中华实验眼科杂志
中華實驗眼科雜誌
중화실험안과잡지
CHINESE JOURNAL OF EXPERIMENTAL OPHTHALMOLOGY
2011年
10期
926-930
,共5页
王松田%郑广瑛%李志刚%王洁%赵丽君%王瑞娜
王鬆田%鄭廣瑛%李誌剛%王潔%趙麗君%王瑞娜
왕송전%정엄영%리지강%왕길%조려군%왕서나
高度近视%有晶状体眼%后房型人工矫正晶状体%视觉质量
高度近視%有晶狀體眼%後房型人工矯正晶狀體%視覺質量
고도근시%유정상체안%후방형인공교정정상체%시각질량
High myopia%Phakic eye%Posterior chamber phakic introcular corrective lens%Visual quality
背景 有晶状体眼后房型人工矫正晶状体(ICL)植入术是矫正高度近视的手术方法之一,与准分子激光角膜原位磨镶术(LASIK)不同的是,该术式保留了角膜与晶状体像差固有的匹配关系,但术后视觉质量是患者和医师较为关注的问题.目的 探讨ICL植入术矫正高度近视术后视觉质量的变化.方法 对高度近视患者42例84眼行ICL植入术,于术后ld、1个月和6个月复查裸眼视力、最佳矫正视力(BCVA)、屈光状态、波前像差、对比敏感度以及调节力并与术前进行比较.结果 采用前瞻性病例观察试验设计.本组患者术前视力均＜0.3,术后各随访时间点裸眼视力和BCVA均＞0.3,明显好于术前.术后各时间点间视力增加的眼数差异无统计学意义(x2=10.70,P＞0.05).本组患者术前平均等效球径屈光度为(-15.38±1.03)D,术后ld平均等效球镜屈光度为(+0.55+0.06)D,术后1个月平均等效球镜屈光度为(-1.22±0.09)D,术后6个月平均等效球镜屈光度为(-0.68±0.06)D,各时间点比较等效球镜屈光度的差异有统计学意义(F=16 559.90,P＜0.01)；术眼术前平均波前总像差为11.00±0.25,术后6个月平均总像差为2.21±0.56,其中术前和术后6个月高阶像差分别为0.43±0.05和0.47+0.04,差异无统计学意义(t=1.65,P=0.10).明视和暗视状态下术后各空间频率的对比敏感度和眩光敏感度与术前比较均有增高,手术前后各时间点的对比敏感度和眩光敏感度差异有统计学意义(P＜0.05)；术后1个月和6个月时屈光度＜-16 D组术眼调节力较术前明显增加(术前:2.75±1.20,术后1个月:5.75±1.44；术后6个月:6.00±1.52),差异均有统计学意义(F=1597.70,P＜0.05)；而屈光度＞-16 D组手术前后调节力的变化差异无统计学意义(F=2.67,P＞0.05).结论 ICI植入术矫正高度近视后患者的视觉质量较术前明显改善,但远期疗效及安全性尚需进一步观察.
揹景 有晶狀體眼後房型人工矯正晶狀體(ICL)植入術是矯正高度近視的手術方法之一,與準分子激光角膜原位磨鑲術(LASIK)不同的是,該術式保留瞭角膜與晶狀體像差固有的匹配關繫,但術後視覺質量是患者和醫師較為關註的問題.目的 探討ICL植入術矯正高度近視術後視覺質量的變化.方法 對高度近視患者42例84眼行ICL植入術,于術後ld、1箇月和6箇月複查裸眼視力、最佳矯正視力(BCVA)、屈光狀態、波前像差、對比敏感度以及調節力併與術前進行比較.結果 採用前瞻性病例觀察試驗設計.本組患者術前視力均＜0.3,術後各隨訪時間點裸眼視力和BCVA均＞0.3,明顯好于術前.術後各時間點間視力增加的眼數差異無統計學意義(x2=10.70,P＞0.05).本組患者術前平均等效毬徑屈光度為(-15.38±1.03)D,術後ld平均等效毬鏡屈光度為(+0.55+0.06)D,術後1箇月平均等效毬鏡屈光度為(-1.22±0.09)D,術後6箇月平均等效毬鏡屈光度為(-0.68±0.06)D,各時間點比較等效毬鏡屈光度的差異有統計學意義(F=16 559.90,P＜0.01)；術眼術前平均波前總像差為11.00±0.25,術後6箇月平均總像差為2.21±0.56,其中術前和術後6箇月高階像差分彆為0.43±0.05和0.47+0.04,差異無統計學意義(t=1.65,P=0.10).明視和暗視狀態下術後各空間頻率的對比敏感度和眩光敏感度與術前比較均有增高,手術前後各時間點的對比敏感度和眩光敏感度差異有統計學意義(P＜0.05)；術後1箇月和6箇月時屈光度＜-16 D組術眼調節力較術前明顯增加(術前:2.75±1.20,術後1箇月:5.75±1.44；術後6箇月:6.00±1.52),差異均有統計學意義(F=1597.70,P＜0.05)；而屈光度＞-16 D組手術前後調節力的變化差異無統計學意義(F=2.67,P＞0.05).結論 ICI植入術矯正高度近視後患者的視覺質量較術前明顯改善,但遠期療效及安全性尚需進一步觀察.
배경 유정상체안후방형인공교정정상체(ICL)식입술시교정고도근시적수술방법지일,여준분자격광각막원위마양술(LASIK)불동적시,해술식보류료각막여정상체상차고유적필배관계,단술후시각질량시환자화의사교위관주적문제.목적 탐토ICL식입술교정고도근시술후시각질량적변화.방법 대고도근시환자42례84안행ICL식입술,우술후ld、1개월화6개월복사라안시력、최가교정시력(BCVA)、굴광상태、파전상차、대비민감도이급조절력병여술전진행비교.결과 채용전첨성병례관찰시험설계.본조환자술전시력균＜0.3,술후각수방시간점라안시력화BCVA균＞0.3,명현호우술전.술후각시간점간시력증가적안수차이무통계학의의(x2=10.70,P＞0.05).본조환자술전평균등효구경굴광도위(-15.38±1.03)D,술후ld평균등효구경굴광도위(+0.55+0.06)D,술후1개월평균등효구경굴광도위(-1.22±0.09)D,술후6개월평균등효구경굴광도위(-0.68±0.06)D,각시간점비교등효구경굴광도적차이유통계학의의(F=16 559.90,P＜0.01)；술안술전평균파전총상차위11.00±0.25,술후6개월평균총상차위2.21±0.56,기중술전화술후6개월고계상차분별위0.43±0.05화0.47+0.04,차이무통계학의의(t=1.65,P=0.10).명시화암시상태하술후각공간빈솔적대비민감도화현광민감도여술전비교균유증고,수술전후각시간점적대비민감도화현광민감도차이유통계학의의(P＜0.05)；술후1개월화6개월시굴광도＜-16 D조술안조절력교술전명현증가(술전:2.75±1.20,술후1개월:5.75±1.44；술후6개월:6.00±1.52),차이균유통계학의의(F=1597.70,P＜0.05)；이굴광도＞-16 D조수술전후조절력적변화차이무통계학의의(F=2.67,P＞0.05).결론 ICI식입술교정고도근시후환자적시각질량교술전명현개선,단원기료효급안전성상수진일보관찰.
Background Implantation of phakic posterior chamber intraocular corrective lens(ICL)is a new choice for correction of high myopia.Different from laser assisted in situ keratomileusis,implantation of phakic posterior chamber ICL will allow the good imaging quality because it remaines the matched relationship between cornea and lens.But its visual quality after operation is concerned by patient and ophthalmologists.ObjectiveThis study was to observe the effectiveness of implantation of posterior chamber phakic ICL on visual quality in patients with high myopia.Methods Eighty-four high myopia eyes of 42 patients accepted implantation of posterior chamber phakic ICL and follow-up of 6-month duration.The visual acuity,refractive status,wavefront,contrast sensitivity and accommodation were examined and compared before and after surgery.This clinical study complied with Declaration of Helsinki.The written informed consent was obtained from each patient before operation.Results A prospective observational trial design was used.The uncorrected visual acuity and best corrected visual acuity after operation were better than preoperative ones in all of the patients.The eye numbers of ＞ 0.3 were increased after operation in comparison with before operation with a stable result among 1 day,1 month and 6 months after surgery (x2 =10.70,P＞0.05).Spherical equivalent refraction was(-15.38 ± 1.03)D before surgery and(+0.55 ±0.06)at 1 day,(-1.22±0.09)D at 1 month and(-0.68 ± 0.06)D after 6 months,showing a significant difference among them(F=16 559.90,P＜0.05).Total aberrations and higher-order aberrations were 11.00±0.25 and 0.43 ±0.05 before surgery,the wavefront aberrations were 2.21 ± 0.56 and 0.47±0.04 at 6 months after surgery with significant difference(t =1.65,P =0.10).Each spatial frequency contrast sensitivity and glare sensitivity on photopic and seotopie conditions in postoperation were higher compared with the preoperative(P＜0.05).The accommodation in 1 month and 6 months after surgery was greater than that of preoperative in the patients ＜-16 D(preoperation:2.75 ± 1.20 ; postoperation 1 month:5.75 ± 1.44,postoperation 6 months:6.00 ± 1.52)(P＜ 0.05),however,in the ＞-16 D group,no considerably change in accommodation was seen after surgery(F=1597.70,P＜0.05).No significant difference was found in accommodation between before and after surgery in ＞-16 D group(F=2.67,P＞0.05).Conclusions Visual quality of high myopia is obviously improved after implantation of posterior chamber phakic ICL,but its long-term outcome is need to further study.
