光照强度对有晶状体眼人工晶状体植入术后拱高的影响

The influence of lighting conditions on vault in eyes with implantable collamer lens

目的分析有晶状体眼人工晶状体(ICL)植入术后不同光照强度下拱高的变化情况。方法前瞻性临床研究。纳入郑州爱尔眼科医院2020年6月至2020年9月ICL(V4c)植入术61例(117眼),采用自身对照的方法,根据光照强度分为暗环境组(2 lux)、常规环境组(60 lux)和明环境组(600 lux),以海德堡OCT的眼前节模块测量瞳孔直径及拱高,并根据常规环境组的拱高分为低拱高组(≤250μm)、中低拱高组(251~500μm)、中高拱高组(501~750μm)和高拱高组(>750μm)。分别比较常规环境组与暗环境组、明环境组瞳孔直径和拱高的差异。结果各拱高组的暗环境下瞳孔直径均大于常规环境下者,明环境下瞳孔直径均小于常规环境下者,差异均有统计学意义(P<0.05)。在不同光照强度下,各拱高组均未发生ICL接触晶状体的情况。低拱高组,暗环境下拱高大于常规环境下者(t=2.795,P=0.019),明环境下拱高小于常规环境下者(t=2.516,P=0.031);中低拱高组、中高拱高组及高拱高组,暗环境下拱高与常规环境下者差异均无统计学意义(t=1.924,1.772,0.821;P=0.062,0.082,0.425),明环境下拱高均小于常规环境下者(t=7.456,10.644,7.894;均P<0.001)。结论ICL植入术后拱高受光照强度的影响,但是其动态变化仍可保持在相对安全的范围之内。

Objective To analyze the changes of vault under different lighting conditions in eyes with implantable collamer lens(ICL).Methods This was a prospective clinical study.Total of 117 eyes of 61 patients with ICL(V4c)implantation in Zhengzhou Aier Eye Hospital from Jun.2020 to Sep.2020 were collected.All cases were divided into dark environment(2 lux)group,conventional environment(60 lux)group and bright environment(600 lux)group based on the lighting conditions.The pupil diameter and vault were measured with the anterior segment module of Heidelberg optical coherence tomography.According to the vault of the conventional environment group,the eyes were further divided into low vault(≤250μm)group,medium low vault(251-500μm)group,medium high vault(501-750μm)group and high vault(>750μm)group.Compared to the conventional environment group,the pupil diameter and vault of the dark environment group and the bright environment group were analyzed.Results The pupil diameter of each vault group in dark environment was larger than that in conventional environment,and that in bright environment was smaller than that in conventional environment.And the differences were statistically significant(P<0.05).There was no ICL contact with the lens in each vault group under different lighting conditions.In the low vault group,the vault was greater in dark environment than that in conventional environment(t=2.795,P=0.019),and the vault in bright environment was less than that in conventional environment(t=2.516,P=0.031).And the differences were statistically significant.In the medium low vault group,medium high vault group and high vault group,there was no significant difference between vault in dark environment and that in normal environment(t=1.924,1.772,0.821;P=0.062,0.082,0.425),but the vault in bright environment was lower than that in normal environment(t=7.456,10.644,7.894;all P<0.001).Conclusion The vault in eyes with ICL can be affected by lighting conditions,but its dynamic changes can still be kept within a relatively safe range.