摘要
目的:观察新型中央孔型后房型人工晶状体(ICL-V4c)植入术治疗-10 D以上超高度近视的安全性和有效性,并探讨视力提高情况(△LogMAR)与术前球镜度(SD)之间的关系。方法:回顾性研究。选取2016年12月至2020年1月于北京同仁医院行ICL-V4c植入术治疗超高度近视患者802例(1380眼),术前SD-23.50~-6.00(-11.54±3.59)D。根据患者术前SD将患者分为A组(-10 D<SD≤-6 D)、B组(-23.5 D≤SD≤-10 D),B组按照组距3 D分为B1(-13 D<SD≤-10 D)、B2(-16 D<SD≤-13 D)、B3(-19 D<SD≤-16 D)、B4(-22 D<SD≤-19 D)、B5(-23.5 D≤SD≤-22 D)共5个亚组。使用Kruskal-Wallis检验及卡方检验分析比较各组患者术前和术后1周、2个月的视力、眼压及视力提高情况。结果:B组患者SD术后得到明显改善(P<0.001),最佳矫正视力(BCVA)得到明显提高(P<0.001);2组患者手术的安全指数和有效指数平均值均>1。△LogMAR和组别之间存在相关性(P<0.001);B3、B4组患者术后△LogMAR明显高于A、B1、B2组(调整后均P<0.001)。B组患者术后眼压高于A组(P<0.001),且术后高眼压的比例更高(P=0.008)。结论:ICL-V4c植入术治疗SD≤-10 D以上的超高度近视是安全、有效的,远期效果需进一步观察;治疗-22~-16 D的超高度近视患者术后收益高于>-16~-6 D的患者。
Objective:To observe the safety and effectiveness of ICL-V4c implantation in the treatment of ultra-high myopia over-10 D,and to explore the relationship and rules between the improvement of vision(△LogMAR)and preoperative spherical diopter(SD).Methods:This was a retrospective study.Eight hundred and two patients(1380 eyes)with ultra-high myopia were treated by ICL-V4c implantation in Beijing Tongren Hospital from December 2016 to January 2020.The preoperative SD was-23.50 D≤SD≤-6.00 D(mean-11.54±3.59 D).The patients were divided into group A(-10 D<SD≤-6 D)and group B(-23.5 D≤SD≤-10 D)according to their preoperative SD.Group B was further divided into five sub groups:B1(-13 D<SD≤-10 D),B2(-16 D<SD≤-13 D),B3(-19 D<SD≤-16 D),B4(-22 D<SD≤-19 D)and B5(-23.5 D≤SD≤-22 D).The preoperative and postoperative visual acuity at 1 week and 2 months and improvement in visual acuity and intraocular pressure of the patients were analyzed by Kruskal-Wallis test and Chi-square test.Results:The postoperative SD and best corrected visual acuity(BCVA)of patients in group B were significantly improved(P<0.001).Both mean safety and effectivity indices were>1.There was a significant correlation between△LogMAR and group(P<0.001).△LogMAR in the B3 and B4 groups was significantly higher than that in A,B1 and B2 groups(adjusted,P<0.001).The intraocular pressure(IOP)in group B was higher than that in group A(P<0.001),and the proportion of postoperative high IOP was higher(P=0.008).Conclusions:ICL implantation is safe and effective for patients with ultra-high myopia over-10 D,but the long-term effect needs further explorations.The improvement of BCVA in patients with-22 D≤SD≤-16 D was higher than that of patients with-16 D<SD≤-6 D.
作者
熊瑛
孙秀丽
毛迎燕
李婧
曹凯
张景尚
王进达
万修华
Ying Xiong;Xiuli Sun;Yingyan Mao;Jing Li;Kai Cao;Jingshang Zhang;Jinda Wang;Xiuhua Wan(Beijing Institute of Ophthalmology,Beijing Tongren Eye Center,Beijing Key Laboratory of Ophthalmology and Visual Sciences,Beijing Tongren Hospital,Capital Medical University,Beijing 100005,China)
出处
《中华眼视光学与视觉科学杂志》
CAS
CSCD
2021年第4期292-297,共6页
Chinese Journal Of Optometry Ophthalmology And Visual Science
关键词
有晶状体眼后房型人工晶状体
中央孔型V4c疗效
超高度近视
屈光手术
posterior chamber intraocular lens of phakic eye
efficacy of central hole phakic implantable contact lens V4c
super-high myopia
refractive surgery