CAJ | 학술논문

目的观察有晶状体眼后房型人工晶状体(PPC-ICL)植入术治疗高度近视后眼前节形态学变化,探讨PPC-ICL植入术对前房角、角膜内皮以及邻近组织的影响.方法前瞻性研究.收集2011年1月至2013年6月在宁夏眼科医院行PPC-ICL植入术的高度近视患者58例(106眼),于术后1、6、12个月进行随访,观察指标包括裸眼视力(UCVA)、最佳矫正视力(BCVA)、眼压(IOP)、角膜内皮细胞计数和超声生物显微镜(UBM)检查.UBM检查包括前房深度(ACD)、拱高(vault)、房角开放距离(AOD500)以及小梁虹膜角(TIA)在2、4、8、10 4个钟点上的变化.采用重复测量方差分析对数据进行处理.结果所有患者的术后UCVA达到或高于术前BCVA,术前术后IOP和角膜内皮细胞计数相比较差异无统计学意义.UBM检查显示手术前后ACD、AOD500和TIA差异有统计学意义(F=12.372、21.393、22.076、21.154、21.763、19.471、19.823、19.836、19.247,P＜0.05),术后1个月时3项指标均比术前显著减小(P＜0.05),但术后1个月与6、12个月的ACD、AOD500、TIA和拱高相比差异无统计学意义.随访期内有2例患者(2眼)由于术后拱高过小更换了PPC-ICL,所有患者均未发生瞳孔阻滞性青光眼和晶状体前囊膜下混浊等并发症.结论 PPC-ICL植入术后1年随访期内前房结构稳定,角膜内皮细胞无明显减少.
목적 관찰유정상체안후방형인공정상체(PPC-ICL)식입술치료고도근시후안전절형태학변화,탐토PPC-ICL식입술대전방각、각막내피이급린근조직적영향.방법 전첨성연구.수집2011년1월지2013년6월재저하안과의원행PPC-ICL식입술적고도근시환자58례(106안),우술후1、6、12개월진행수방,관찰지표포괄라안시력(UCVA)、최가교정시력(BCVA)、안압(IOP)、각막내피세포계수화초성생물현미경(UBM)검사.UBM검사포괄전방심도(ACD)、공고(vault)、방각개방거리(AOD500)이급소량홍막각(TIA)재2、4、8、10 4개종점상적변화.채용중복측량방차분석대수거진행처리.결과 소유환자적술후UCVA체도혹고우술전BCVA,술전술후IOP화각막내피세포계수상비교차이무통계학의의.UBM검사현시수술전후ACD、AOD500화TIA차이유통계학의의(F=12.372、21.393、22.076、21.154、21.763、19.471、19.823、19.836、19.247,P＜0.05),술후1개월시3항지표균비술전현저감소(P＜0.05),단술후1개월여6、12개월적ACD、AOD500、TIA화공고상비차이무통계학의의.수방기내유2례환자(2안)유우술후공고과소경환료PPC-ICL,소유환자균미발생동공조체성청광안화정상체전낭막하혼탁등병발증.결론 PPC-ICL식입술후1년수방기내전방결구은정,각막내피세포무명현감소.
Objective To assess the effect on anterior chamber angle,corneal endothelial and adjacent tissue after implantation of phakic posterior chamber implantable collamer lens (PPC-ICL) for the correction of high myopia.Methods In this prospective,nonrandomized clinical study,106 consecutive eyes of 58 patients with high myopic received ICL implantation between January 2011 and June 2013 in the Ningxia Eye Hospital.Uncorrected visual acuity (UCVA),best corrected visual acuity (BCVA),intraocular pressure,corneal endothelial cell count were measured preoperatively and at 1 month,6 months and 12 months postoperatively.The ultrasound biomicroscopy (UBM) was used to observe the depth of anterior chamber (ACD) vault,angle opening distance 500 microns from the scleral spur (AOD500),trabecular-iris angle (TIA) at point 2,4,8 and 10 respectively.The repeated measurement ANOVA was used to analyzed statistical data.Results The postoperative UCVA was equally or higher compare with preoperative BCVA in all patients.Intraocular pressure and corneal endothelial cell count were no statistically significant difference between pre-and postoperative (P＞0.05).The postoperaive ACD,AOD500 and TIA value were decreased significantly than preoperative at 1 month (F=12.372,21.393,22.076,21.154,21.763,19.471,19.823,19.836,19.247,P＜0.05).But there were no statistically significant difference of ACD,AOD500,vault and TIA between 1-month and 6-month,12-month postoperatively.No pupillary block glaucoma or anterior capsule opacification occurred during the follow-up.Conclusion The structure of anterior chamber angle was stable and corneal endothelial cell was no obvious decrease postoperatively during 1 year follow-up.