有晶状体眼后房型人工晶体旋转稳定性的眼内影响因素研究

Study on factors influencing rotation stability of posterior chamber intraocular lens implantation with crystal eye

目的量化观察有晶体眼后房型人工晶体(ICL/TICL)植入术后眼内的相应解剖结构指标的变化,观察ICL/TICL与眼内结构即前房、虹膜、睫状沟、晶状体之间位置的关系,以期发现影响ICL/TICL在眼内长期稳定性的眼内因素。方法回顾性分析行ICL/TICL植入术的28例(41只眼)患者的临床资料。术后1年,利用散瞳裂隙灯显微镜观察ICL/TICL的旋转程度(ICL与0°轴位的偏差;TICL与预定轴位的偏差),将患者分为A组(ICL/TICL旋转角度<10°组,16例,24只眼)和B组(ICL/TICL旋转角度≥10°组,12例,17只眼)。分析两组的各项生物测量指标。结果B组的角膜水平直径(白到白距离)、水平睫状沟距离、垂直睫状沟距离、ICL/TICL长度均大于A组(P<0.05)。ICL长度与术前的角膜水平直径(白到白距离)、水平睫状沟距离、垂直睫状沟距离有相关性(P<0.05)。结论较大的角膜水平直径、水平睫状沟距离、垂直睫状沟距离可能是长期ICL旋转稳定性差的影响因素,提示对于具有上述特征的患眼,选择ICL型号时可能需考虑适当增加其长度,提升稳定性。

Objective To quantitatively observe the changes of the corresponding intraocular anatomical structure indexes in the eye after implantable collamer lens/toric implantable collamer lens(ICL/TICL),and observe the relationship between the position of ICL/TICL and intraocular structures,namely anterior chamber,iris,ciliary groove and lens,in order to find the intraocular structural factors affecting the long-term stability of ICL/TICL in the eye.Methods The clinical data of 28 patients(41 eyes)who underwent ICL/TICL implantation were analyzed retrospectively.One year after operation,the rotation degree of ICL/TICL(the deviation between ICL and 0°axis position;the deviation between TICL and predetermined axis position)was observed under mydriatic slit lamp microscope,and the patients were divided into group A(ICL/TICL rotation angle<10°group,16 cases,24 eyes)and group B(ICL/TICL rotation angle≥10°group,12 cases,17 eyes).The biometric indexes between the two groups were analyzed.Results The corneal horizontal diameter(white-to-white distance),horizontal ciliary sulcus distance,vertical ciliary sulcus distance and ICL/TICL length in the group B were greater than those in the group A(P<0.05).The length of ICL was correlated with the corneal horizontal diameter(white-to-white distance),horizontal ciliary sulcus distance,vertical ciliary sulcus distance before operation(P<0.05).Conclusion Large corneal horizontal diameter,horizontal ciliary sulcus distance and vertical ciliary sulcus distance may be the influencing factors for the poor rotation stability of ICL in the long term,suggesting that the length of ICL should be appropriately increased to improve the stability of the affected eyes with the above characteristics.