ICL植入术后晶体更换的原因分析

Analysis of the causes of intraocular lens replacement after implantable collamer lens implantation

目的:分析有晶状体眼后房型人工晶体(ICL)植入术后晶体更换的原因。方法:根据患者的拱高及房角情况,对拱高异常的ICL患者进行晶体更换,收集术前、术后及更换术后3个月的资料,分析可能导致晶体更换的原因。结果:回顾性分析ICL植入术96例(186眼)因拱高问题行人工晶体更换7例(7眼),其中4眼为拱高过低,3眼为拱高过高。导致拱高过低的原因包括角膜水平直径(WTW)测量偏小、ICL型号选择偏小。导致拱高过高的原因包括WTW测量偏大和位于人工晶体襻固定位置的睫状体囊肿。观察期间未发现前囊下白内障或其他严重并发症。结论:ICL植入术后晶体更换的主要原因有测量误差、晶体型号选择不当、睫状体结构异常等,术前精准检查测量是解决问题的关键。

Objective: To analyze the causes of lens replacement after implantable collamer lens(ICL) implantation. Methods: According to the vault and anterior chamber angle, the patients were replaced with intraocularlens. The clinical data of the patients before operation, after ICL implantation and 3 months after ICL replacement were collected, and the possible causes of intraocularlens replacement were analyzed. Results: A total of 96 patients(186 eyes) received ICL implantation, and 7 patients(7 eyes) underwent lens replacement, among which 4 eyes were due to low vault and 3 eyes were due to vault height. The causes leading to low vault included low WTW distance measurement and small ICL model. The causes leading to high vault included high WTW distance measurement and ciliary body cysts located at the position where the haptics of the ICL wereplaced. No subcapsular cataract or other serious complications were found during the observation. Conclusion: The main reasons for crystal replacement after ICL implantation are measurement error, improper model selection, abnormal ciliary structure, etc. Accurate preoperative inspection and measurement is the key to solve the problem.