中心孔型有晶状体眼人工晶状体植入术治疗高度近视的疗效

Efficacy of implantable collamer lens V4c implantation in the treatment of high myopia

目的:观察中心孔型有晶状体眼人工晶状体(ICL V4c)植入术治疗高度近视的效果及对眼前节形态的改变。方法:前瞻性研究。选取2018-02/2021-03本院收治的高度近视患者100例200眼,均行ICL V4c植入术治疗。比较患者术前,术后6、12mo最佳矫正视力(BCVA)、裸眼视力(UCVA)、眼压、高阶像差、眼前节形态[前房角(ICA)、中央前房深度(ACD)、前房容积(ACV)、角膜厚度(CCT)、角膜曲率(K)]、明视与暗视下对比敏感度。结果:所有患者均完成随访。术后6、12mo UCVA、BCVA较术前明显改善(P<0.05);手术前后总高阶像差、水平彗差、垂直彗差比较均无差异(P>0.05),术后6、12mo球差、ICA、ACD、ACV均较术前明显减小(P<0.05);明视状态下,术后6、12mo 3.0、6.0c/d对比敏感度较术前明显增大(P<0.05);暗视状态下,术后6、12mo 6.0c/d对比敏感度较术前明显增大(P<0.05);手术前后CCT、K、眼压比较均无差异(P>0.05)。结论:ICL V4c植入术虽然减小了高度近视患者ICA、ACD、ACV,但能有效提高其视力与视觉质量。

AIM:To observe the effect of implantable collamer lens V4c(ICL V4c)implantation on high myopia,and the changes in anterior segment morphology.METHODS:A prospective study was conducted on 100 patients(200 eyes)with high myopia who were treated with ICL V4c implantation in the hospital from February 2018 to March 2021.The best corrected visual acuity(BCVA),uncorrected visual acuity(UCVA),intraocular pressure,higher-order aberration,anterior segment morphology\,photopic and scotopic contrast sensitivity before operation and 6 and 12mo after operation were comparatively analyzed.RESULTS:All patients were followed-up.UCVA and BCVA were significantly improved at 6 and 12mo after operation(P<0.05).Total higher-order aberration,horizontal coma and vertical coma showed no significant difference before and after operation(P>0.05).Spherical aberration,ICA,ACD and ACV at 6 and 12mo after operation were significantly smaller than those before operation(P<0.05).Under photopic state,the contrast sensitivity of 3.0 and 6.0 c/d was significantly higher at 6 and 12mo after operation when compared with that before operation(P<0.05).Under scotopic state,the contrast sensitivity of 6.0 c/d was significantly higher at 6 and 12mo after operation when compared with that before operation(P<0.05);there was no significant difference in CCT,K,or intraocular pressure before and after operation(P>0.05).CONCLUSION:Although ICA,ACD and ACV in patients with high myopia are reduced after ICL V4c implantation,the operation can effectively improve visual acuity and visual quality.