有晶状体眼后房型人工晶状体植入术矫正高度近视的临床观察

目的 观察有晶状体眼后房型人工晶状体(PPC-ICL)植入术矫正高度近视的有效性、安全性和视觉质量.方法 前瞻性研究.选择拟行PPC-ICL植入的患者28例(50眼),其中男10例(14眼),女18例(36眼),平均球镜度(-8.26±2.15)D,等效球镜度(SE)(-9.88±2.39)D,其中36眼接受了散光型PPC-ICL植入.术前与术后6个月分别进行视力、波前像差检测;术后6个月进行视觉质量问卷评分.采用配对t检验进行统计分析.结果 术前、术后1d、术后1周、术后6个月UCVA(标准对数视力表)分别为3.82±0.08、4.76±0.26、5.02±0.13、5.03±0.10.术后6个月UCVA较术前增加(t=72.88,P＜0.05).术后6个月UCVA与术前BCVA相比等于、提高1行、提高2行及以上分别为16眼、26眼、4眼,占全部眼数的92％.术后6个月残余度数在±0.50 D以内的眼数占96％.术前全眼总高阶像差、球差、彗差、三叶草均方根(RMS)值分别为(0.309±0.098)、(-0.008±0.111)、(0.197±0.103)、(0.142±0.076) μm;术后6个月分别为(0.320±0.152)、(-0.114±0.117)、(0.026±0.534)、(0.204±0.122) μm.术后全眼总高阶像差与球差较术前有增加但差异无统计学意义,全眼彗差较术前减少(t=-3.454,P＜0.05),全眼三叶草像差较术前增加(t=2.556,P＜0.05).在视觉质量问卷方面:全部28例(50眼)均对白天远视力和手术整体效果表示满意,其他视觉质量评分由高到低依次为(分数越高越满意):白天骑车/开车容易度、白天近视力、夜间视力、电脑、近距离阅读、夜间骑车/开车容易度、视物疲劳、光晕、眩光、眼干.结论 PPC-ICL植入术是矫正高度近视的一种安全有效的手术方法,患者术后UCVA明显提高,彗差减少,与术前比较有更好的视觉质量.     

有晶状体眼后房型人工晶状体植入术矫正高度近视

目前,屈光性手术方法众多,主要可分为两大类:一类是角膜屈光性手术,另一类是晶状体屈光性手术.前者包括角膜镜片术或表面角膜移植术、角膜磨镶术、角膜内镜片植入术(如角膜基质内角膜环植入术)、放射状角膜切开术(RK)、自动板层角膜成形术(ALK)、准分子激光角膜切削术(PRK)以及准分子激光原位角膜磨镶术(LASIK)等.后者如透明晶状体摘出术包括植入与不植入后房型人工晶状体、有晶状体眼植入双凹或凹凸前房型人工晶状体、有晶状体眼植入后房型人工晶状体等.以往的各种屈光性手术均存在诸多的缺点和并发症,相对而言,有晶状体眼后房型人工晶状体植入术,除具备有晶状体眼前房型人工晶状体植入术的诸多优点外,人工晶状体植入更符合生理解剖状态,并大大减少了并发症,被视作一种前景甚好的屈光性手术.     

有晶状体眼人工晶状体植入术矫正高度近视

探讨有晶状体眼中用负度数的人工晶状体矫正高度近视的临床疗效。方法在８例１１眼高度近视角膜较薄的患眼中植入房角支撑型人工晶状体。结果手术前,后平均远视力分别为０．０４和０．６,平均近视力分别为０．７５和０．７０,平均最佳矫正视力分别为０．７４和０．９１,其中２眼瞳孔变形伴有眩光,未发现房角损害相关的青光眼。     

有晶状体后房型人工晶状体植入术矫正高度近视的研究进展

有晶状体后房型人工晶状体植入术是矫正高度近视的有效方法之一,其具有较好的临床疗效、安全性和稳定性,本文将对此治疗方法的研究进展进行综述。     

有晶状体眼后房型人工晶状体植入术矫正高度近视

目的 探索有晶状体眼后房型人工晶状体( Phakic posterior chamber intraocular lens)植入术矫正高度近视的有效性和安全性.方法 高度近视63例(117眼).球面等效屈光度-6.25～-19.00D,矫正视力≥0.8者101眼,0.5～0.6者15眼,1眼＜0.3.术前检查裸眼视力、最佳矫正视力、角膜内皮细胞计数、超声生物显微镜、眼压、散瞳前后屈光度、角膜曲率、轴长、前房深度、角膜厚度及角膜水平经线直径(WTW).屈光度取较平均的值进行计算,计算公式为Starr公司专用公式;根据角膜水平直径加0.5 mm选择人工晶状体的长径;人工晶状体为美国Starr公司产品,以胶原异分子聚合物为材料,双凹单片式.术前行钇铝石榴石晶体(YAG)激光虹膜周边切除术,每眼2点,相隔90°,手术选择表面麻醉,经颞侧透明角膜隧道切口,植入折叠式人工晶状体,置于透明晶状体与虹膜之间,吸除黏弹剂,缩瞳,充盈前房.术后检查屈光度、角膜、前房、眼压、人工晶状体等情况.结果 117眼均成功,术后视力提高,屈光度明显降低且稳定,随访无回退,前房深度无改变,术后无持续眼压升高,人工晶状体相容性好,2例(2眼)前囊下晶状体局限性浑浊.结论 有晶状体眼后房型人工晶状体植入预测性好,视力恢复迅速,无严重并发症,适用屈光度范围广.     

有晶状体眼后房型人工晶状体V4c植入术对波前像差的影响

目的：探讨有晶状体眼后房型人工晶状体V4c植入术对全眼、眼内及角膜波前像差的影响。方法： 前瞻性临床研究。纳入2019年5月至2020年12月在南昌爱尔眼科医院拟行有晶状体眼后房型人工 晶状体V4c植入术矫治中高度近视的患者44例（88眼）。使用角膜屈光分析仪测量术前及术后3个月 在3、4、6 mm瞳孔直径下的全眼波前像差、角膜波前像差及眼内波前像差值。手术前后全眼、眼内 及角膜各波前像差值［如总像差、低阶像差Tilt（S1）值、高阶像差、彗差、三叶草像差、球差］比较 采用配对t检验进行分析。结果：术后3个月,手术的安全性指数和有效性指数分别为1.15±0.12和 1.11±0.12。在3、4、6 mm瞳孔直径下,术后全眼总像差分别为（0.34±0.14）μm、（0.57±0.23）μm、 （1.81±0.83）μm,眼内总像差分别为（0.34±0.11）μm、（0.52±0.16）μm、（1.74±0.68）μm,术后全眼 总像差、眼内总像差均较术前明显减少,且差异均有统计学意义（全眼：t=14.67, P<0.001; t=16.68, P<0.001; t=14.35, P<0.001。眼内: t=15.41, P<0.001; t=13.89, P<0.001; t=13.21, P<0.001）。在6 mm瞳 孔直径下,术后全眼高阶像差、彗差、球差均较术前增加,差异均有统计学意义（t=-3.62, P=0.001; t=-2.84, P=0.008; t=-2.94, P=0.006）;眼内高阶像差、彗差较术前增加,差异有统计学意义（t=-2.65, P=0.013; t=-3.02, P=0.005）。余像差手术前后差异无统计学意义。结论：有晶状体眼后房型人工晶 状体V4c植入术矫正中高度近视安全、有效,能降低全眼、眼内总像差,但角膜像差无明显变化。     

有晶状体眼后房型人工晶状体植入术对高度近视的疗效

目的：通过双通道客观视觉质量分析系统Ⅱ(OQAS Ⅱ)评价有晶状体眼后房型人工晶状体(ICL)植入术对高度近视的临床疗效。

方法：选取2017-12/2018-12安徽医科大学第一附属医院收治的高度近视患者26例52眼,所有患者均行ICL植入术。随访获取所有患者术前BCVA以及术前和术后1wk,1、3mo的UCVA、客观散射指数(OSI)、调制传递函数(MTF)、斯特列尔比(SR)和100%、20%及9%的模拟对比度视力(Predicted VA)等一系列参数。

结果：与术前BCVA相比,术后1wk,1、3mo UCVA情况均优于术前且日渐改善(P<0.01)。与术前OSI、MTF、SR和Predicted VA 100%、20%及9%相比,术后1wk,1、3mo情况均好转(P<0.01)。

结论：ICL植入术能够有效地矫正高度近视,提高裸眼视力。通过OQAS Ⅱ分析,ICL植入术后OSI比术前减小,术后的MTF、SR和Predicted VA 100%、20%及9%比术前均有提高,高度近视患者视觉质量得到良好的改善。     

高度近视有晶状体眼后房型人工矫正晶状体植入术后视觉质量的临床评价

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1d、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,术后各随访时问点裸眼视力和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（-15．384-1．03）D,术后1d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=16559．90,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〈-16D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〉-16D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ICL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。     

有晶状体眼前房型人工晶状体植入矫治高度近视术后波阵面像差分析

目的 探讨2种不同前房型人工晶状体植入矫治高度近视术后波阵面像差及成像质量的差异。方法 使用WASCA波阵面像差仪,在瞳孔直径5 mm时,测量有晶状体眼前房型人工晶状体植入矫治高度近视患者36例63眼（虹膜夹型33眼;房角支撑型30眼）,并选择年龄匹配的近视患者21例30眼,排除眼病疾患作为对照组。获得整体像差、各分阶像差的均方根（RMS）,及Z6-Z14项系数。结果 ①实验组两亚组总高阶像差（RMSh）和3-7阶各阶均方根均比对照组大,指标的差异均有统计学意义（P〈0.05〉。②房角支撑型RMS5、Z13大于虹膜夹型,而Z10、Z12项小于虹膜夹型,差异均有统计学意义。③实验组术后整体高阶像差（RMSh）的均方根与术前等效球镜屈光度均呈显著正相关。（R=0.826,P〈0.05 R=0.754,P〈0.05）。结论 实验组眼的视网膜成像质量较自然晶状体眼差。二种人工晶状体眼高阶像差差异性不大,房角支撑型视网膜成像质量可能优于虹膜夹型。实验组术前近视度数越高的眼,术后视网膜成像质量越差。     

有晶状体眼后房型人工晶状体植入术矫正高度近视术后视觉质量的变化分析

目的：探讨有晶状体眼后房型人工晶状体（ ICL）植入术矫正高度近视术后视觉质量的变化。方法选取在本院行有晶状体眼后房型人工晶状体植入术的高度近视患者55例（110只眼）,比较手术后不同时间点的裸眼视力、最佳矫正视力、各眼前节参数、暗视下和明视下不同空间频率对比敏感度与术前的差异。结果患者在手术后的不同时间点的裸眼视力（UCVA）和最佳矫正视力（BCVA）与术前比较均升高,且差异具有统计学意义（ P ＜0．05）;研究对象在手术后的安全指数为（1．57±0．49）,有效指数为（1．37±0．51）。患者手术后各时间的前房深度（ACD）和点方位前房角（ICA）与术前比较均降低,且差异具有统计学意义（ P ＜0．05）;患者手术后各时间的角膜曲率（K）和角膜厚度（CCT）与术前的差异无统计学意义（ P ＞0．05）。患者手术后各时间的暗视下3cpd、6cpd、12cpd空间频率下对比敏感度与术前比较均升高,且差异具有统计学意义（ P ＜0．05）;患者手术后各时间的明视下1．5cpd、3cpd、6cpd、12cpd、18cpd空间频率下对比敏感度与术前比较均升高,且差异具有统计学意义（ P ＜0．05）。结论有晶状体眼后房型人工晶状体植入术矫正高度近视术后明显提高了患者的视觉质量。     

有晶状体眼后房型人工晶状体植入术后人工晶状体更换手术的短期临床效果

目的：观察有晶状体眼后房型人工晶状体（PPC-ICL）植入术后人工晶状体（ICL）更换手术的有效性和安全性。方法：回顾性系列病例研究。选择2015 年4 月至2016 年3 月在重庆爱尔眼科医院因ICL V4c在眼内的拱高低于100 μm而接受PPC-ICL更换手术的高度近视患者7 例（10 眼）。术后随访6 个月,观察裸眼视力（UCVA）、最佳矫正视力（BCVA）、拱高、角膜内皮细胞数量（ECD）、瞳孔直径及眼压（IOP）等变化。采用重复测量方差分析和配对t检验对术前和术后数据进行统计学分析。结果：ICL植入术前、ICL更换术前及术后6个月UCVA（LogMAR）分别为1.52±0.29、0.02±0.08、0.00±0.08,总体差异有统计学意义（F=230.08,P < 0.001）。ICL更换术后6 个月UCVA、BCVA均较ICL植入术前UCVA、BCVA显著提高（P < 0.05）,与ICL更换术前差异无统计学意义。所有眼ICL更换术后6 个月UCVA等于或超过ICL植入术前BCVA。ICL更换术后6 个月拱高（410±175）μm,较ICL更换术前[（74±25）μm]明显增加（t=5.93,P < 0.001）。ICL植入术前、ICL更换术前及术后6个月ECD、瞳孔直径、IOP总体差异均无统计学意义。术后无一术眼出现晶状体前囊膜下混浊。随访期间亦未出现严重并发症。结论：针对PPC-ICL植入术后拱高过低进行ICL更换手术是有效的,但远期安全性仍需进一步观察。     

Artisan Phakic Intraocular Lens for Correcting High Myopia

Objectives: To evaluate the safety indexes and efficacy of Artisan phakic intraocular lens (IOL) for the correction of high myopia. Methods: Retrospective interventional case series reports. Thirty-one eyes (22 patients) with myopia from −5.25 to −19.00 diopters underwent implantation of an Artisan phakic IOL. Follow-up examinations were performed at 1 day, 1 week, 1 month, and 3 months. The following parameters were recorded: manifest refraction, slit-lamp examination, applanation tonometry, uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), complications or adverse reactions. The primary variable was the refractive outcome at 3 months. Secondary variables were change in BSCVA, and efficacy and safety indexes. Results: At 3 months, mean spherical equivalent was −0.50 ± 0.36 diopters (range, −1.25 – plano). In 29 eyes (93.5%) UCVA was 6/12 or better; the other three eyes had UCVA of 6/15. The difference between preoperative and 1 week postoperative BSCVA was not statistically significant (p=0.25). Comparison of BSCVA at 1 week and at 1 month was statistically significant (p=0.05); this difference was even more significant at 3 months (p=0.01). The BSCVA remained the same or improved for all the eyes. BSCVA for 20 eyes (64.5%) had improved one or more lines in visual acuity. Mean endothelial cell loss at 3 months was 3.96%. Conclusion: The Artisan lens is a safe, predictable, and efficacious method to correct high myopia. Postoperative gain in BSCVA was achieved for the majority of eyes. Future study to assess safety indexes and risk of complications is required with long-term follow-up.     

有晶状体眼后房型人工晶状体植入矫正中低度近视的临床效果

目的：分析中央孔型有晶状体眼后房型人工晶状体（ICL）植入矫正中低度近视的短期有效性、安全性和稳定性。方法：回顾性队列研究。连续纳入2020年7—12月在成都爱尔眼科医院植入V4c ICL晶状体的低度近视患者490例（707眼）,均完成术后6个月随访,术前及术后1、3、6个月测量裸眼视力、矫正视力、眼压、拱高和角膜内皮细胞计数,并计算手术安全性、有效性、预测性以及稳定性。术前、术后数据采用配对t检验进行统计分析。结果：随访至术后6个月,患者裸眼视力（-0.076±0.079）LogMAR,手术有效性指数为1.26±0.21,最佳矫正视力（-0.079±0.080）LogMAR,安全指数为1.13±0.18。术后屈光度在±0.5 D以内的占比94.9%,可预测性为99.1%;等效球镜度在术后1个月为（-0.063±0.135）D,术后6个月为（-0.071±0.126）D;角膜内皮细胞计数术前（3 078±258）个/mm2,术后6个月为（2 953±206）个/mm2,损失率为（1.05±0.39）%。术后1个月拱高为（498±143）μm,术后6个月为（474±177）μm。ICL更换比例为1.4%。术后未出现严重威胁视力的并发症。结论：ICL 植入术（中央孔型,V4c ICL）矫正中低度近视具备良好的效果,手术安全、可靠,且预测性高,患者视力稳定。     

不同放置方向对有晶状体眼后房型人工晶状体植入术后拱高变化的影响

目的：分析不同放置方向对有晶状体眼后房型人工晶状体（ICL）植入术后拱高变化的影响。方法：回顾性病例对照研究。收集2018年1月至2019年12月在青岛新视界眼科医院行ICL植入术的近视患者47例（94眼）,根据ICL的放置方向分为水平放置组24例（48眼）和垂直放置组23例（46眼）,术后随诊时间大于1年。应用光学相干断层扫描（OCT）前节程序检查患者术后1周、1个月、3个月、6个月和1年时的拱高,并分析2组患者术后拱高的变化趋势以及2组之间拱高变化的差异。采用卡方检验、独立样本和配对样本t检验分析数据。结果：术后不同时间点,2组间拱高差异均无统计学意义。2组患者自术后1周至1年拱高都在不断下降（均P<0.001）,术后1周至1个月时,垂直放置组拱高下降幅度更为明显（t=-2.692,P=0.008）,术后1个月至3个月、术后3个月至6个月以及术后6个月至1年时的拱高下降幅度在2组之间差异均无统计学意义。结论：ICL植入术后1年内,拱高都在持续下降,这与ICL水平放置或垂直放置无关,但是ICL垂直放置时,术后1个月内拱高下降幅度更大。     

有晶状体眼后房型人工晶状体植入和准分子激光原位角膜磨削术矫正超高度近视的临床评价

目的:比较和评价有晶状体眼后房型人工晶状体(Phakic Posterior Chamber Intraocular Lens,PPCI-OL)植入和准分子激光原位角膜磨削术(Laser in situ Keratomileusis,Lasik)矫正高度近视的有效性、安全性和稳定性。方法:高度近视患者43例,随机分为PPCIOL组和Lasik组,分别行可植入接触镜(Implantable Con-tact Lens,ICL)植入术和Laisk,随访并比较两组有效性和安全性指数,两年屈光度回退≤2 D的生存率,低对比度视力和眩光视力的改变。结果:PPCIOL组术前平均等效球面屈光度(-16.77±3.37)D(-11.75--25.75 D);Lasik组术前平均等效球镜度(-13.8±2.71)D(-9.37--23.75 D)。术后1个月两组有效性无统计学差异,PPCIOL组安全性指数高于Lasik组(P<0.001),2 a时屈光度回退率分别为0、32.56％(P<0.001),术后3个月低对比视力和眩光视力PPCIOL组较术前提高比Lasik组明显(P<0.001)。PPCIOL组有1例2眼术后6个月时有晶状体前囊混浊,两组未见其他并发症。结论:有晶状体眼后房型人工晶状体植入矫正超高度近视有效,安全性和稳定性较Lasik更好,并能获得良好的视觉质量。     

有晶状体眼人工晶状体后房方位与拱高的相关性

目的：探讨有晶状体眼人工晶状体（ICL）后房方位与拱高的相关性。方法：回顾性系列病例研究。 选择2017年6月至2019年6月在重庆爱尔麦格眼科医院因第一只眼将ICL置于水平位拱高高于750 μm 而另一只眼将同长度ICL置于垂直位的双眼中高度近视患者32例。术前检查包括裂隙灯显微镜下测 量角膜水平直径（WTW）及超声生物显微镜（UBM）测量前房深度（ACD）、睫状沟到沟（STS）水平直 径、STS垂直直径以及晶状体厚度（LT）。术后随访大于6个月,采用UBM测量拱高。数据采用配对 t检验、多元回归分析和受试者工作特征（ROC）曲线分析。结果：ICL置于垂直位眼较对侧眼术后 拱高小（280±205）μm,差异有统计学意义（t=5.375,P<0.001）,双眼STS水平-垂直直径差异为 （0.42±0.21）mm。多元线性回归显示,双眼拱高差异与STS水平-垂直直径差异具有相关性（调整 R2 =0.545,F=10.30,P<0.001）,与WTW、ACD和LT无明显相关性。以垂直位ICL拱高下降至理想范 围（250～750 μm）为标准,对双眼STS水平-垂直直径差异绘制ROC曲线：曲线下面积（AUC）为0.917, 95%CI 0.764～0.985,P<0.001,最佳临界值为0.3,灵敏度为83.33%,特异性为100%。以双眼拱高 差异≥100、200、300 μm为标准,分别对双眼STS水平-垂直直径差异绘制ROC曲线：AUC≥100 μm为 0.859,P≥100 μm=0.007,最佳临界值为0.30,灵敏度为76.92%,特异性为100%;AUC≥200 μm为0.778, P≥200 μm=0.008,最佳临界值为0.36,灵敏度为77.78%,特异性为71.43%;AUC≥300 μm为0.754, P≥300 μm=0.015,最佳临界值为0.36,灵敏度为85.71%,特异性为66.67%。结论：ICL置于水平位后拱 高偏高者,如果STS水平-垂直直径差异>0.3 mm,ICL置于垂直位拱高有极高的可能性下降至理想 范围。     

The Relationship between the Posterior Chamber Position and Vault after Implantation of the Implantable Collamer Lens

Objective: To study the relationship between the posterior chamber position and vault after implantation of the implantable collamer lens (ICL). Methods: This was a retrospective case series study. From June 2017 to June 2019, 32 cases of middle and high myopia with ICLs in the horizontal or vertical position were selected in Chongqing Aier Maige Ophthalmology Hospital because the vault of one eye was higher than 750 μm and an ICL at the same length was placed in the vertical position in the contralateral eye. The preoperative examination included the measurement of white-to-white (WTW) diameter undera slit lamp microscope, anterior chamber depth (ACD), sulcus-to-sulcus (STS) horizontal diameter, STS vertical diameter and lens thickness (LT) measured by ultrasound biomicroscopy (UBM). The vault was also measured by UBM. The data were analyzed by a paired t test,multiple linear regression and the receiver operating characteristic (ROC) curve. Results: The vault of the ICL in the vertical position decreased significantly (280±205 μm) compared with that in the horizontal position (t=5.375, P<0.001), and the horizontal-vertical diameter difference in the STS in both eyes was 0.42±0.21 mm. Multiple linear regression showed that the difference in vault was significantly related to the difference in the STS horizontal-vertical diameter (adjusted R2 =0.545, F=10.30, P<0.001), but not related to WTW, ACD or LT. The ROC curve was drawn for the horizontal-vertical diameter difference in STS in both eyes according to the standard of the vertical ICL vault falling into the ideal range (250-750 μm). The area under the curve (AUC) was 0.917, 95%CI 0.764-0.985, P<0.001. The optimal cut-off value was 0.3, the sensitivity was 83.33%, and the specificity was 100%. The ROC curve was drawn for the horizontal-vertical diameter difference in STS in both eyes according to the standard of vault difference in both eyes 100, 200 and 300 μm and above: AUC≥100 μm was 0.859, P≥100 μm=0.007, the optimal cut-off value was 0.3, sensitivity was 76.92%, specificity was 100%; AUC≥200 μm was 0.778, P≥200 μm=0.008,the optimal cut-off value was 0.36, sensitivity was 77.78%, specificity was 71.43%; AUC≥300 μm was 0.754, P≥300 μm=0.015, the optimal cut-off value was 0.36, sensitivity was 85.71%, specificity was 66.67%. Conclusions: In the case of a high vault in the horizontal position, if the horizontal-vertical diameter difference is STS>0.3 mm, there is a high probability that the vault of the ICL in the vertical position can be reduced to the ideal range.     

Two-Year Follow-Up of Artisan Iris-Supported Phakic Anterior Chamber Intraocular Lens for Correction of High Myopia

Purpose: To evaluate the results of Artisan iris-supported phakic anterior chamber intraocular lens (pIOL) implantation in patients with high myopia. Methods: Medical records of patients who underwent Artisan pIOL implantation for surgical correction of myopia were retrospectively reviewed. Only patients with at least a two- year follow-up were included. Spherical equivalent of manifest refractive error (SE), uncorrected visual acuity (UDVA), distance corrected visual acuity (CDVA), and endothelial cell density (ECD) were analyzed at six months, one year, and two years after surgery. Results: Sixty-two eyes of 42 patients were included in the study. All patients had a minimum anterior chamber depth of 3.0?mm from the endothelium. At two years, 68% of the patients were within ±0.50 D. Mean ECD was 2723?±?311 cells/mm² preoperatively and 2630?±?291 cells/mm² at six months postoperatively (3.4% loss, p?=?0.001). ECD loss from six months postoperatively to two years postoperatively was not statistically significantly different. In three eyes (4.8%) of two patients, a temporary, steroid-induced increase in intraocular pressure (IOP) was detected. Conclusion: Artisan pIOL implantation is a safe and highly effective procedure for surgical correction of high myopia. ECD loss stabilizes in the early postoperative period.     

Comparison of Verisyse and Veriflex Phakic Intraocular Lenses for Treatment of Moderate to High Myopia 36 Months after Surgery

Purpose: To compare refractive stability, endothelial cell count (ECC), incidence of complications, and patients’ satisfaction between a rigid Verisyse (group I, n = 198) and foldable Veriflex (group II, n = 212) phakic intraocular lenses (pIOL) over 36 months postop. Materials and methods: This was a retrospective study. Patients’ satisfaction and incidence of photic phenomena were evaluated at one month and one year postop. Data were analyzed to determine difference between groups for astigmatism, mean spherical equivalent (MRSE), uncorrected (UDVA) and corrected (CDVA) monocular distance visual acuity, complication rate (acute and chronic), and ECC. Differences were considered statistically significant when p < 0.05. Results: Group II cases had significantly higher UDVA, CDVA, and lower astigmatism during the entire follow-up. There was no significant difference in mean MRSE or mean ECC postoperatively. In both groups, mean ECC reduced significantly at one month postop, followed by a gradual linear decline between 1 and 36 months of 22.4 cells/mm²/annum (group I) and 13.32 cells/mm²/annum (group II). Overall complication rates were ≤ 10% with no significant inter-group differences. Group I patients reported lower incidence of halos at one month but more problems with night vision at one year compared with group II. Overall satisfaction was high and total incidence of reported photic phenomena was low. Conclusion: Both Verisyse and Veriflex pIOLs are effective in correcting myopia. The Veriflex lens demonstrated better refractive outcome; however, subclinical inflammation observed in the Veriflex group and potential influence of inflammation on ECC loss require further investigation.     

有晶状体眼前房虹膜夹型人工晶状体植入矫治高度近视术后波阵面像差

目的评价有晶状体眼前房虹膜夹型人工晶状体植入矫治高度近视术后的波前像差,以阐明其术后的视觉质量。方法采用对照研究的方法,实验组为有晶状体眼前房虹膜夹型人工晶状体植入矫治高度近视术后的患者20例32眼,年龄18～40岁。对照组选择年龄匹配的普通近视眼17例30眼,年龄18～39岁。使用客观型像差仪进行波前像差检测,获得整体像差、各分阶像差的均方根(RMS),及Z7、Z8、Z12项系数和像差图。结果实验组术后1月整体高阶像差(Rh)及各分阶像差的RMS均较对照组高,其中3、4阶高出最明显,差异均有显著性(P<0.05)。实验组术后3月Rh及各分阶像差的RMS均较对照组大(P<0.05),其中3、4阶增高最明显,差异均有显著性。实验组术后3月的Rh、RMS3、RMS4、RMS5、RMS7较术后1月均降低,差异均无统计学意义(P>0.05);第3阶降低最明显;RMS6较术后1月增高,差异无统计学意义(P>0.05)。实验组术后1、3月的Rh与球面屈光度显著正相关(r=0.963、P=0.000;r=0.952、P=0.000)。术后1月的Rh与术前柱面屈光度呈显著正相关(r=0.428、P=0.042)。结论有晶状体眼前房虹膜夹型人工晶状体植入矫治高度近视术后眼的高阶像差高于正常眼。随着时间的推移,除RMS6外,术后1月较高的像差在术后3月时均不同程度的减少。术前球面、柱面屈光度越高,术后1月的Rh越高;术前球面屈光度越高,术后3月的Rh越高。