中华眼科杂志
中華眼科雜誌
중화안과잡지
Chinese Journal of Ophthalmology
2009年
10期
908-912
,共5页
汪晓宇%沈晔%杜持新%李毓敏%董映
汪曉宇%瀋曄%杜持新%李毓敏%董映
왕효우%침엽%두지신%리육민%동영
有晶状体眼%人工晶状体植入术%前房%显微镜检查%声学
有晶狀體眼%人工晶狀體植入術%前房%顯微鏡檢查%聲學
유정상체안%인공정상체식입술%전방%현미경검사%성학
Phakic%intraocular lenses%Anterior chamber%Microscopy%acoustic
目的 应用超声活体显微镜(UBM)评价有晶状体眼后房型人工晶状体(ICL)植入术后前房及前房角的变化.方法 前瞻性系列病例研究.分析15例(30只眼)高度近视患者术前及ICL植入术后1周、1、3、6个月及1年的眼压变化;末次随访(术后1年)时行UBM检查,测最中央前房深度(ACD)、ICL后表面与晶状体之间的距离、小梁虹膜夹角,ICL周边部与晶状体之间的距离.小梁虹膜夹角比较则采用非参数检验;ICL周边部与晶状体之间的距离采用One-way ANOVA分析;术前术后各时间点的眼压比较采用重复测量方差分析和Bonferroni检验;中央ACD比较采用配对t检验.结果 术前眼压为(13.75±2.27)mm Hg(1 mm Hg=0.133 kPa),术后1周、1个月、3个月、6个月及1年时眼压分别为(14.27±1.70)mm Hg、(14.70±2.07)mm Hg、(14.07±2.24)mm Hg、(14.00±2.69)mm Hg和(13.97±2.95)mm Hg,术前及术后各次眼压间进行比较,发现仅术后1个月时眼压与术前、术后3个月时眼压比较差异有统计学意义(t=-3.706、3.898,P<0.05).UBM检查发现中央角膜内表面与晶状体之间的距离为(2.97±0.11)mm,中央角膜内表面与ICL之间的距离为(2.24±0.21)mm,两者之间差异有统计学意义(t=20.63,P<0.01).小梁虹膜夹角在钟表位12:00、3:00、6:00、9:00位差异无统计学意义,仅55.8%手术眼的小梁虹膜夹角>30°,ICL周边部与晶状体之间的距离在钟表位12:00、3:00、6:00、9:00位差异无统计学意义.ICL后表面与晶状体之间的距离为(0.63±0.16)mm,ICL与晶状体无接触.结论 ICL植入术后ICL位于晶状体前,致使术后中央ACD变浅、部分手术眼前房角宽度变窄.ICL与晶状体无接触,与虹膜后表面接触.
目的 應用超聲活體顯微鏡(UBM)評價有晶狀體眼後房型人工晶狀體(ICL)植入術後前房及前房角的變化.方法 前瞻性繫列病例研究.分析15例(30隻眼)高度近視患者術前及ICL植入術後1週、1、3、6箇月及1年的眼壓變化;末次隨訪(術後1年)時行UBM檢查,測最中央前房深度(ACD)、ICL後錶麵與晶狀體之間的距離、小樑虹膜夾角,ICL週邊部與晶狀體之間的距離.小樑虹膜夾角比較則採用非參數檢驗;ICL週邊部與晶狀體之間的距離採用One-way ANOVA分析;術前術後各時間點的眼壓比較採用重複測量方差分析和Bonferroni檢驗;中央ACD比較採用配對t檢驗.結果 術前眼壓為(13.75±2.27)mm Hg(1 mm Hg=0.133 kPa),術後1週、1箇月、3箇月、6箇月及1年時眼壓分彆為(14.27±1.70)mm Hg、(14.70±2.07)mm Hg、(14.07±2.24)mm Hg、(14.00±2.69)mm Hg和(13.97±2.95)mm Hg,術前及術後各次眼壓間進行比較,髮現僅術後1箇月時眼壓與術前、術後3箇月時眼壓比較差異有統計學意義(t=-3.706、3.898,P<0.05).UBM檢查髮現中央角膜內錶麵與晶狀體之間的距離為(2.97±0.11)mm,中央角膜內錶麵與ICL之間的距離為(2.24±0.21)mm,兩者之間差異有統計學意義(t=20.63,P<0.01).小樑虹膜夾角在鐘錶位12:00、3:00、6:00、9:00位差異無統計學意義,僅55.8%手術眼的小樑虹膜夾角>30°,ICL週邊部與晶狀體之間的距離在鐘錶位12:00、3:00、6:00、9:00位差異無統計學意義.ICL後錶麵與晶狀體之間的距離為(0.63±0.16)mm,ICL與晶狀體無接觸.結論 ICL植入術後ICL位于晶狀體前,緻使術後中央ACD變淺、部分手術眼前房角寬度變窄.ICL與晶狀體無接觸,與虹膜後錶麵接觸.
목적 응용초성활체현미경(UBM)평개유정상체안후방형인공정상체(ICL)식입술후전방급전방각적변화.방법 전첨성계렬병례연구.분석15례(30지안)고도근시환자술전급ICL식입술후1주、1、3、6개월급1년적안압변화;말차수방(술후1년)시행UBM검사,측최중앙전방심도(ACD)、ICL후표면여정상체지간적거리、소량홍막협각,ICL주변부여정상체지간적거리.소량홍막협각비교칙채용비삼수검험;ICL주변부여정상체지간적거리채용One-way ANOVA분석;술전술후각시간점적안압비교채용중복측량방차분석화Bonferroni검험;중앙ACD비교채용배대t검험.결과 술전안압위(13.75±2.27)mm Hg(1 mm Hg=0.133 kPa),술후1주、1개월、3개월、6개월급1년시안압분별위(14.27±1.70)mm Hg、(14.70±2.07)mm Hg、(14.07±2.24)mm Hg、(14.00±2.69)mm Hg화(13.97±2.95)mm Hg,술전급술후각차안압간진행비교,발현부술후1개월시안압여술전、술후3개월시안압비교차이유통계학의의(t=-3.706、3.898,P<0.05).UBM검사발현중앙각막내표면여정상체지간적거리위(2.97±0.11)mm,중앙각막내표면여ICL지간적거리위(2.24±0.21)mm,량자지간차이유통계학의의(t=20.63,P<0.01).소량홍막협각재종표위12:00、3:00、6:00、9:00위차이무통계학의의,부55.8%수술안적소량홍막협각>30°,ICL주변부여정상체지간적거리재종표위12:00、3:00、6:00、9:00위차이무통계학의의.ICL후표면여정상체지간적거리위(0.63±0.16)mm,ICL여정상체무접촉.결론 ICL식입술후ICL위우정상체전,치사술후중앙ACD변천、부분수술안전방각관도변착.ICL여정상체무접촉,여홍막후표면접촉.
Objective To study the changes of anterior chamber and chamber angle structures after implantable contact lens (ICL) implantation in high myopia by using ultrasound biomicroscopy (UBM).Methods A prospective series case study was conducted on 15 high myopia patients (30 eyes) treated with ICL implant.These patients were followed for one year postoperatively.Intraocular pressure (IOP) was measured by Goldmann applanation tonometer after surgery.All eyes were examined by UBM one year after the surgery.Central anterior chamber depth (ACD), trabecular-iris angle (TIA), the distance between the posterior surface of ICL and the lens and the distance between peripheral surface of ICL and the lens were measured.Nonparametric test was used to compare TIA.One-way ANOVA was used to assess the distance between peripheral surface of ICL and the lens.Repeated Measure ANOVA and Bonferroni test was performed to compare the IOP level before and after surgery.Paired t-test was used to compare ACD.Results Intraocular pressure changed from (13.75±2.27) mm Hg(1 mm Hg=0.133 kPa) preoperatively to (14.27±1.70), (14.70±2.07), (14.07±2.24), (14.00±2.69) and (13.97±2.95) mm Hg at 1 week, 1,3, 6 and 12 months after the surgery, respectively.There was a statistically significant increase of the IOP one month after the surgery, which was normalized completely at 3 months after surgery.The distances between central posterior surface of the cornea to the ICL and the lens were (2.24±0.21 ) and (2.97±0.11) mm, respectively.There was significant difference between these two data (t=20.63, P< 0.01).TIA was measured in 12: 00, 3: 00, 6:00 and 9: 00.There were no statistically differences between them.TIA was greater than 30 degree in 55.8% of cases.The distance between the central anterior surface of the ICL to the lens (central section) was (0.63±0.16)mm.No contact was found between the ICL and the crystalline lens.Conclusions Posterior chamber phakic intraccular lens implantation for the surgical correction of high myopia is a safe procedure as evaluated with immediate visual and refractive results.We found that the iridocorneal angle and the anterior chamber depth are decreased after the surgery.There is no contact between the crystalline leas and ICL.The ICL contacts with the posterior iris surface.
