圆锥角膜并发白内障人工晶状体度数计算1例

44岁男性,因右眼视力下降3年余就诊。患者右眼圆锥角膜病史并佩戴硬性角膜接触镜(RGP)24年。双眼最佳矫正视力：右眼0.05(-19.00/-5.00×130°),左眼1.0(-9.25/-0.50×180°)。裂隙灯检查:右眼角膜局限膨出,膨出区域角膜变薄,晶状体混浊。诊断为右眼并发性白内障,圆锥角膜;行右眼白内障超声乳化联合人工晶状体(IOL)植入术,手术顺利。术前停戴RGP 3周后,根据IOL master 700测量结果(K1=50.15 D,K2=56.96 D,眼轴=31.00 mm),使用Kane圆锥角膜(Kane KCN)公式计算出Rayner零球差IOL度数为-3.0 D,预计术后近视度数为-4.07 D。术后第24天,右眼裸眼视力0.6,矫正视力-1.50/-5.50×105°→0.5(右眼视力不稳定),术后等效球镜度数-4.25 D,屈光误差+0.18 D。讨论体会：对于存在角膜曲率极值、角膜不规则的圆锥角膜患者,首先需要采用多种方法(特别是Pentacam)测量角膜形态、曲率等判断圆锥角膜分级和进展,并通过比较获得较为准确的测量值。另外,应选择合适的IOL计算...     

中央孔型有晶状体眼后房型人工晶状体植入术后近视患者早期视力恢复的影响因素分析

目的 探讨中央孔型有晶状体眼后房型人工晶状体植入术(ICL)后近视患者早期视力恢复的影响因素。方法 回顾性病例对照研究。收集2016年5月至2022年1月在首都医科大学附属北京同仁医院行ICL V4c植入术,且术后1周裸眼视力(UCVA)<术前最佳矫正视力(BCVA),术后1周UCVA(logMAR)≥0的近视患者64例(64眼)为视力恢复较差组;匹配同期在我院行ICL植入术,且术后1周UCVA≥术前BCVA的近视患者160例(160眼)为视力恢复较好组。检查患者术前非接触性眼压(NCT)、球镜度数、柱镜度数、等效球镜度数(SE)、白到白距离(WTW)、角膜曲率(K)、角膜前表面中央扁平子午线曲率(K₁)、角膜前表面陡峭子午线曲率(K₂)、角膜内皮细胞计数(ECC)、中央角膜厚度(CCT)、瞳孔直径、前房深度(ACD)、眼轴长度(AL)、晶状体厚度(LT),测量患者术后1周的非接触性眼压(NCT)、球镜度数、柱镜度数、等效球镜度数(SE)、拱高,并记录术中植入ICL的球镜度数、柱镜度数、预期晶状体残留度数和ICL直径。对两组患者手术前后...     

角膜缝线效应对外伤性白内障人工晶状体度数测算准确性的影响

目的:探讨缝线效应对外伤性白内障人工晶状体度数测算准确性的影响。方法:前瞻性研究。收集2017-03/2019-03拟在我院实施Ⅱ期人工晶状体植入术的角膜穿通伤缝合联合白内障摘除术后患者57例57眼并进行分组,观察组于术前1wk拆除角膜缝线,对照组于术中拆除角膜缝线。比较观察组患者角膜缝线拆除前后角膜曲率、角膜散光、前房深度、眼轴长度及理论人工晶状体度数的变化,观察两组患者术后裸眼视力和角膜散光情况。结果:角膜缝线拆除前后,观察组患者角膜曲率(43.15±1.32D vs 45.05±1.20D)、角膜散光(-5.23±2.52D vs-2.04±1.44D)及理论人工晶状体度数(22.24±2.36D vs20.40±1.46D)均有差异(P<0.05),而前房深度、眼轴均无差异(P>0.05)。术后1d,1wk,1、3mo,观察组患者裸眼视力均优于对照组,角膜散光均低于对照组(P<0.05)。结论:角膜缝线效应对外伤性白内障患者角膜散光和理论人工晶状体度数测算及术后屈光状态影响显著。     

有晶状体眼人工晶状体植入术治疗高度近视眼的准备与配合

1临床资料患者,女,38岁,术前检查:手术前例行检查同超声乳化术。检查眼轴长度、前方深度、角膜曲率带入公式计算人工晶状体度数。检查角膜曲率排除圆锥角膜。检查结果见表1。手术适应证:高度近视不能接受眼镜、角膜接触镜;有较好矫正视力,视网膜无干性裂孔或有周边变性行光凝术后;无高眼压和青光眼;无葡萄膜炎。对高度近视眼患者进行有晶状体眼人工晶状体植入术前准备与术中配合。术后裸眼视力:右眼0.6,左眼0.8,眼压:右眼11mmHg,左眼12mmHg。2讨论由于患者除了高度近视,无其他眼疾,而有晶状体眼人工晶状体(implantable contact lens,ICL)植入术后可能发生白内障、眼压高等并     

白内障超声乳化联合人工晶状体植入术后眼高阶像差的多因素研究

目的 观察白内障超声乳化并人工晶状体植入术后眼高阶像差与人工晶状体各参数的关系,探讨改善白内障术后眼高阶像差的途径.方法 采用Zywave波前像差仪,检测白内障超声乳化并人工晶状体植入术后129例(129眼)患者的术眼总高阶像差、球差、彗差等各高阶像差的均方根值,常规检查裸眼视力、最佳矫正视力、人工晶状体位置、前后囊混浊情况、眼压、眼底,并记录术眼的人工晶状体类型、人工晶状体度数、眼轴长度、瞳孔直径、白内障分级、泪膜破裂时间等影响波前像差的多种临床因素资料,进行多元逐步回归分析.结果 术后3个月,平均裸眼视力(LogMAR视力)为0.29±0.09,最佳矫正视力(LogMAR视力)为0.02±0.06.所有患者的术眼除Z310、Z420、Z530外,其余高阶像差与多种临床因素存在线性回归关系(均为P<0.05).其中,人工晶状体类型是术后眼高阶像差的主要影响因素,白内障分级与眼轴长度等对其也有一定影响.总高阶像差的回归方程中,眼轴长度与人工晶状体类型的标准化线性回归系数分别为0.25和-0.38,后者对总高阶像差的影响较大.结论 白内障超声乳化并人工晶状体植入术后患眼高阶像差受多种临床因素影响,非球面人工晶状体可以降低术眼高阶像差.     

角膜塑形镜控制青少年近视进展的效果和影响因素分析

目的:评价角膜塑形镜对青少年近视的控制效果和相关影响因素.方法:选择2012-01/2014-12在我院眼科门诊就诊的8~17岁低中度近视的患者97例189眼,配镜后随访2a,观察患者视力、角膜曲率、屈光度、眼轴长度的变化,并分析青少年近视进展的影响因素.结果:患者裸眼视力、角膜水平曲率及角膜垂直曲率戴镜1mo后与戴镜前相比,差异均有统计学意义(P<0.001).配戴角膜塑形镜的患者在戴镜2a后等效球镜变化量(-0.51±0.64D,t=10.864,P<0.001),眼轴长度增加(0.33±0.31mm,t=14.879,P<0.001),角膜散光变化量(-0.25±0.43D,t=5.375,P<0.001),差异均有统计学意义.等效球镜变化量相关因素分析显示,年龄、戴镜前球镜、戴镜前等效球镜、基础眼轴与等效球镜变化量均呈负相关(P<0.05).结论:角膜塑形镜可有效提高患者裸眼视力.虽然配戴角膜塑形镜患者的眼轴和屈光度有小幅增加,但仍是一种有效控制近视发展的矫治方法.角膜塑形术对于年龄较大,基础眼轴长,近视度数高的患者,其近视控制效果更好.     

透明角膜3mm切口白内障超声乳化术后的屈光状态研究

目的:观察3mm透明角膜切口白内障超声乳化吸除及折叠式人工晶状体植入术后患者的屈光状态及其变化规律,确定最佳配镜时间。方法:老年性白内障患者68例(79眼)行3mm透明角膜切口白内障超声乳化吸除及折叠式人工晶状体植入术,术后行EAS-1000检查,除外人工晶状体存在偏位情况。然后1,2,3,4wk;3,6mo行视力及显然验光检查,记录患者的视力、球镜、柱镜和散光轴,分别对结果行多因素方差分析。结果:术后1,2,3,4wk;3,6mo的裸眼及矫正视力,球镜、柱镜度数及其散光轴的变化差异均无显著性(P>0.05)。结论:3mm透明角膜切口白内障超声乳化吸除及折叠式人工晶状体植入术后1wk屈光状态趋于稳定,即可配镜。     

LASEK治疗白内障摘除联合IOL植入术后屈光不正的观察

目的:观察准分子激光上皮下角膜磨镶术(LASEK) 治疗白内障摘除联合人工晶状体植入术后屈光不正的安全性及疗效。方法:对白内障摘除联合人工晶状体植入术后屈光不正的42例49眼施行LASEK,术后随访6mo以上,记录角膜地形图、视力、屈光度数、角膜haze等情况。结果:术后6mo裸眼视力≥1.0者32眼(65.3%),≥0.8者42眼(85.7%)。球镜度数±1.0D内者为45眼(91.8%),±0.5D内者为34眼(69.4%)。柱镜度数±1.0D内者43眼(87.8%),±0.5D内者为31眼(63.3%)。术后6mo 0.5级haze 4眼(8.2%),其余均为0级,无继发性圆锥角膜、继发性青光眼、切削偏中心等并发症。结论:LASEK治疗白内障人工晶状体植入术后屈光不正屈光不正安全性高,疗效确切。     

小切口非超声乳化白内障手术联合人工晶状体植入术后屈光状态的分析

目的分析小切口非超声乳化白内障手术联合人工晶状体植入术术后屈光状态。方法老年性白内障52例（68眼）。术前应用手动角膜曲率计及眼科A/B超测量角膜曲率及眼轴长度,计算所需人工晶状体度数,全部行小切口白内障囊外摘出联合PMMA人工晶状体植入术,术后观察视力、角膜曲率、散光及实际屈光度。结果所有手术均顺利完成,术后3月,裸眼视力0.5～0.8者51眼（75.00%）,裸眼视力〉0.8者13眼（19.12%）;最佳矫正视力〈0.5者4眼（5.88%）（检查发现此4眼为老年性黄斑变性）。角膜曲率平均K值44.22±1.45,角膜散光（0.98±0.76）D,与术前比较,差别均无统计学意义（P〉0.05）;术后屈光度等值球镜（0.10±0.95）D,与术前预测目标屈光度差别有高度统计学意义（P〈0.02）。结论现代小切口非超声乳化白内障摘出术对角膜散光影响较小,手术安全,并发症少。但术后实际屈光度与术前预测值存在差别,应在工作中进一步探索准确计算所需人工晶状体度数的手段。     

球面及非球面散光矫正型人工晶状体植入术后的裸眼视力对比

目的:比较术前伴有角膜散光的白内障患者在植入球面散光矫正型人工晶状体和非球面散光矫正型人工晶状体术后的裸眼视力,并探讨术前角膜散光的程度对散光矫正型人工晶状体植入术后裸眼远视力的提高程度的影响.方法:收集患者44例57眼的病例资料,其中球面组有23例27眼,非球面组有21例30眼,记录术前及术后1d裸眼远视力(UDVA)、术前角膜散光度数、人工晶状体型号及等效球镜度数、术中人工晶状体轴位.比较两组术前与术后1d裸眼远视力(LogMAR)差别以及术后1d裸眼视力0.4以上患者的比例,并按散光度数进行分层,散光度数小于2.0D为低散光层,散光度数≥2.0D为中高散光层,比较两组术后裸眼远视力的提高效果.结果:球面组和非球面组术后1d裸眼远视力0.4以上患者比例分别为92.6％、93.3％,与术前14.8％、13.3％相比明显增加.两组术前、术后1d裸眼远视力比较,差异无统计学意义(P＞0.05);两组术后1d裸眼远视力与术前相比均明显提高,差异有统计学意义(P＜0.01).各散光层内两种人工晶状体植入术后裸眼视力的差异无统计学意义(P＞0.05);植入术后1d裸眼远视力与术前相比均明显提高,差异有统计学意义(P＜0.01).术前不同程度散光的白内障患者在植入散光矫正型人工晶状体后,术后裸眼远视力之间的差异无统计学意义(P＞0.05);植入术后1d裸眼远视力与术前相比均明显提高,差异有统计学意义(P＜0.01).结论:球面及非球面散光矫正型人工晶状体植入可以有效地提高白内障合并角膜散光患者的裸眼远视力,但在提高裸眼视力方面,非球面散光矫正型人工晶状体并不优于球面散光矫正型人工晶状体.     

Clinical outcomes of management of posterior capsule rupture with air bubble techniques

AIM: To evaluate the clinical outcomes after implantation of a new intrastromal corneal ring segment associated with photorefractive keratectomy (PRK) to correct high myopia (ICRS HM) in patients with thin corneas. METHODS: We evaluated 42 eyes of 23 patients that had ICRS HM implantation followed by PRK. The mean age of patients was 29.1±7.12y (range 18 to 40 years old). Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), keratometry, spherical equivalent, pachymetry, and aberrometry were compared using ANOVA with repeated measurements assessed preoperatively and at last follow-up visit after the procedures. The refractive predictability and simulated/real corneal ablation were also assessed. RESULTS: The mean follow-up time after PRK was 6.8±1.6mo. The mean preoperative UCVA improved from 20/800 preoperative to 20/100 after ICRS and 20/35 after PRK. The mean preoperative BCVA was 20/25 (range from 20/40 to 20/20) and remained unchanged after ICRS HM implantation. Following the PRK the mean BCVA was 20/25 (range from 20/40 to 20/20). The mean spherical equivalent decreased from -7.25±1.12 (range -5.00 to -9.00) preoperatively to -3.32±1.0 (range -2.00 to -5.00) postoperatively (P<0.001) after ICRS HM, ICRS implantation and decreased from -2.44±1.51 preoperatively to 0.32±0.45 (range -0.625 to 0.875) postoperatively (P<0.001) after PRK. The change in BCVA and topographic astigmatism was statistically significant (P<0.0001). CONCLUSION: ICRS HM associated with PRK can be a tissue saving procedure and an alternative surgical option for correction of moderate to high myopia.     

Impact of ultrasound and optical biometry on refractive outcomes of cataract surgery after penetrating keratoplasty in keratoconus

AIM: To analyse the impact of ultrasound and optical intraocular lens (IOL) calculation methods on refractive outcomes of cataract phacoemulsification performed after penetrating keratoplasty (PK) in keratoconus. METHODS: Phacoemulsification cataract surgery was performed on 42 eyes of 34 patients with keratoconus who had previously undergone PK. The IOL power was determined by using both standard and corneal topography-derived keratometry using the SRK/T formula. We used two independent methods-ultrasound biometry (UB) and interferometry [optical biometry (OB)] for IOL calculation. The analysed data from medical records included demographics, medical history, best corrected visual acuity (BCVA) on Snellen charts, technique of IOL calculation and calculation formula and its impact on final refractive result. RESULTS: BCVA ranged from 0.01 to 0.4 (mean 0.09±0.19) before surgery and ranged from 0.2 to 0.7 (mean 0.38±0.14) at 1mo and from 0.2 to 1.0 (mean 0.56±0.16) (P<0.05) at 3mo, postoperatively. The refractive aim differed significantly from the refractive outcome in both the UB and OB groups (P<0.05). There was no statistically significant difference in the accuracy of the two biometry methods. CONCLUSION: The refractive aim in keratoconus eyes post-PK is not achieved with either ultrasound or OB.     

Intraocular lens power calculation using the IOLMaster and various formulas in eyes with long axial length

PURPOSE: To evaluate the predictability of intraocular lens (IOL) power calculations using the IOLMaster (Carl Zeiss) and different IOL power calculation formulas in eyes with a long axial length (AL). SETTING: Department of Ophthalmology, Far Eastern Memorial Hospital, Taipei, Taiwan. METHODS: This study included 68 eyes with an AL longer than 25.0 mm that had phacoemulsification with IOL implantation. Preoperative AL and keratometric index measurements were obtained with the IOLMaster (Group 1) or, respectively, with applanation ultrasound and automatic keratometry (Group 2). The power of the implanted IOL was used to calculate the predicted postoperative spherical equivalence (SE) by various formulas: SRK/T, SRK II, and Holladay 1 (Groups 1 and 2) and Haigis (Group 1). The predictive accuracy of the formula was analyzed by comparing the mean difference between the actual and predicted postoperative SE; that is, the mean absolute error (MAE). RESULTS: The mean AL was significantly longer in Group 1 than in Group 2 (P = .03). The MAEs calculated by the SRK/T, SRK II, and Holladay 1 formulas were comparable between the 2 groups (P>.05). The lowest MAE was obtained using the IOLMaster data in the Haigis formula (P<.05). CONCLUSIONS: Although AL measured by the IOLMaster was longer than that measured by ultrasound, use of optical or ultrasound biometry data in the SRK/T, SRK II, and Holladay 1 formulas resulted in similar accuracy of IOL power prediction in eyes with higher myopia. The IOL power calculated using the Haigis formula predicted the best refractive outcome in long eyes.     

Evaluation of anterior and posterior surfaces of the cornea using a dual Scheimpflug analyzer in keratoconus patients implanted with intrastromal corneal ring segments

AIM: To evaluate corneal parameters measured with a dual Scheimpflug analyzer in keratoconus patients implanted with intrastromal corneal ring segments (ICRS). METHODS: Fifty eyes of 40 keratoconus patients had Ferrara ICRS implantation from November 2010 to April 2014. Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), refraction, keratometry, asphericity, elevation, pachymetry, root mean square (RMS), spherical aberration and coma were studied. All patients were evaluated using a dual Scheimpflug system. RESULTS: The mean follow-up time after the procedure was 12.7mo. The mean UCVA improved from 0.82 to 0.31 (P<0.001); the mean BCVA improved from 0.42 to 0.05 (P<0.0001), the mean spherical refraction changed from -3.06±3.80 D to -0.80±2.5 D (P<0.0001) and the mean refraction astigmatism reduced from -4.51±2.08 D to -2.26±1.18 D (P<0.0001). The changes from preoperative to postoperative, in parameters of the anterior and posterior surface of the cornea, were statistically significant except the elevation posterior at the apex of the cornea and posterior asphericity. CONCLUSION: The implantation of Ferrara ICRS induces changes in both anterior and posterior surfaces of the cornea.     

Intraocular lens power calculation changes before and after isotonic collagen cross-linking in keratoconus patients

Purpose:To find the intraocular lens (IOL) power calculation changes before and after isotonic collagen cross-linking (CXL) in keratoconus patients.Methods:Thirty-five eyes of 25 patients who underwent isotonic CXL were included. The cases included conventional CXL (n = 16), accelerated CXL (n = 7), contact lens-assisted CXL (CACXL) (n = 9), accelerated CACXL (n = 3). All underwent ocular biometry (IOL master), corneal topography (Orbscan II), and simulated keratometry (Orbscan II) preoperatively and 1-year post CXL. Change in best-corrected visual acuity (BCVA), axial length (AL), simulated keratometry (Sim K), anterior chamber depth (ACD), and IOL power were analyzed in the overall data and then grouped based on flattening (Group A) and no flattening (Group B) of Sim K value post CXL procedure.Results:For the overall data, there was no significant change in IOL power (P = 0.05) at the end of 1 year, BCVA showed a significant increase (P < 0.01), and Sim K reading showed a statistically significant flattening (P = 0.001); ACD and AL showed insignificant change. In intergroup comparison, there was no statistically significant change in IOL power. However, in Group A, a significant change in BCVA and Sim K values was observed. In both groups (Group A and Group B), IOL power was found to be negatively correlated with AL and Sim K values.Conclusion:Isotonic CXL did not affect IOL power calculation at the end of 1 year. However, significant change in BCVA and sim K reading was noted.     

Outcomes of secondary sulcus intraocular lens implantation in unilateral anterior persistent fetal vasculature

AIM: To evaluate the surgical results of sulcus intraocular lens (IOL) implantation in children with unilateral anterior persistent fetal vasculature (PFV) underwent primary vitrectomy combined with lensectomy and preservation of the peripheral anterior capsule. METHODS: Twenty-two eyes of 22 children with unilateral anterior PFV who underwent sulcus secondary IOL implantation were analyzed. Main outcome measures were preoperative and postoperative visual acuity, and complications both intraoperatively and postoperatively. RESULTS: Review of 22 consecutive patients identified best-corrected visual acuity (BCVA) improvement from 1.37±0.84 to 0.73±0.57 logarithm of the minimal angle of resolution (logMAR) after IOL implantation (P<0.001) with a mean follow-up was 16.55±5.86mo. Average age at secondary IOL implantation was 41.05±15.41mo. Three eyes (13.64%) achieved BCVA of 0.3 logMAR at the final visit. Transient intraocular pressure rise (4 eyes; 18.18%), postoperative increased inflammation (3 eyes; 13.64%) and postoperative hypotony (2 eyes; 9.09%) were common complications. CONCLUSION: Properly preservation of the anterior lens capsule during the primary surgery facilitated secondary sulcus IOL implantation in pediatric patients with anterior PFV, with favorable postoperative visual outcomes and compatible percentage of complications.     

Metabolomics and biomarkers in ocular matrix: beyond ocular diseases

AIM: To evaluate the therapeutic effect of combined phacovitrectomy with membrane peeling and intraocular lens (IOL) implantation in patients with severe idiopathic epiretinal membrane (iERM) and concurrent cataract.METHODS: A total of 34 eyes from 34 patients who underwent phacovitrectomy and epiretinal membrane peeling at the First Affiliated Hospital of Zhejiang University between 2015 and 2017. The best-corrected visual acuity (BCVA) and central foveal thickness (CFT) were measured preoperatively and at 1, 3, 6mo and 1y postoperatively. Temporal changes and bivariate correlations of these parameters were analyzed.RESULTS: Mean logMAR BCVA improved and CFT decreased significantly (P<0.001) until 6mo after surgery. Correlation analysis revealed a positive correlation between preoperative and postoperative logMAR BCVA (r=0.716, P<0.001 at 1mo, r=0.417, P=0.014 at 3mo, r=0.359, P=0.037 at 6mo, and r=0.369, P=0.032 at 12mo post-op respectively), but preoperative CFT was neither associated with postoperative CFT nor with postoperative logMAR BCVA. There was a positive correlation between CFT and logMAR BCVA at 1mo (r=0.346, P=0.045), 6mo (r=0.347, P=0.045), and 12mo (r=0.342, P=0.048) post-operatively. The intra- and postoperative complications were relatively mild, and the incidences were generally low.CONCLUSION: For severe iERM patients with significant visual symptoms, combined phacovitrectomy with membrane peeling and IOL implantation is safe and effective in improving BCVA and decreasing CFT. Early surgery in selected patients may help preserving better visual function.     

角膜屈光术后人工晶状体度数计算的临床观察

目的：探讨角膜近视屈光术后白内障患者的人工晶状体度数的计算方法,观察初步的临床效果。方法：回顾性分析2013－03／2015－06于我院行白内障手术同时伴有角膜近视屈光手术史的患者14例23眼。根据患者既往角膜手术方式分为 LASIK （ laser in situ keratomileusis）组9例15眼,RK（ radial keratotomy）组5例8眼。将每例患者的角膜地形图中央2．5 mm最低点曲率值,带入SRK－T公式,按照预留－1．00～－1．50 D选择人工晶状体度数,完成常规的白内障超声乳化联合人工晶状体植入术。术后随访3mo,观察术后视力、矫正视力和屈光状态。计算出术后人工晶状体计算公式的预测屈光误差,分别与www．iolcalc．org网站上的Shammas公式和Barrett True K公式进行比较,观察其应用效果,采用独立样本t检验进行统计分析。结果：LASIK组和RK组相比,两组患者术后3 mo的裸眼视力（LogMAR）分别是0．15±0．11、0．21±0．16,术后屈光度分别是－0．43±1．04、－1．52±1．01D,SRK－T公式预测屈光误差分别是－0．71±0．80、0．43±0．99,LASIK组均优于RK组且两组间差异均有统计学意义（ P＜0．05）。将本研究方法分别与Shammas公式和Barrett True K公式相比,观察各种公式的预测屈光误差,本研究方法的屈光误差最小,但是差异无统计学意义（P＞0．05）。结论：应用研究方法的术后屈光状态均为轻度近视,适用于因近视行角膜屈光手术的白内障患者进行人工晶状体度数的选择,此方法对于LASIK手术史患者的人工晶状体度数预测性更佳。     

Efficacy of scleral-fixated 3-looped haptics intraocular lens implantation for surgical management of microspherophakia

AIM: To evaluate the safety and efficacy of scleral-fixated 3-looped haptics intraocular lens (IOL) implantation for surgical management of microspherophakia. METHODS: A retrospective case series include 10 microspherophakic patients (15 eyes) who underwent lens removal plus a modified surgical treatment of scleral-fixated 3-looped haptics IOL implantation. The primary outcomes involved visual acuity, intraocular pressure (IOP). Secondary outcomes were spherical equivalent (SE), anterior chamber depth (ACD), corneal endothelial cell density and postoperative complications. RESULTS: After a postoperative follow-up of 17.60±15.44mo, improved visual outcomes can be observed. The uncorrected distance visual acuity (UCVA) logMAR improved from 1.54±0.59 preoperatively to 0.51±0.35 postoperatively (P=0.001), and best corrected visual acuity (BCVA) logMAR improved from 0.97±0.91 preoperatively to 0.24±0.23 postoperatively (P=0.003). Moreover, the SE decreased from -9.58±7.47D preoperatively to -0.65±2.21 D postoperatively (P<0.001). In terms of safety profile, the average IOP decreased from 21.10±12.94 mm Hg preoperatively to 14.03±3.57 mm Hg postoperatively (P=0.044), and the previously elevated IOP of three eyes decreased to the normal range. The ACD increased from 2.25±1.45 mm preoperatively to 3.35±0.39 mm postoperatively (P=0.017). The density of corneal endothelial cells did not change significantly after surgery (P=0.140). The posterior chamber IOLs were well centered and no severe complications were found. CONCLUSION: Lens removal plus the modified surgical treatment of scleral-fixated 3-looped haptics IOL implantation can help in improvement of visual acuity, which can be regarded as a relative safe method for the surgical management of microspherophakia.     

ICL-V4c植入对人工晶状体度数计算的影响

目的：观察中央孔型有晶状体眼后房型人工晶状体ICL-V4c植入对人工晶状体（IOL）度数计算的影响。方法：前瞻性临床研究。选取2020年12月至2021年6月在新疆军区总医院北京路医疗区行ICL-V4c植入术并符合本研究纳排标准的患者40例（80眼）,在术前及术后1d、1周、1个月、3个月使用IOLMaster500测量每例患者角膜屈光度、眼轴、前房深度（ACD）,并通过SRK-T、HolladayⅠ、Haigis、Hoffer-Q公式计算得出IOL度数。采用重复测量方差分析进行数据分析。结果：角膜屈光度（K1、K2）术前及术后各时间点测量值之间的差异有统计学意义（F=34.23,P<0.001;F=14.64,P<0.001）。K1术后各时间点测量值均明显小于术前测量值（均P<0.001）,术后各时间点测量值呈逐渐上升趋势;K2术后1d、1周、1个月、3个月测量值均明显大于术前测量值（均P<0.05）,术后各时间点测量值呈逐渐降低趋势。ACD在术前及术后各时间点测量值之间的差异有统计学意义（F=36.90,P<0.001）,术后各时间点测量值均明显小于术前测量值（均P<0.001）,术后各时间点测量值之间两两比较差异均无统计学意义,呈平稳趋势。眼轴在术前及术后各时间点测量值之间的差异无统计学意义,各时间点测量值两两比较差异均无统计学意义。使用SRK-T、HolladayⅠ、Haigis、Hoffer-Q 公式计算获得的IOL度数在术前及术后各时间点的差异无统计学意义（均P>0.05）。结论：角膜屈光度及ACD的测量可能受ICL-V4c植入的影响,IOLMaster500通过SRK-T、HolladayⅠ、Haigis、Hoffer-Q公式计算IOL度数不受ICL-V4c的植入的影响。