Clinical Effect Analysis of Posterior Chamber Intraocular Lens Implantation for Correcting High Myopia and Astigmatism

Objective:To explore the corrective effect of posterior chamber intraocular lens implantation with phakic eyes in the treatment of high myopia and astigmatism.Methods:From May 2023,the hospital began to collect the case data of diagnosis and treatment of high myopia and astigmatism.By May 2024,310 cases were included,all of which were treated with posterior chamber intraocular lens implantation.The visual acuity,astigmatism and axial position of the intraocular lens were observed before and after treatment.Results:At different time points after the operation,the patient’s vision was significantly improved compared with that before the operation(P<0.05),and the vision level was equal to or greater than the best-corrected vision before the operation.At different time points after the operation,the average rotation of the intraocular lens was less than 5 degrees.Astigmatism was significantly lower than that before the operation(P<0.05).After the operation,the intraocular pressure increased in 11 cases,accounting for 3.55%,with no adverse complications such as lens turbidity,glare and obvious halo occurring.Conclusion:The posterior chamber intraocular lens implantation with phakic eyes has an ideal correction effect in the treatment of high myopia and astigmatism,which can effectively improve the vision level of patients and reduce the degree of astigmatism,and has high effectiveness and safety.

New Management of Angle-closure Glaucoma by Phacoemulsification with Foldable Posterior Chamber Intraocular Lens Implantation

Objective:To investigate the management of angle-closure glaucoma by phacoemulsification with foldable posterior chamber intraocular lens(PC-IOL)implantation.Design:Retrospective,noncontrolled interventional case series.Participants:In36eyes with angle-closure glaucoma(ACG),there were18eyes with primary acute angle-closure glaucoma(PACG),14eyes with primary chronic angle-closure glaucoma(PCCG),3eyes with secondary acute angle-closure glaucoma(SACG)and 1eye with secondary chronic angle-closure glaucoma(SCCG).Intervention:Phacoemulsification with posterior chamber intraocular lens implantation.Main Outcome Measures:Postoperative visual acuity,IOP,axial anterior chamber depth.Results:After a mean postoperative follow-up time of 8.81±7.45months,intraocular pressure was reduced from a preoperative mean of 23.81±17.84mmHg to a postoperative mean of 12.54±4.73mmHg(P=0.001).Mean anterior hamber depth was1.75±0.48mm preoperatively and2.29±0.38mm postoperatively(P=0.000).Best spectacle-corrected visual acuith in 36eyes ranged from0.01to0.7(20/200to20/30)postoperatively,which was better than preoperative VA ranging from hand movement to 0.4(20/50)(P=0.000).Conclusion:Phacoemulsification with posterior chamber foldable intraocular lens implantation can be a good alternative in treating angle-closure glaucoma,Eye Science 2000;16:22-28.

New Management of Malignant Glaucoma by Phacoemulsification with Posterior Chamber Foldable Intraocular Lens Implantation

Objective:To investigate the feasibility of phacoemulsification with posterior chamber foldable intraocular lens implantation in the management of malignant glaucoma. Patients and Methods:Fourteen patients with malignant glaucoma diagnosed in the Department of Glaucoma were enrolled in the study.12 patients developed malignant glaucoma after filtration surgery.1 developed after peripheral iridectomy.1 patient developed malignant glaucoma without any clear cause.Cataract phacoemulsification was performed.Posterior chamber intraocular foldable lens was implanted in 10 cases of patients.Results:All 14 patients were cured wiht normal intraocular pressure,normal anterior chamber depth and increased visual acuity.Conclusion:Phacoemulsification with posterior chamber foldable intraocular lens implantation is a good alternative in treating malignant glaucoma.

A Clinical Analysis of 120 Cases with Traumatic Cataract Treated by Extracapsular Cataract Extraction and Posterior Chamber Intraocular Lens Implantation

Extracapsular cataract extraction was performed combined with posterior chamber intraocular lens implantation on 120 inpatients (122 eyes) with traumatic cataract from 1992 to 1997. The results revealed that this combined operation can make most of them get useful visual acuity, although they were often accompanied with several comlicated eye injuries. We think the most important thing is to choose suitable opertion time, the reasonable operation method and take close followup after operation.

Membrane Formation on the Surface of Implanted Posterior Chamber Intraocular Lenses

Purpose:To study the prevention and treatment of the membrane formation on the lens surface after extracapsular cataract extraction(ECCE)with posterior chamber intraocular lens(PCIOL)implantation.Methods:We reviewed the records of 312 cataractous patients that had undergone ECCEwith PCIOLimplantation between1989and1993,Postoperatively all pa-tients were examined under slit-lamp microscopy.The membrane formation on the surface of PCIOLin pupilar area was divided into four grades.Two mem-branes of surgical removal were observed under a transmission electrom mi-croscopy.One PCIOLof surgical removal was observed under a scanning electron microscopy.Results;Of312 patients,21 had the membrane formation on the surface of the PCIOL postoperatively.The incidence of the membrane formation was6.7%.Comparisone with cases of senile cataract showed the incidence to be significantly the highest among;1.patients who had traumatic cataract(P<0.05);2.pa-tients with complicated cataract(P<0.05).Interoperatively residual lens corten and rupture of posterior capsule,interval time betwwen the first and second eye operations less than 1month are the main factors of menbrane formation.The ultrastructure in membrane and cytology on the lens surface showed that the membrane on the surface of PCIOLs is usually composed of acellular protein film and cellular elements,including macrophages.fibroblast-like cells,epithelioid cells,giant cells,fibroblasts and collagen fibrils,etc.Conclusions:The cellular response on the surface of an implanted PCIOLis a chonic foreign-body inflammatory reaction and the membrane of the surfaceof implanted PCIOL is a reactive membrane of the foreign-body.Eye Science1995;11:131-135.

AcrySof phakic angle-supported intraocular lens for the correction of high to extremely high myopia:one-year follow-up results

AIM: To assess the safety, efficacy and predictability of the AcrySof phakic angle-supported intraocular lens (IOL) (Alcon Inc., U.S.A.) for correction of high-to-extremely high myopia in adults. METHODS: In this prospective study performed in Tianjin Medical University Eye Center & College of Optometry, Tianjin, China, 25 eyes of 13 patients were implanted with AcrySof phakic angle-supported IOLs and followed for 1 year postoperatively. Preoperative manifest refractive sphere was (-12.08 +/- 2.44) diopters (D) and cylinder was (-1.35 +/- 0.62)D. Visual acuity, predictability and stability of manifest refraction spherical equivalent (MRSE), adverse events, and endothelial cell density were analyzed during 1-year of follow-up. RESULTS: After 1 year of follow-up, no eyes lost 1 line (best spectacle-corrected visual acuity)BSCVA; an uncorrected visual acuity (UCVA) of 20/20 or better was achieved in 60% of eyes; 100% had an UCVA of 20/40 or better; a BSCVA of 20/30 or better was achieved by 100% of eyes; 84% had a BSCVA of 20/20 or better. The overall mean percentage change in endothelial cell density 1 year after surgery was (-0.27 +/- 3.60)%. Two eyes (8%) had increased intraocular pressure (IOP) on the day of surgery. No pupil ovalization, pupillary block, or retinal detachment events were observed. CONCLUSION: After 1 year of follow-up, the implantation of AcrySof phakic angle-supported IOL is proved to be safe, effective and predictable with minimal complications in patients with high-to-extremely high myopia. Due to the limitation of visiting time, long-term of clinical investigation is necessary to verify the safety and efficacy of this IOL.

Safety and visual outcomes following posterior chamber phakic intraocular lens bilensectomy

Background:To evaluate the safety,efficacy,refractive outcomes and causes for bilensectomy(phakic intraocular lens–pIOL–explantation with cataract surgery and pseudophakic intraocular lens implantation)in patients previously implanted with posterior chamber pIOLs.Methods:This multi-center retrospective study included 87 eyes of 55 patients who underwent bilensectomy for posterior chamber pIOL with a follow up time of 12 months.The uncorrected and best corrected distance visual acuities(UDVA,CDVA),endothelial cell density before and after bilensectomy were assessed,as well as the cause of bilensectomy and intra or postoperative complications.Results:There was a statistically significant improvement in uncorrected and best corrected visual acuities after bilensectomy(p=0.00).The main reason for bilensectomy was cataract development(93.1%of the cases),followed by miscalculation of lens size,and corneal edema.The endothelial cell count remained stable without a statistically significant change after surgery(p=0.67).The refractive efficacy index was 0.8,none of the patients lost lines of CDVA after surgery,73%of the patients were within±1 D(spherical equivalent)of the target refraction.Intraoperative complications were one posterior capsule rupture with the intraocular lens(IOL)implanted in the sulcus,and 3 eyes required the use of pupil expanders for adequate pupil dilation.Postoperatively,one eye developed retinal detachment.The three pIOLs models explanted were the Implantable Collamer Lens(ICL),Implantable Phakic Contact Lens(IPCL)and the Phakic Refractive Lens(PRL).Conclusions:Good safety and visual outcomes were observed 1 year after bilensectomy for posterior chamber phakic intraocular lenses(PC pIOLs).There were few intra and postoperative complications and there was no significant endothelial cell loss after the bilensectomy procedure.

Safety and visual outcomes following posterior chamber phakic intraocular lens bilensectomy

Background:To evaluate the safety,efficacy,refractive outcomes and causes for bilensectomy[phakic intraocular lens(plOL)explantation with cataract surgery and pseudophakic intraocular lens(IOL)implantation]in patients previously implanted with posterior chamber plOLs(PC plOLs).Methods:This multi-center retrospective study included 87 eyes of 55 patients who underwent bilensectomy for PC plOL with a follow-up time of 12 months.The uncorrected and corrected distance visual acuities(UDVA,CDVA),endothelial cell density before and after bilensectomy were assessed,as well as the cause of bilensectomy and intra or postoperative complications.Results:There was a statistically significant improvement in UDVA and CDVA after bilensectomy(P=0.00).The main reason for bilensectomy was cataract development(93.1%of the cases),followed by miscalculation of lens size,and corneal edema.The endothelial cell count remained stable without a statistically significant change after surgery(P=0.67).The refractive efficacy index was 0.8,none of the patients lost lines of CDVA after surgery,73%of the patients were within±1.0D(spherical equivalent)of the target refraction.Intraoperative complications were one posterior capsule rupture with the IOL implanted in the sulcus,and three eyes required the use of pupil expanders for adequate pupil dilation.Postoperatively,one eye developed retinal detachment.The three plOLs models explanted were the implantable collamer lens(ICL);implantable phakic contact lens(IPCL)and the phakic refractive lens(PRL).Conclusions:Good safety and visual outcomes were observed one year after bilensectomy for PC plOLs.There were few intra and postoperative complications and there was no significant endothelial cell loss after the bilensectomy procedure.

高度近视有晶状体眼后房型人工晶状体植入术后患者视力恢复的影响因素

目的 探讨高度近视有晶状体眼后房型人工晶状体(ICL)植入术后患者视力恢复的影响因素。方法 前瞻性研究。选取2021年5月至2023年3月郑州大学第二附属医院收治的210例(420眼)行ICL植入术的高度近视患者作为研究对象。根据术后3个月视力恢复情况将患者分为恢复良好组(最佳矫正视力恢复≥0.3 D)、恢复不良组(最佳矫正视力恢复<0.3 D)。比较两组患者基线资料,采用Logistic回归分析影响患者视力恢复的因素,采用受试者工作特征曲线(ROC)分析Logistic回归模型对高度近视患者ICL植入术后视力恢复不良的预测价值。结果 术后3个月,恢复良好组的患者共149例298眼,恢复不良组的患者共61例122眼。两组患者性别、年龄、近视年限、体重指数、学业情况比较,差异均无统计学意义(均为P>0.05)。恢复不良组患者角膜散光度<1.30 D占比(55.74%)、角膜屈光度<45 D占比(59.02%)、匹茨堡睡眠质量指数(PSQI)<7分占比(63.93%)、中央平均曲率半径[(7.82±0.27) mm],均低于恢复良好组[83.89%、81.88%、85.91%及(7.90±0.24)mm],角膜前表面中央扁平子午线曲率(k1)[(43.27±1.43)D]、角膜前表面陡峭子午线曲率(k2)[(44.84±1.53)D]、拱高[(628.49±67.28)μm]均高于恢复良好组[(42.73±1.42)D、(44.12±1.47)D、(417.56±80.14)μm],差异均有统计学意义(均为P<0.05)。Logistic回归分析结果显示,角膜散光度、角膜屈光度、k1、k2、拱高、睡眠PSQI评分均为高度近视患者ICL植入术后患者视力恢复不良的独立影响因素(均为P<0.05)。ROC曲线分析显示,Logistic回归模型预测高度近视患者ICL植入术后视力恢复不良的ROC曲线下面积为0.938(95%CI:0.896~0.966),敏感度为83.61%,特异度为91.95%(P<0.05)。结论 角膜散光度、角膜屈光度、k1、k2、拱高、睡眠PSQI评分等均可影响高度近视ICL植入术后患者视力恢复,基于上述因素构建的Logistic回归模型对ICL植入术后患者视力恢复有较高预测价值。

Dynamic assessment of variations in pupil diameter using swept-source anterior segment optical coherence tomography after phakic collamer lens implantation

Purpose To dynamically assess variations in pupil diameter induced by changes in brightness in myopic eyes implanted with an implantable collamer lens(ICL,STAAR Surgical)with a central port.Methods This prospective,observational single-center case series study comprised 65 eyes from 65 consecutive patients undergoing ICL implant.A modified commercially available swept-source Fourier-domain anterior segment optical coherence tomography(AS-OCT)device was used for imaging and performing dynamic pupillometry under changing light conditions before and after a mean follow-up interval of four months after surgery.Results Preoperative mean pupil size under photopic conditions was 3.38±0.64 mm;after surgery,this increased to 3.48±0.61 mm.Mean pupil size under scotopic light conditions was 5.72±0.79 mm before surgery and 5.84±0.77 mm postoperatively.The differences between preoperative and postoperative pupil diameter in miosis and mydriasis were 0.10±0.44 mm(P=0.078)and 0.12±0.58 mm(P=0.098),respectively.The scotopic pupil exceeded the optic zone of the implanted lens in 39 eyes(60%).The mean central vault value was 412±177μm under maximum miosis and 506±190μm under maximum mydriasis.We found a positive correlation between vault and differences in pupil diameter under all light conditions(P<0.05).Conclusion Dynamic AS-OCT enables a very precise determination of the pupillary diameter in the iris plane.The changes in the pupil diameter under different light conditions after the implantation of an ICL are related to the postoperative vault.

ICL植入术后拱高大于1000μm的中高度近视患者疗效观察

目的:观察有晶状体眼后房型人工晶状体(ICL)植入术后拱高大于1000μm的中高度近视患者的疗效。方法:回顾性研究。选择2014-01/2017-01在我院接受ICL植入术且术后拱高大于1000μm的中高度近视患者42例73眼。比较患者术前及术后1、3、6mo,1a以及末次随访时的视力、眼压、角膜内皮细胞密度、前房相关参数(房角、中央前房深度和前房容积)以及拱高的变化情况。结果:术后1、3、6mo,1a以及末次随访时的裸眼视力(UCVA)均优于术前(均P<0.05),房角、中央前房深度和前房容积均低于术前(均P<0.05),但术后各时间点的UCVA、房角、中央前房深度和前房容积比较均无差异(均P>0.05)。术后1mo时眼压低于术前(P<0.05),但术后3、6mo,1a以及末次随访时的眼压与术前比较均无差异(均P>0.05)。术后1、3、6mo,1a以及末次随访时的角膜内皮细胞密度与术前比较均无差异(均P>0.05)。术后1、3、6mo,1a以及末次随访时的拱高呈逐渐降低趋势,术后各时间点拱高比较均有差异(均P<0.05)。结论:ICL植入术后拱高大于1000μm的中高度近视患者的近远期疗效较好,对患者眼压、角膜内皮细胞无明显影响,术后前房结构较稳定,且拱高随时间推移呈下降趋势,密切观察即可,一般不需要更换。

20G灌注头辅助下无粘弹剂植入V4c-ICL矫正对高度近视早期调节功能的影响

目的:探讨20G灌注头辅助下无粘弹剂植入有晶状体眼后房型人工晶状体(V4c-ICL)对高度近视(HM)患者早期调节功能的影响。方法:选取HM患者493例(986眼)作为研究对象,按手术方式不同分为V4c-ICL植入术组(研究组,n=247)和全飞秒小切口基质透镜取出术(SMILE)组(对照组,n=246)。随访两组患者术前、术后1个月视力[裸眼视力(UDVA)、最佳矫正视力(BCVA)]、眼压、调节功能[正负相对调节(PRA/NRA)、单眼调节幅度(M-AMP)、远近水平隐斜、调节性集合与调节比值(AC/A)],行国家眼科研究所视功能问卷-25(NEI-VFQ-25)评分,记录并发症情况。结果:术后1个月,两组患者UDVA、BCVA均较术前升高,眼压降低(P<0.05),但两组间比较,差异无统计学意义(P>0.05);两组PRA、远近水平隐斜、AC/A比值较术前降低,M-AMP升高,其中研究组PRA、远水平隐斜、AC/A比值低于对照组,M-AMP高于对照组(P<0.05);两组NEI-VFQ-25评分均较术前升高(P<0.05),其中研究组除色觉(CV)维度外,其余各维度评分均高于对照组(P<0.05)。两组并发症总发生率比较,差异无统计学意义(P>0.05)。结论:SMILE与20G灌注头辅助下无粘弹剂下V4c-ICL矫治HM均可获得良好的术后视力,但相比SMILE,无粘弹剂下V4c-ICL可获得更好的双眼调节功能,改善患者视觉相关生活质量,值得临床优先选择。

超高度近视眼行有晶状体眼人工晶体植入术前后视网膜和脉络膜厚度及血流参数变化

目的通过光学相干断层扫描血管成像技术(OCTA)观察超高度近视眼行中央有孔型有晶状体眼后房型人工晶体前植入术(ICL-V4c)前后视网膜和脉络膜厚度、黄斑区及视盘旁视网膜血流密度的变化。方法选取2020年4月-2021年5月于首都医科大学附属北京同仁医院就诊且双眼等效球镜度(SE)≥±10.0 D的患者15例(30眼),所有眼均行ICL-V4c治疗。观察并比较患者术前及术后2 h、1周、1个月、9个月时视力、眼压的变化,并采用OCTA监测黄斑区视网膜和脉络膜厚度、黄斑区及视盘旁视网膜血流密度的变化。结果患者术后各时间点裸眼视力与术前最佳矫正视力比较差异无统计学意义(P>0.05);术后眼压呈下降趋势,但与术前比较差异无统计学意义(P>0.05);术后9个月拱高较术后1周降低,差异有统计学意义(P=0.002)。手术前后各时间点深层视网膜血流密度、黄斑区视网膜厚度、黄斑区脉络膜厚度、视盘旁放射状毛细血管网血流密度、神经纤维层厚度差异均无统计学意义(P>0.05),而术后2 h时,上下鼻颞4个方向的浅层视网膜血流密度均较术前明显下降,差异有统计学意义(P<0.05)。术后其余时间点各区域血流密度与术前比较差异均无统计学意义(P>0.05)。结论超高度近视眼行ICL-V4c植入术早期对浅层视网膜血流密度有影响,随时间延长可恢复至术前水平,对于黄斑部视网膜脉络膜厚度及深层视网膜血流密度、视盘旁毛细血管网血流密度和神经纤维层厚度无影响。

优化ICL V4c植入术的临床研究进展

随着有晶状体眼后房型人工晶状体植入术的发展及可植入式接触镜(ICL)的不断改进,ICL V4c植入术目前已经成为矫正中高度近视的主流术式之一。术后拱高是评价手术安全性的重要指标,在常规ICL V4c植入手术的基础上,如何优化手术以获得更理想的拱高是近年来学者们研究的热点。本文以术前检查、术中手术设计以及术后随访为中心,总结分析优化ICL V4c植入手术的方案,为提高手术安全性提供帮助。

有晶状体眼后房型人工晶状体植入术术前检查操作规范专家共识(2023)

目前有晶状体眼后房型人工晶状体植入术临床应用广泛, 其安全性、有效性和稳定性已被临床验证。作为眼内手术, 术中和术后可能存在潜在风险。术前检查是避免出现并发症, 保证手术安全的重要保障。本专家共识依据国内外的重要文献及循证医学证据对术前检查提出推荐意见, 即除了常规的眼部查体外, 还需进行如下检查:主导眼、屈光度检查、角膜厚度、角膜曲率、角膜水平白到白间距、睫状沟直径、前房深度、晶状体厚度及矢高、瞳孔直径及暗瞳的测量。由于屈光手术患者对术后效果及视觉质量要求较高, 因此, 有条件单位可根据患者情况做以下眼部检查:视觉质量相关检查、干眼相关检查、视功能相关检查。本共识旨在规范有晶状体眼后房型人工晶状体植入术的术前检查, 以期为该领域开展此项手术的眼科医师提供参考和帮助。

超高度近视有晶状体眼后房屈光晶状体植入术后拱高的影响因素分析

目的:探讨超高度近视有晶状体眼后房屈光晶状体植入术后拱高的影响因素。方法:回顾性病例研究。选取2019-01/2021-01于我院行PC-PRL植入术的超高度近视患者40例77眼。术后随访至少2a,评估裸眼视力(UCVA)、最佳矫正视力(BCVA)和中央前房深度(ACD)、前房容积(ACV)、前房角(ACA)、晶状体厚度及术后拱高等眼前节参数,分析术后拱高的影响因素。结果:PC-PRL植入术后纳入患者UCVA和BCVA均较术前显著改善(P<0.001),术后2a平均安全指数(术后BCVA/术前BCVA)为1.36±0.32,平均有效指数(术后UCVA/术前BCVA)为1.23±0.31。术后2a拱高与术前ACD、术前ACV、术前ACA及晶状体厚度均具有一定的相关性,其中术前ACV和晶状体厚度对术后2a拱高具有显著影响。结论:超高度近视PC-PRL植入术安全有效,可显著改善视力,术前ACV和晶状体厚度是影响术后拱高的重要因素。

PC-PRL植入术治疗超高度近视的研究进展

有晶状体眼后房型人工晶状体植入术是在后房植入有屈光力的人工晶状体来矫正屈光不正,其有效性、安全性、稳定性和可预测性高。依镜—有晶状体眼后房屈光晶状体(PC-PRL)是一种悬浮型人工晶状体,具有良好视觉效果、调节可得到维持、安全、可逆等优势,成为大多数高度、超高度近视患者的选择,术后的疗效受到越来多人的关注。此文就手术优势、晶状体的设计、术后的视力、屈光度、拱高、眼压、角膜内皮细胞计数、视觉质量及光学结果等方面作一概述。

二期张力环缝合固定治疗先天性晶状体不全脱位手术技术

先天性晶状体不全脱位是一种较为罕见的晶状体悬韧带异常的疾病,其手术治疗极具挑战性。以人工晶状体悬吊为代表的传统手术方式易出现囊袋破裂、玻璃体疝、人工晶状体脱位和继发性青光眼等严重并发症。近年来,以重建囊袋悬韧带隔为目标,新型囊袋辅助装置的应用极大程度提高了先天性晶状体不全脱位的手术成功率。然而,以改良式张力环为代表的囊袋辅助装置在我国仍难以得到普及且操作繁琐。因此,如何最大程度利用普通张力环等最常见的装备,设计出一种安全可靠手治疗先天性晶状体不全脱位的手术方式是眼科界亟待解决的问题。本文将介绍一种二期张力环缝合固定治疗先天性晶状体不全脱位手术技术。该技术仅需使用普通张力环,具有操作简单安全、术后效果稳定和易于技术推广的优点。

Dynamic assessment of variations in pupil diameter using swept‑source anterior segment optical coherence tomography after phakic collamer lens implantation

Purpose:To dynamically assess variations in pupil diameter induced by changes in brightness in myopic eyes implanted with an implantable collamer lens(ICL,STAAR Surgical)with a central port.Methods:This prospective,observational single-center case series study comprised 65 eyes from 65 consecutive patients undergoing ICL implant.A modified commercially available swept-source Fourier-domain anterior segment optical coherence tomography(AS-OCT)device was used for imaging and performing dynamic pupillometry under changing light conditions before and after a mean follow-up interval of four months after surgery.Results:Preoperative mean pupil size under photopic conditions was 3.38±0.64 mm;after surgery,this increased to 3.48±0.61 mm.Mean pupil size under scotopic light conditions was 5.72±0.79 mm before surgery and 5.84±0.77 mm postoperatively.The differences between preoperative and postoperative pupil diameter in miosis and mydriasis were 0.10±0.44 mm(P=0.078)and 0.12±0.58 mm(P=0.098),respectively.The scotopic pupil exceeded the optic zone of the implanted lens in 39 eyes(60%).The mean central vault value was 412±177μm under maximum miosis and 506±190μm under maximum mydriasis.We found a positive correlation between vault and differences in pupil diameter under all light conditions(P<0.05).Conclusion:Dynamic AS-OCT enables a very precise determination of the pupillary diameter in the iris plane.The changes in the pupil diameter under different light conditions after the implantation of an ICL are related to the postoperative vault.

ICL植入术矫正超高度近视的临床效果观察

目的:评估有晶状体眼后房型人工晶状体(ICL)矫正超高度近视的疗效及安全性。方法:对超高度近视患者20例40眼接受普通型ICL或散光型后房型人工晶状体(TICL)治疗,术前屈光度球镜-10.0～-18.0D,柱镜-0.25～-3.00D,等效球镜-15.32D,术后随访12mo,观察指标包括UCVA,BCVA、角膜地形图、主观和客观验光、角膜内皮细胞计数、眼压测量、裂隙灯检查。结果:术后12mo,裸眼视力≥0.8者占80.0%(32眼)。30.0%(12眼)的术眼BCVA较术前提高1行,15.0%(6眼)的术眼BCVA较术前提高2行。术后12mo术眼屈光度在±0.50D者达70.0%(28眼)。术前患者平均眼压为16±2.8mmHg,术后6mo平均眼压为17±3.4mmHg,术前术后相比较差异无显著性(t=0.518,P=0.776),术前患者角膜内皮细胞计数平均为2823±243.6个/mm2,术后6mo平均为2709±273.2个/mm2,术前术后比较无显著性差异(t=0.794,P=0.422)。未发生继发性青光眼、视网膜脱离及并发性白内障。结论:ICL植入术矫正超高度近视具有良好的疗效和安全性,远期效果有待进一步观察。