高度近视患者晶状体眼后房型人工晶状体植入术后拱高的影响因素分析

Related Influencing Factors of Arch Height in Patients with High Myopia after PPC-ICL Implantation

【目的】探讨高度近视患者晶状体眼后房型人工晶状体(posterior chamber intraocularlens im-plantable collamer lens,PPC-ICL)植入术后拱高的影响因素。【方法】选取2016年5月至2018年1月在本院接受PPC-ICL植入术的高度近视患者,其中高拱高56例(58只眼,拱高>750 pm,高拱高组),低拱高64例(76只眼,拱高<250μm,低拱高组);另选取同期接受PPC-ICL植入术后随访拱高正常的140例(140眼)患者作为正常对照组。比较三组术前相关参数,多元回归分析高度近视患者PPC-ICL植入术后拱高变化的影响因素。【结果】三组患者年龄、等效球镜(Spherical equivalent,SE),睫状突高度(height of ciliary processes,T值)、平均角膜曲率(meankeratometry,Km)比较差异无统计学意义(P>0.05);但白到白距离(White-to-white distance,WTW)、后房角、前房深度(Anterior chamber depth.ACD).睫状沟到睫状沟水平间距(Sulcus-to-suleus,STS).晶状体厚度(Lens thickness,LT),ICL尺寸、眼轴长度(axial length,AL)比较差异有统计学意义(P<0.05)。多元逐步回归分析结果显示:WTW、ACD、STS、LT、ICL,尺寸均是异常拱高的独立影响因素(P<0.05);SE,STS则是PPC-ICL,植入术后拱高变化量的独立影响因素(P<0.05)。【结论】高度近视患者PPC-ICL植入术后异常拱高与术前WTW、ACD、STS、LT、ICL尺寸等参数有关。且拱高变化量与SE.STS水平距离密切相关。

【Objective】To explore the influencing factors of arch height changes in patients with high myo pia after phakic posterior chamber implantable contact lens(PPC-ICL)implantation.【Methods】Patients with high myopia who underwent PPC-ICL implantation in our hospital from May 2016 to January 2018 were recruited as study subjects,including 56 cases(58 eyes)with high arch height (>750/μm.the high arch height group)and 64 cases(76 eyes)with low arch height(<250μm the low arch height group).Meanwhile,140 patients(140 eyes)with normal arch height were selected as the healthy control group.The preoperative relat ed parameters were compared among the three groups.Multivariate regression analysis of arch height changes in patients with high myopia after PPC-ICL implantation was performed.【Results】There were no significant differences in age,spherical equivalent(SE),height of ciliary processes(T value)and mean keratometry(Km)among the three groups(P>0.05),however,the differences in white-to-white distance(WTW),posterior angle,anterior chamber depth(ACD),horizontal distance of sulcus-to-sulcus(STS),lens thickness(LT),ICL size and axial length(AL)were statistically significant(P<0.05)among groups.Multivariate lo gistic regression analysis showed that WTW,ACD,horizontal and vertical distance of STS,LT and ICL size were independent influencing factors of abnormal arch height(P<0.05).SE and horizontal distance of STS were independent influencing factors of arch height variation after PPC-ICL implantation(P<0.05).【Conclusion】The abnormal arch height in high myopia patients after PPC-ICL implantation is related to multiple parameters such as preoperative WTW,ACD,STS,LT and ICL size.The arch height variation is closely related to SE and horizontal distance of STS.