CAJ | 학술논문

目的研究可植入接触镜(implantable contact lens,implantable collamer lens,ICL)植入术矫正高度近视术后调节功能的变化,观察术后的临床效果,评价有效性和安全性.方法临床病例系列研究.对2012年5～11月于贵阳医学院附属医院行ICL植入术治疗高度近视的患者资料33例66只眼.所有患者按照术前、术后ld、l周、1个月、3个月的随访时间运用综合验光仪、眼前节OCT(Visante OCT)观察裸眼视力(UCVA)、矫正视力(BCVA)、术前术后屈光度、调节幅度、正相对调节(PRA)、负相对调节(NRA)、正负相对调节的比值(PRA/NRA).采用SPSSl6.0统计软件行重复测量设计资料的方差分析,并进行两两比较.结果 ICL植入术后裸眼视力显著提高,各时间点屈光度稳定.术后1d、1周、1个月、3个月时调节幅度平均值分别为(8.81±3.47)D、(9.05±3.10)D、(9.06±2.84)D、(9.40±3.06)D均明显高于术前平均值(7.60±3.10)D,差异有统计学意义(F=1 1.169,P=0.000,P＜0.05),术后3月大于术后1d、1周、1个月,差异有统计学意义(P＜0.05).正相对调节、负相对调节分别在术后1d、1周与术前比较差异无统计学意义(P＞0.05),术后1个月、3个月与术前比较有明显提高,差异有统计学意义(P＜0.05).正负相对调节比值(PRA/NRA)术前与术后、术后各时间点比较差异无统计学意义(F =1.824,P=0.135,P＞0.05).结论 ICL植入术矫正高度近视是安全有效的.术后调节功能得到提高.术后1个月、3个月调节幅度、正相对调节、负相对调节均大于术前.术后各时间点正负相对调节比值无显著变化.
목적 연구가식입접촉경(implantable contact lens,implantable collamer lens,ICL)식입술교정고도근시술후조절공능적변화,관찰술후적림상효과,평개유효성화안전성.방법 림상병례계렬연구.대2012년5～11월우귀양의학원부속의원행ICL식입술치료고도근시적환자자료33례66지안.소유환자안조술전、술후ld、l주、1개월、3개월적수방시간운용종합험광의、안전절OCT(Visante OCT)관찰라안시력(UCVA)、교정시력(BCVA)、술전술후굴광도、조절폭도、정상대조절(PRA)、부상대조절(NRA)、정부상대조절적비치(PRA/NRA).채용SPSSl6.0통계연건행중복측량설계자료적방차분석,병진행량량비교.결과 ICL식입술후라안시력현저제고,각시간점굴광도은정.술후1d、1주、1개월、3개월시조절폭도평균치분별위(8.81±3.47)D、(9.05±3.10)D、(9.06±2.84)D、(9.40±3.06)D균명현고우술전평균치(7.60±3.10)D,차이유통계학의의(F=1 1.169,P=0.000,P＜0.05),술후3월대우술후1d、1주、1개월,차이유통계학의의(P＜0.05).정상대조절、부상대조절분별재술후1d、1주여술전비교차이무통계학의의(P＞0.05),술후1개월、3개월여술전비교유명현제고,차이유통계학의의(P＜0.05).정부상대조절비치(PRA/NRA)술전여술후、술후각시간점비교차이무통계학의의(F =1.824,P=0.135,P＞0.05).결론 ICL식입술교정고도근시시안전유효적.술후조절공능득도제고.술후1개월、3개월조절폭도、정상대조절、부상대조절균대우술전.술후각시간점정부상대조절비치무현저변화.
Objective To investigate the changes of accommodation function,and to observe the clinical effect,estimate the effectiveness and security,after ICL implantation.Methods Thirty-three patients (66 eyes) with high myopia were performed ICL by one surgeon in Ophthalmic Center,Affiliated Hospital of Guiyang Medical University from May to November in 2012.Uncorrected visual acuity (UCVA),best corrected visual acuity (BCVA),preoperative and postoperative refraction,amplitude of accommodation,positive relative accommodation (PRA),negative relative accommodation (NRA),the ratio of relative accommodation (PRA/NRA) were observed at pre-operation,1 day,1 week,1 month and 3 months post-operation using Synthetical optometry and anterior segment OCT (Visante OCT).Data were analyzed with Windows statistic software (SPSS version 16.0).Results After ICL implantation,uncorrected visual acuity increased significantly.Refraction was in steady condition at different time.The average amplitude of accommodation were (8.81±3.47)D (1 day),(9.05± 3.10)D (1 week),(9.06±2.84)D (1 month),(9.40±3.06)D (3 months),which were evidently higher than the pre-operation (7.60±3.10)D.The comparisons had statistical significance (F =11.169,P =0.000).Moreover,the average amplitude of accommodation in three months postoperatively was higher than that in one day,in one week and in one month postoperatively.The comparisons had statistical significance.To compare positive relative accommodation (PRA),negative relative accommodation (NRA) and the total of binoculus relative accommodation in one day or one week postoperatively with that in pre-operation,the comparisons had no statistical significance.However,in comparison with that in postoperative one month or three months,all of them had great improvement.The comparisons had statistical significance.The ratio of relative accommodation (PRA/NRA) had no statistical significance by comparison with difference times in preparation and post operation (F =1.824,P =0.135).Conclusions ICL implantation for correction of high myopia is safe and effective.Accommodative function is improved after operation.Amplitude of accommodation,PRA and NRA has great improvement in one month or three months post-operation.The ratio of relative accommodation (PRA/NRA) has no change.