CAJ | 학술논문

目的研究ICL (Implantable contact lens,ICL)晶状体的距离以及虹膜张力在ICL并发白内障中的意义.方法临床病例对照研究.对2006年8月至2012年8月在深圳市眼科医院就诊患者,采用眼前段全景OCT观察并发白内障患者ICL在后房的位置变化,并采用Independent-Samples TTest与无并发白内障的患者进行比较.结果瞳孔散大后,ICL并发白内障患者的ICL周边部距晶状体前表面最小间距(D3值)为(77.75±8.70) μm,变化范围69.05 ～ 86.45 μm；ICL合并正常晶状体患者的D3值为(145.68士28.88) μm,变化范围116.8～ 174.56 μm,二者进行Independent-Samples TTest,P=0.001 ＜0.05,差异有统计学意义.ICL并发白内障患者D2-D1值(虹膜张力差)为(321±21.31) μm,变化范围299.69～342.31 μm; ICL术后透明晶状体患者的D2-D1值为(286.32±60.46) μm,变化范围225.86～ 346.78 μm,P=0.03＜0.05,差异有统计学意义.结论 ICL周边部距晶状体前表面的最小间距(D3值)和虹膜张力差(D2-D1值)在并发性白内障的发病机制中具有重要作用.D3值大于116.8μm是相对安全的间距,发生并发性白内障的几率较小；当D3小于86.45 μm和D2-D1值大于299.69 μm时,并发性白内障的几率增大.
목적 연구ICL (Implantable contact lens,ICL)정상체적거리이급홍막장력재ICL병발백내장중적의의.방법 림상병례대조연구.대2006년8월지2012년8월재심수시안과의원취진환자,채용안전단전경OCT관찰병발백내장환자ICL재후방적위치변화,병채용Independent-Samples TTest여무병발백내장적환자진행비교.결과 동공산대후,ICL병발백내장환자적ICL주변부거정상체전표면최소간거(D3치)위(77.75±8.70) μm,변화범위69.05 ～ 86.45 μm；ICL합병정상정상체환자적D3치위(145.68사28.88) μm,변화범위116.8～ 174.56 μm,이자진행Independent-Samples TTest,P=0.001 ＜0.05,차이유통계학의의.ICL병발백내장환자D2-D1치(홍막장력차)위(321±21.31) μm,변화범위299.69～342.31 μm; ICL술후투명정상체환자적D2-D1치위(286.32±60.46) μm,변화범위225.86～ 346.78 μm,P=0.03＜0.05,차이유통계학의의.결론 ICL주변부거정상체전표면적최소간거(D3치)화홍막장력차(D2-D1치)재병발성백내장적발병궤제중구유중요작용.D3치대우116.8μm시상대안전적간거,발생병발성백내장적궤솔교소；당D3소우86.45 μm화D2-D1치대우299.69 μm시,병발성백내장적궤솔증대.
Objective To study the significance of the distances from ICL to lens and iris tension in complicated cataract of ICL.Methods Based on the position changes of ICL in the posterior chamber with complicated cataract patients and with no complicated cataract patients with anterior segment and full-field optical coherence tomography,the data of the two group were analysed with the Independent-samples T Test.Results Under mydriasis,the average minimum distance between ICL peripheral part and the front surface of lens (D3 value) in study group was (77.75 ± 8.70)μm,ranged from 69.05 to 86.45μm,and (145.68 ±28.88)μm,ranged from 116.8 to 174.56μm in control group.The Independent-samples T Test showed the highly significant difference statistically between them (P =0.03＜0.05); The iris tension differential (D2-D1value) was respectively (321 ±21.31) μm(range 299.69 to 342.315μm) and (286.32±60.46)μm (range 225.86 to 346.78μm) in study group and control group.A statistical comparison between the two groups is significant with regard to iris tension (P =0.03＜0.05).Conclusions The minimum distance between the peripheral part of ICL and the front surface of lens (D3 value) and the iris tension (D2-D1 value) is of great significance in the etiology of complicated cataract after ICL implant.D3 value of more than 116.8μm is relatively safe and not easy to cause lens opacity.But D3 value less than 86.45μm and D2-D1 value more than 299.69μm would increase the chance of contact between the ICL and the lens and then the occurrence of post-operative cataract.