CAJ | 학술논문

背景矫正近视的手术可分为激光矫治术和人工晶状体(IOL)植入术.高度近视患者角膜比正常人薄,不适合激光矫治手术,宜考虑IOL植入术.目的对比观察两种有晶状体眼IOL植入术治疗高度近视的视觉质量.方法选取在郑州大学第一附属医院和解放军第91中心医院行前房虹膜夹型人工晶状体(Verisyse PIOL)植入术的高度近视患者19例34眼随机分为两种手术组,其中10例17眼为PIOL组,行后房型人工晶状体(ICL)植入术者9例17眼为ICL组.两种手术均由同一高年资医师完成.随访期为6个月,观察患者术后的裸眼视力、最佳矫正视力、对比敏感度(CS)和波前像差,对2组的检测指标进行比较.结果术后6个月2组间患者裸眼视力和最佳矫正视力的差异均无统计学意义(t=0.489,P>0.05;t=0.853,P>0.05);2组患者间无眩光时在3、6、12、18 c/d空间频率下CS的差异均无统计学意义(t=0.906,P>0.05;t=0.103,P>0.05;t=0.694,P>0.05;t=1.583,P>0.05);3、6、12、18 c/d空间频率下2组间患者的眩光敏感度比较差异均无统计学意义(t=0.323,P>0.05;t=0.041,P>0.05;t=0.024,P>0.05;t=0.363,P>0.05).PIOL组三阶彗差(RMS3)、四阶球差(RMS4)、总高阶像差(RMSh)均高于ICL组.其中RMS3、RMSh明显高于ICL组,差异均有统计学意义(t=11.400,P<0.05;t=11.350,P<0.05).2组间 RMS4 的差异无统计学意义(t:0.240,P>0.05).结论虹膜夹型IOL与ICL植入矫正高度近视均能达到预期的效果,术后视力相当,但虹膜夹型IOL的视觉质量稍逊于ICL,远期效果还需进一步随访观察.
배경 교정근시적수술가분위격광교치술화인공정상체(IOL)식입술.고도근시환자각막비정상인박,불괄합격광교치수술,의고필IOL식입술.목적 대비관찰량충유정상체안IOL식입술치료고도근시적시각질량.방법선취재정주대학제일부속의원화해방군제91중심의원행전방홍막협형인공정상체(Verisyse PIOL)식입술적고도근시환자19례34안수궤분위량충수술조,기중10례17안위PIOL조,행후방형인공정상체(ICL)식입술자9례17안위ICL조.량충수술균유동일고년자의사완성.수방기위6개월,관찰환자술후적라안시력、최가교정시력、대비민감도(CS)화파전상차,대2조적검측지표진행비교.결과술후6개월2조간환자라안시력화최가교정시력적차이균무통계학의의(t=0.489,P>0.05;t=0.853,P>0.05);2조환자간무현광시재3、6、12、18 c/d공간빈솔하CS적차이균무통계학의의(t=0.906,P>0.05;t=0.103,P>0.05;t=0.694,P>0.05;t=1.583,P>0.05);3、6、12、18 c/d공간빈솔하2조간환자적현광민감도비교차이균무통계학의의(t=0.323,P>0.05;t=0.041,P>0.05;t=0.024,P>0.05;t=0.363,P>0.05).PIOL조삼계혜차(RMS3)、사계구차(RMS4)、총고계상차(RMSh)균고우ICL조.기중RMS3、RMSh명현고우ICL조,차이균유통계학의의(t=11.400,P<0.05;t=11.350,P<0.05).2조간 RMS4 적차이무통계학의의(t:0.240,P>0.05).결론홍막협형IOL여ICL식입교정고도근시균능체도예기적효과,술후시력상당,단홍막협형IOL적시각질량초손우ICL,원기효과환수진일보수방관찰.
Background High myopia can be corrected using laser therapy and intraocular lens(IOL)implantation.IOL implantation is more suitable than laser therapy for high myopia if the patients suffer from thinner cornea.Objective This clinical trail was to assess and compare the visual quality following phakic iris-claw intraocular lens (IOL) and implantable contact lens(ICL) implantation for high myopia.MethodsIris-claw phakic intraocular lens was implanted in 17 eyes of 10 patients with high myopia,and age-,refractive-matched 17 eyes of 9 patients were in implantable contact lens (ICL) implantation group.Uncorrected visual acuity,best correct visual acuity,contrast sensitivity under the 3,6,12 and 18 c/d spatial frequencies,wave-front aberrations,including RMS3,RMS4 and RMSh,were examined in 6 months after operation.Written informed consent was obtained from each patient before surgery.Results There were no significant difference in uncorrected visual acuity,best correct visual acuity between two groups(t=0.489,P>0.05;t=0.853,P>0.05).Non-glare CS under the 3 c/d,6 c/d,12 c/d and 18 c/d spatial frequencies were insignificantly different between two groups ( t = 0. 906, P > 0.05 ; t = 0. 103, P > 0. 05 ; t =0. 694 ,P>0. 05 ; t = 1. 583, P>0. 05), and the similar outcomes were found in glare CS ( t = 0. 323, P>0.05, t =0.041 ,P>0. 05, t = 0.024, P>0. 05; t = 0. 363, P>0.05) in postoperative 6 months. RMS3 and RMSh were significantly elevated in PIOL group compared with ICL group ( t = 11.40, P< 0. 05 ; t = 11.35, P < 0.05), but no evident difference was found in RMS4 between two groups( t = 0. 24,P>0. 05). Conclusion Both PIOL and ICL implantation for high myopia can achieve an equal visual acuity. But clinical outcomes of ICL implantation is much better than PIOL group. A long-term effect should be observed for the further evaluation.