目的：研究基于超声生物显微镜(UBM)测量的睫状沟直径(STS)等数据选择有晶状体眼后房型人工晶状体(ICL)尺寸对术后拱高的安全性及有效性的影响，同时探讨影响拱高的相关因素。

方法：前瞻性病例观察研究。选取福州眼科医院2022-01/12收治的行ICL植入术并规律复查6 mo的患者，纳入进行ICL尺寸优化的95例188眼屈光不正患者为优化组； 未进行ICL尺寸优化的90例174眼屈光不正患者为普通组。分别于术后1 d，1 wk，1、3、6 mo进行随访，收集裸眼视力(UCVA)、最佳矫正视力(BCVA)、屈光情况、眼压(IOP)、角膜情况、前房深度(ACD)、房角开放度、拱高、角膜内皮细胞计数等资料。

结果：两组术后等效球镜、UCVA、BCVA组间比较无差异(均P>0.05)。优化组和普通组患者术后6 mo的视力安全指数分别为1.21±0.24、1.19±0.21，视力疗效指数分别为1.18±0.22、1.07±0.26。两组患者术后6 mo拱高分别为407.77±159.31、467.16±250.07 μm，优化组92.0%眼术后拱高达到理想状态，普通组74.1%眼术后拱高达到理想状态； 两组患者术后拱高随时间有轻微下降趋势，组间比较无差异(F_组间=3.478，P_组间=0.063)。普通组术后存在6眼ICL置换、2眼因房角关闭诱发急性闭角型青光眼而导致ICL取出的病例。

结论：基于UBM测量的STS等数据选择ICL尺寸并设计植入方向，具有良好的安全性、有效性和拱高可预测性。

METHODS: Prospective case observational study. A total of 95 patients(188 eyes)with ametropia who underwent ICL size optimization and 90 patients(174 eyes)without ICL size optimization, from January to December 2022 and underwent regular follow-up for 6 mo were selected. Patients were divided into an optimized group and a standard group based on whether ICL size optimization was performed. The patients were followed up at 1 d, 1 wk, 1, 3, and 6 mo, and uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), refraction state, intraocular pressure(IOP), corneal status, anterior chamber depth(ACD), angle opening, vaults and corneal endothelial cell count were collected.

RESULTS: No significant difference in spherical equivalent, UCVA and BCVA was found between the two groups(all P >0.05). The safety index was 1.21±0.24 and 1.19±0.21 at 6 mo for the two groups, respectively, while the efficacy index were 1.18±0.22 and 1.07±0.26. The vaults at 6 mo for the two groups was 407.77±159.31 and 467.16±250.07 μm, respectively. In the optimization group, 92.0% of eyes achieved the desired vaults postoperatively, while 74.1% of eyes in the standard group reached the desired vaults. Both groups exhibited a slight downward trend in vaults over time, with no significant differences between the two groups(F=3.478, P=0.063). However, the standard group experienced 6 eyes of ICL replacement and 2 eyes of ICL removal due to acute angle-closure glaucoma induced by angle closure.

CONCLUSION: Selecting the ICL size and determining the implantation orientation based on sulcus to sulcus(STS)and other data measured by UBM provides good safety, efficacy, and predictability for postoperative vaults.