高度近视有晶状体眼后房型人工晶状体植入术后眼前节解剖变化

目的 分析高度近视眼患者植入有晶状体眼后房型人工晶状体（Visian ICL V4）术后眼前节解剖结构的变化.方法 本研究入选行有晶状体眼人工晶状体植入术的高度近视患者93例（175眼）,平均年龄（30.52 ±7.00）岁（18～48岁）,其中119眼接受ICL植入术,46眼接受Toric-ICL植入术.比较术前和术后1周前房容积（ACV）、前房深度（ACD）、房角角度（ACA）（3：00 ～9：00位方向）变化、ICL光学区后表面到晶状体前囊膜中央距离（拱高）、角膜-晶状体间距、虹膜-晶状体间距、人工晶状体等效球镜（pIOL SE）等各参数间的关系.结果 术前、术后1周ACV分别为（200.29±31.76） mm3及（116.49±21.88） mm3,ACV减少（t=48.456,P=0.000）.术前、术后ACD由（3.17 ±0.23） mm减少到（2.89±0.33） mm（t=12.237,P=0.000）,术前、术后房角由（36.40 ±4.90）°减少到（23.44 ±5.07）°（t=31.131,P=0.000）;术后ACV和术后ACD与术后ACA呈现正相关（分别为r=0.637,P=0.000;r=0.393,P=0.000）.术后的角膜-晶状体间距较术前增加（0.40 ±0.31） mm（t=-16.935,P=0.000）,其与拱高呈正相关（r=0.446,P=0.000）.多因素回归分析,拱高与角膜-晶状体间距比值、手术前后的瞳孔变化率是独立的手术前后角膜-晶状体间距变化的影响因素（分别是P =0.001和P=0.048）.结论 ICL植入术后,虹膜平面抬升,使前房容积变小和房角变窄.

Anatomical changes of anterior segment after phakic collamer implantation

Objective To evaluate the anatomical changes of anterior segment after posterior chamber phakic intraocular lens （Visian ICL V4,Implantable Collamer Lenses V4） implantation for high myopic eyes.Methods One hundred and seventy-five eyes of 93 patients who underwent myopic inplantable collamer lens （ICL） implantation were recruited aged （30.52 ± 7.0） yearing,range from 18 to 48 years].One hundred and nineteen eyes underwent conventional ICL implantation and 46 eyes underwent Toric-ICL implantation.Preoperative and postoperative （one week） anterior chamber volume （ACV）,anterior chamber depth （ACD）,anterior chamber angle （ACA） （scan from 3：00 ～ 9：00）,the distance between central posterior surface of the ICL and anterior surface of the crystalline lens （vault）,cornea-lens distance,iris-lens distance,and spherical equivalent of phakic intraocular lens （pIOL SE） were recorded and analyzed.Results The mean ACV decreased from （200.29 ± 31.76） mm3 preoperatively to （116.49 ± 21.88） mm3 one week postoperatively （t =48.456,P =0.000）.The ACD decreased from （3.17 ±0.23） mm （preoperatively） to （2.89 ±0.33） mm （1 week postoperatively） （t =12.237,P =0.000）.The anterior chamber angle decreased from （36.40 ± 4.90）° （preoperatively） to （23.44 ± 5.07）° （1 week postoperatively） （t =31.131,P =0.000）.Postoperative ACA was positively correlated with postoperative ACV（r =0.637,P =0.000） and postoperative ACD（r =0.393,P =0.000）.Postoperative corneal-lens distance were greater than preoperative cornea-lens distance mean difference （0.40 ± 0.31） mm,P =0.000].Positive correlation was observed between corneal-lens distance and vault （r =0.446,P =0.000）.Stepwise regression analysis showed that the ratio of vault to cornea-lens distance and the change rate of preoperative and postoperative pupil diameter were two independent predictors of the changes of corneallens distance.（P =0.001,0.048 respectively）.Conclusions IC