ICL植入术后拱高大于1 000μm的中高度近视患者疗效观察

Observation on the efficacy of moderate and high myopia patients with vault greater than 1 000 μm after implantation of phakic posterior chamber implantable contact lens

摘要:

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1 000μm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1 000μm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1 000μm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。

Abstract:

AIM: To observe the efficacy of moderate and high myopia patients with vault greater than 1 000μm after implantation of phakic posterior chamber implantable contact lens(ICL).

METHODS: A total of 42 patients(73 eyes)who received ICL implantation in the hospital and had postoperative vault greater than 1 000 μm between January 2014 and January 2017 were selected and retrospectively studied. Changes in visual acuity, intraocular pressure, corneal endothelial cell density, anterior chamber-related parameters(chamber angle, central anterior chamber depth, anterior chamber volume)and vault were compared among patients before surgery, at 1, 3, 6mo and 1a after surgery and at the last follow-up.

RESULTS: The uncorrected visual acuity(UCVA)at 1, 3, 6mo and 1a after surgery and at the last follow-up was better than that before surgery(all P<0.05), and the chamber angle, central anterior chamber depth and anterior chamber volume were smaller or lower than those before surgery(all P<0.05), but there were no statistical differences in UCVA, chamber angle, central anterior chamber depth and anterior chamber volume at each time point after surgery(all P>0.05). The intraocular pressure at 1mo after surgery was lower than that before surgery(P<0.05), but the intraocular pressure at 3, 6mo and 1a after surgery and at the last follow-up was not statistically different from that before surgery(all P>0.05). There was no statistical significance in the corneal endothelial cell density at 1, 3, 6mo and 1a after surgery and at the last follow-up compared with that before surgery(all P>0.05). The vault at 1, 3, 6mo and 1a after surgery and at the last follow-up showed a decreasing trend, and the difference was statistically significant at each time point after surgery(all P<0.05).

CONCLUSION: The short-term and long-term efficacy are better in moderate and high myopia patients with vault greater than 1 000 μm after ICL implantation, and there are no significant effects on the intraocular pressure and corneal endothelial cell. The postoperative anterior chamber structure is relatively stable and the vault tends to decrease over time. In most cases, close observation is sufficient and intraocular lens replacement is generally not required.