[关键词]
[摘要]
后房型有晶状体眼人工晶状体(implantable collamer lens,ICL)及环曲面ICL(toric ICL,TICL)是目前临床上常用的可植入式人工晶状体,主要矫治高度近视以及角膜条件不适合角膜激光手术的中低度近视。术前精准的测量,术中安全的植入与术后合适的位置是保证ICL矫正效果的关键,且中央孔型V4c ICL的出现更大程度地保证了该手术的安全性。然而术后ICL及TICL在眼内的位置并非一成不变,有研究表明,ICL术后拱高有逐年降低的趋势,原因不明。TICL术后可发生自发旋转,引起视力的下降,是TICL更换的主因之一。术后中央孔的位置的变化也需要引起关注。此外,ICL/TICL植入术后术眼的视觉质量会发生改变,然而人工晶状体在眼内位置的变动是否会对术后的视觉质量造成影响,也是需要关注并探究的问题。因此本文将对ICL术后拱高的变化、TICL轴位的改变、ICL术后中央孔位置的变化及其原因,以及这些改变对术后视觉质量的影响进行综述,希望对术前ICL/TICL的精准选择以及手术设计有临床指导意义,提高ICL植入矫正近视屈光不正的有效性和稳定性。
[Key word]
[Abstract]
Implantable collamer lens(ICL)and toric ICL(TICL)are clinically common types of posterior chamber phakic intraocular lenses, they are mainly used to correct high myopia and low-to-moderate myopia of eyes whose corneal conditions are not suitable for corneal laser surgery. Accurate preoperative measurement, safe intraoperative implantation and appropriate postoperative location of lenses are critical to ensure the outcome of ICL implantable, and the appearance of V4c ICL with a central hole ensures the safety of this surgery to a greater extent. However, the intraocular position of both ICL and TICL is not invariable. Some studies have shown that the vault has a trend of decreasing year by year after ICL surgery, but its reason is unknown. And spontaneous rotation may occur after the TICL surgery, thereby causing visual loss, which is one of the main causes of TICL replacement. And postoperative changes in the position of the central hole also need attention. In addition, the visual quality of the operated eye will change after ICL/TICL implantation, but whether the change of intraocular positions of implanted lenses will affect the postoperative visual quality is also a problem that needs to be paid attention to and explored. Therefore, this paper reviewed the postoperative changes in vault, TICL axis, position of the central hole and their causes, as well as the effects of these changes on postoperative visual quality, offering valuable clinical guidance for accurate preoperative selection of ICL/TICL and surgical design, so as to improve the effectiveness and stability of ICL implantation in correction of myopic refractive error.
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