CAJ | 학술논문

目的评价虹膜夹型有晶状体眼人工晶状体(IFPIOL)植入治疗高度近视术后患者调节功能的变化,为IFPIOL植入术后患者的生活质量评估提供临床依据.方法病例对照研究.试验组为IFPIOL植入术治疗高度近视患者12例(23只眼),对照组选择年龄、性别匹配的正视眼11例(22只眼),试验组在术前、术后1个月及术后3个月时检查调节幅度、单眼调节灵活度和双眼正和(或)负相对性调节.对照组也做同样检查.采用随机区组设计定量资料方差分析对试验组手术前后调节功能的数据进行分析;试验组和对照组之间的比较行两独立样本t检验.结果术后1个月和3个月时调节幅度分别为(8.90 ±2.13)D、(9.10 ±1.72)D,明显高于术前(7.35 ±2.20)D,差异有统计学意义(F=19.88,P<0.01),且术后3个月时与对照组(10.10 ±2.09)D相比,差异无统计学意义(t=-1.76,P=0.09).调节灵活度在术后1个月和3个月时分别为(8.17±2.09)cyc/min、(8.67±1.80)cyc/min,明显高于术前(5.67±1.53)cyc/min(F=64.27,P<0.01),且术后3个月时低于对照组的(14.51 ±3.81)cyc/min,差异有统计学意义(t=-6.29,P<0.01).正相对性调节术后3个月时为(2.45±0.81)D,明显高于术前(1.61±0.80)D(F=6.10,P=0.01),且术后3个月时显著低于对照组(3.89 ±1.49)D(t=-2.83,P=0.01).结论 IFPIOL植入术后患者保留了正常的调节功能,而且有一定程度的提高,并随着时间的推移保持稳定,但与正视眼相比仍有差距,较长期的影响尚有待进一步观察.
목적 평개홍막협형유정상체안인공정상체(IFPIOL)식입치료고도근시술후환자조절공능적변화,위IFPIOL식입술후환자적생활질량평고제공림상의거.방법 병례대조연구.시험조위IFPIOL식입술치료고도근시환자12례(23지안),대조조선택년령、성별필배적정시안11례(22지안),시험조재술전、술후1개월급술후3개월시검사조절폭도、단안조절령활도화쌍안정화(혹)부상대성조절.대조조야주동양검사.채용수궤구조설계정량자료방차분석대시험조수술전후조절공능적수거진행분석;시험조화대조조지간적비교행량독립양본t검험.결과 술후1개월화3개월시조절폭도분별위(8.90 ±2.13)D、(9.10 ±1.72)D,명현고우술전(7.35 ±2.20)D,차이유통계학의의(F=19.88,P<0.01),차술후3개월시여대조조(10.10 ±2.09)D상비,차이무통계학의의(t=-1.76,P=0.09).조절령활도재술후1개월화3개월시분별위(8.17±2.09)cyc/min、(8.67±1.80)cyc/min,명현고우술전(5.67±1.53)cyc/min(F=64.27,P<0.01),차술후3개월시저우대조조적(14.51 ±3.81)cyc/min,차이유통계학의의(t=-6.29,P<0.01).정상대성조절술후3개월시위(2.45±0.81)D,명현고우술전(1.61±0.80)D(F=6.10,P=0.01),차술후3개월시현저저우대조조(3.89 ±1.49)D(t=-2.83,P=0.01).결론 IFPIOL식입술후환자보류료정상적조절공능,이차유일정정도적제고,병수착시간적추이보지은정,단여정시안상비잉유차거,교장기적영향상유대진일보관찰.
Objective To evaluate the changes of accommodative function after implantation of irisfixated phakic intraocular lens (IFPIOL) for correction of high myopia, and compared with gender and age matched emmetropes. This study also provides clinical basis for assessing the quality of life after implantation of the IFPIOL. Methods It was a case-control study. Iris-fixated in phakic intraocular lens implantation was performed in 23 eyes of 12 high myopic patients. Control group included 22 eyes in 11 emmetropes. All patients and controlled subjects had the same examinations including amplitude of accommodation, accommodative facility test, and negative/positive relative accommodation before, 1 month and 3 months after operation. Surgery was performed by the same surgeon. Randomized block design analysis of variance was applied to analyze accommodative function between the patients preoperative and postoperative, and two independent samples t-test was applied to analyze accommodative function between the control group and the patients. P value less than 0.05 was considered significant. Results The mean amplitude of accommodation at 1 month and 3 months was (8. 90 ± 2. 13) D and (9. 10 ±1.72) D after IFPIOL implantation, respectively. Mean amplitude of accommodation after the operation was significantly greater than that from preoperative eyes ( 7. 35 ± 2. 20 ) D, ( F = 19. 88, P < 0. 01 ). Mean amplitude of accommodation at 3 months in eyes after IFPIOL implantation showed no significant difference (t = - 1.76, P = 0.09) as compared with the control group (10. 10 ±2.09) D. Mean accommodative facility at 1 month and 3 months after IFPIOL implantation was (8. 17 ± 2. 09) cyc/min and (8. 67 ± 1. 80) cyc/min, respectively. This was significantly increased from preoperative data which was (5. 67 ± 1. 53) cyc/min,(F = 64. 27, P < 0. 01). Mean accommodative facility at 3 months after IFPIOL implantation had no statistically significant difference (t = -6.29, P < 0. 01) as compared with the control group ( 14. 51 ± 3.81) cyc/min. In addition, mean positive relative accommodation (2.45 ± 0. 81) D was significantly greater than that in preoperative eyes ( 1. 61 ±0. 80) D, (F -6. 10,P = 0. 01 ) but, not significantly different (t = -2.83, P = 0. 01) from the control group ( 3. 89 ± 1. 49 ) D. Conclusions Patients can obtain physioloGlcal accommodative function after the implantation of IFPIOL for correction of high myopia. Moreover, the accommodative function increases with time and is stable. Nevertheless, accommodative function could not reach the level of normal emmetropic eyes. Longer-term results would be further observed.