近视患者晶状体参数与眼部解剖特征参数的关系

Relationship between lens parameters and ocular anatomical characteristics in myopia patients

目的:了解行有晶状体眼后房型人工晶状体植入术的近视患者晶状体参数与其眼部解剖特征参数的关系。方法:回顾性研究。收集2022-06/2023-06在无锡华厦眼科医院行有晶状体眼后房型人工晶状体植入术的近视患者46例46眼。术前评估眼部解剖特征参数包括角膜中央厚度(CCT)、前房深度(ACD)、眼轴长度(AL)等前后径,水平角膜直径(WTW)、水平沟到沟直径(STS_(H))、水平角到角直径(ATA_(H))等水平径,以及垂直沟到沟直径(STS_(V))、垂直角到角直径(ATA_(V))等垂直径,晶状体参数包括水平晶状体矢高(CLR_(H))、垂直晶状体矢高(CLR_(V))、水平晶状体厚度(LT_(H))、垂直晶状体厚度(LT_(V)),并分析上述参数的差异性、一致性及相关性。结果:除WTW与STS_(V)、STS_(H)与ATA_(V)无显著差异(均P>0.05)外,其余水平径与垂直径眼部解剖特征参数均有差异(P<0.05);CLR_(H)与CLR_(V)有显著差异(P<0.01),但LT_(H)与LT_(V)无差异(P>0.05)。Bland-Altman一致性分析结果显示,水平径、垂直径眼部解剖特征参数一致性较差;CLR_(H)与CLR_(V)一致性较差;LT_(H)与LT_(V)一致性较好,其差值的95%一致性界限(LoA)为-0.21-0.28 mm,95%LoA线外点比例为4.35%。Pearson相关性分析结果显示,水平径与垂直径眼部解剖特征参数间均有相关性(P<0.01),前后径参数均无相关性(P>0.05);除CLR_(H)与LT_(H)、LT_(V)无相关性外,其余晶状体参数均有相关性(P<0.05);AL与水平径和垂直径眼部解剖特征参数均具有相关性(P<0.05),但与晶状体参数均无相关性(P>0.05)。多元线性回归分析显示,LT=0.419+0.017×年龄-0.548×ACD+0.371×ATA_(H)+0.884×CLR_(V),CLR_(H)=-0.443+0.809×CLR_(V),CLR_(V)=-0.092-0.200×ATA_(H)+0.560×CLR_(H)(校正R 2=0.458、0.482、0.589)。结论:水平径、垂直径眼部解剖特征参数不可互相替代;CLR_(H)、CLR_(V)不可互相替代,而LT_(H)、LT_(V)可互相替代。部分晶状体参数、WTW、STS、ATA与ACD相关,而年龄、ACD、ATA_(H)、CLR_(V)是LT的影响因素。

AIM:To investigate the relationship among lens parameters and their correlation with ocular anatomic characteristics in myopia patients implanted with posterior-chamber phakic implantable collamer lens(Phakic-ICL).METHODS:Retrospective study.A total of 46 myopia patients(46 eyes)who underwent Phakic-ICL implantation were collected in the Wuxi Huaxia Eye Hospital from June 2022 to June 2023.Preoperative evaluation of ocular anatomical characteristics included corneal central thickness(CCT),anterior chamber depth(ACD),axial length(AL),white-to-white(WTW),horizontal sulcus to sulcus(STS_(H)),horizontal angle to angle(ATA_(H)),and vertical sulcus to sulcus(STS_(V)),vertical angle to angle(ATA_(V)).Furthermore,lens parameters included horizontal crystalline lens rise(CLR_(H)),vertical CLR(CLR_(V))and vertical lens thickness(LT_(V)).The difference,consistency and correlation of the above parameters were analyzed.RESULTS:Except for differences between WTW and STS_(V),STS_(H)and ATA_(V),which were not statistically significant(all P>0.05),the other horizontal and vertical ocular anatomical characteristics were statistically significant(P<0.05).CLR_(H)and CLR_(V)had statistically significant difference(P<0.01),while LT_(H)and LT_(V)were not statistically significant difference(P>0.05).Bland-Altman results revealed that the anatomical characteristics in the horizontal or vertical diameters showed poor consistency.The consistency between CLR_(H)and CLR_(V)was poor.There was consistency between LT_(H)and LT_(V),with the 95%limits of agreement(LoA)between the differences ranging from-0.21 to 0.28 mm,and the proportion of out-of-line points off the 95%LoA was 4.35%.Pearson correlation analysis revealed that there were correlations between the anatomical characteristics of the horizontal and vertical diameters(P<0.01).Meanwhile,there was no correlation between the anteroposterior diameters(P>0.05).There were correlations between the lens parameters(P<0.05),excepted for the CLR_(H),LT_(H)and LT_(V),which had no correlation.AL correlated with the anatomical characteristics of the horizontal and vertical diameters(P<0.05),but it had no correlation with lens parameters(P>0.05).Multiple linear regression analysis revealed that LT=0.419+0.017×age-0.548×ACD+0.371×ATA_(H)+0.884×CLR_(V),CLR_(H)=-0.443+0.809×CLR_(V),CLR_(V)=-0.092-0.200×ATA_(H)+0.560×CLR_(H)(corrected R 2=0.458,0.482,0.589,respectively).CONCLUSION:Horizontal and vertical diameters were not interchangeable.CLR_(H)and CLR_(V)were not interchangeable,while LT_(H)and LT_(V)were interchangeable.Partial lens parameters,WTW,STS,and ATA were correlated with ACD.Finally,age,ACD,ATA_(H),and CLR_(V)influenced LT.