矢量分析法评价TICL V4c植入术矫正中高度近视合并高度散光的临床疗效

Vector analysis of toric implantable collamer lens V4c implantation in correcting moderate to high myopia with high astigmatism

摘要:

目的：采用矢量分析法和屈光矫正者生活质量(QIRC)量表评估散光型中央孔型有晶状体眼后房型人工晶状体(TICL V4c)矫正中高度近视合并高度散光的临床疗效。

方法：回顾性病例系列研究。选取2019-01/2022-12在我院眼科近视手术中心行TICL V4c植入术的中高度近视合并高度散光患者55例90眼。术后随访1 a，观察裸眼视力(UDVA)、最佳矫正视力(BCVA)、屈光度等情况，采用Alpins矢量分析法评估散光矫正效果，并采用QIRC量表评估患者的生活质量。

结果：术后1 a，98%术眼UDVA达到甚至优于术前BCVA，手术安全性指数为1.11±0.14，有效性指数为1.11±0.15； 97%术眼散光的误差角度在±15°以内，散光的矢量分析结果显示散光矫正指数为0.83±0.13，误差角度为1.00°±4.49°，成功指数为0.21±0.15。术后1 a，纳入患者6 mm瞳孔直径下角膜总高阶像差较术前明显增加(P<0.05)，QIRC量表总分明显高于术前(P<0.001)，且QIRC量表总分的增加量与术前球镜度数呈正相关(r_s=0.215，P<0.05)，提示术前近视程度越高，TICL植入术后生活质量提高越显著。

结论：TICL V4c植入术矫正中高度近视合并高度散光安全有效，且术后生活质量显著提高。

Abstract:

AIM: To evaluate the clinical effect of toric implantable collamer lens(TICL)V4c for correcting moderate to high myopia with high astigmatism using vector analysis and quality of life impact of refractive correction(QIRC).

METHODS: Retrospective case series. A total of 55 patients(90 eyes)with moderate to high myopia and high astigmatism who received TICL V4c implantation in the refraction surgery center of ophthalmology department in our hospital from January 2019 to December 2022 were collected. Followed-up for 1 a, the uncorrected distance visual acuity(UDVA), best corrected visual acuity(BCVA)and diopters were observed. Alpins vector analysis was used to evaluate the effect of astigmatism correction, and QIRC scale was used to evaluate patients' quality of life.

RESULTS: At 1 a postoperatively, the UDVA of 98% eyes was the same or better than pre-operative BCVA, the safety index was 1.11±0.14, and the efficacy index was 1.11±0.15. The angle of error of 97% of the astigmatic eyes was within ±15°. The results of vector analysis showed that correction index was 0.83±0.13, angle of error was 1.00±4.49°, and index of success was 0.21±0.15. The total higher order aberrations under a pupil diameter of 6 mm was significantly increased compared with preoperatively(P<0.05), the QIRC score was significantly better than that before surgery(P<0.001), and the increase of total QIRC scores was positively correlated with preoperative spherical equivalent(r_s=0.215, P<0.05), indicating that the higher degree of myopia before surgery the patients, the better the quality of life after TICL implantation.

CONCLUSION: TICL V4c implantation for the correction of moderate to high myopia with high astigmatism is safe and effective, and the patients' quality of life significantly improved after surgery.