusion The ametropia in high myopia is corrected after implantation of V4 c-ICL and the refraction remains stable in the short term.The distant,intermediate and near visual acuities during the follow-up period are obviously improved,and vision related quality of life is also obviously improved.Implantation of V4 c-ICL for high myopia is safe and effective.