有晶状体眼人工晶状体不同植入方向旋转稳定性的比较

Comparison of Rotation Stability of Phakic Implantable Collamer Lens with Different Implantation Orientations

目的:比较水平、斜向、垂直植入有晶状体眼人工晶状体(ICL)及水平植入散光型人工晶状体(TICL)在术后1个月、1年的旋转稳定性。方法:回顾性临床研究。连续性收集2020年1月至2021年6月在郑州爱尔眼科医院屈光手术专科行ICL(V4c)植入术的屈光不正患者92例(184眼)。根据术后1 d的人工晶状体(IOL)轴向分为ICL水平组、ICL斜向组、ICL垂直组和TICL水平组,分别为59、33、36、56眼。记录术后1 d、1个月和1年的裸眼视力、眼压、拱高及IOL轴向等,并计算术后1个月、1年的有效性指数和IOL旋转角度和方向。4组间术后各时间点有效性指数、眼压等计量资料的比较采用重复测量方差分析,IOL旋转角度组间比较采用Kruskal-Wallis检验,IOL旋转方向组间比较采用Pearsonχ^(2)检验。采用Spearman秩相关分析及多元线性回归分析术后1年IOL旋转角度与年龄、性别等指标之间的相关性。结果:ICL水平组、ICL斜向组、ICL垂直组与TICL水平组在术后1个月、1年组间有效性指数、眼压、拱高及角膜内皮细胞密度差异均无统计学意义(均P>0.05)。在术后1个月、1年,4组间IOL旋转角度差异均无统计学意义(H=6.36,P=0.095;H=4.82,P=0.185);IOL旋转方向差异亦无统计学意义(χ^(2)=4.44,P=0.617;χ^(2)=6.03,P=0.420)。术后1年IOL旋转角度与患者年龄、性别等指标均无相关性(均P>0.05)。结论:ICL水平、斜向、垂直植入与TICL水平植入在术后1个月和1年均可获得相对一致的手术效果和旋转稳定性。

Objective:To compare the rotation stability of horizontal,oblique,vertical implantable collamer lens(ICL)implantation and horizontal Toric ICL(TICL)implantation at 1 month and 1 year after operation.Methods:This was a retrospective clinical study.One hundred and eighty-four eyes of 92 consecutive patients with refractive errors who underwent ICL(V4c)implantation in the refractive surgery department of Zhengzhou Aier Eye Hospital from January 2020 to June 2021 were collected,composed of 59 eyes in horizontal ICL group,33 eyes in oblique ICL group,36 eyes in vertical ICL group,and 56 eyes in horizontal TICL group according to the axial orientation of the lens on the first day after the operation.Uncorrected visual acuity,intraocular pressure,vault,and lens axial direction were recorded at 1 day,1 month,and 1 year after operation,and the effectiveness index,lens rotation angle,and lens rotation direction were further calculated.Analysis of variance of repeated measures was used for the data analysis.Kruskal-Wallis test was used to compare lens rotation angles among groups.Pearson Chi-square test was used to compare lens rotation direction among groups.Spearman rank correlation analysis and multiple linear regression analysis were used to explore the correlation of age,gender,and other indicators with the lens rotation angle at 1 year after operation.Results:There were no significant differences in the effectiveness index,intraocular pressure,vault,and endothelial cell density among horizontal ICL group,oblique ICL group,vertical ICL group,and horizontal TICL group at 1 month and 1 year after operation(all P>0.05).There were no significant differences in lens rotation angles among the four groups at 1 month and 1 year after operation(H=6.36,P=0.095;H=4.82,P=0.185).There were no significant differences in lens rotation direction among the four groups at 1 month and 1 year after operation(χ^(2)=4.44,P=0.617;χ^(2)=6.03,P=0.420).There had no correlations of age,gender,and other indicators with lens rotation angle at 1 year after operation(all P>0.05).Conclusion:Horizontal ICL,oblique,vertical implantation,and horizontal TICL implantation can achieve relatively consistent postoperative outcomes and rotational stability at 1 month and 1 year after operation.