中央孔型有晶状体眼后房型人工晶体矫正高度近视的临床研究

目的 评价中央孔型有晶状体眼后房型人工晶体(ICL V4c)矫正高度近视的有效性、安全性、可预测性和稳定性.方法 共纳入58例111只眼高度近视患者,术前检查包括裸眼视力(UCVA)、最佳矫正视力(BCVA)、球镜(SE)和柱镜(CE)、对比敏感度、眼压等.其中41例75只眼植入ICL V4c人工晶体(ICL组),21例36只眼植入散光型TICL V4c人工晶体(TICL组).随访3个月,观察项目同术前,并记录术后并发症情况.结果 术后3个月ICL组UCVA≥1.0占58.67%,61只眼(95.31%)UCVA≥术前BCVA,平均SE为(-0.26±1.16)D,术眼屈光度在±0.50 D者达66.67% (50只眼),安全指数(术后与术前BCVA比值)和疗效指数(术后UCVA与术前BCVA比值)分别为1.37和1.31.TICL组UCVA≥1.0占86.11%,32只眼(96.97%)的UCVA均≥术前BCVA.术后平均SE和CE分别为(0.08±0.84)D和(-0.34±0.54)D,术眼SE在±0.50 D达63.89%(23只眼),CE在±0.50D达66.67%(24只眼),安全指数和疗效指数分别为1.32和1.30.两组患者术后对比敏感度在各空间频率的明视及暗视条件下较术前均有明显提高.手术前后眼压无明显变化.结论 高度近视患者植入ICL V4c后视觉质量得到了明显提高,该手术具有良好的有效性、安全性、可预测性、稳定性.

Evaluation of posterior chamber implantable collamer lens with a central hole for myopic correction

Objective To evaluate the effectiveness,safety,predictability and stability of a new posterior chamber implantable collamer lens with central hole to correct myopia.Methods 111 eyes of 58 patients were evaluated,including uncorrected (UCVA) and best corrected (BCVA) visual acuities,spherical equivalent(SE),cylindrical equivalent(CE),contrast sensitivity,intraocular pressure evaluated preoperatively.75 eyes of 41 patients were implanted with ICL V4c(ICL group) while 36 eyes of 21 patients were implanted with Toric ICL V4c(TICL group).Postoperative observation and adverse events were evaluated over 3 months follow-up.Results 3 months after surgery,the mean UCVA in ICL group was 1.0 or better in 58.67%.The UCVA of 61 eyes (95.31%) was more than BCVA before operation.The mean SE was (-0.26±1.16) D,66.67% of 50 eyes were within ±0.50 D.The safety and efficacy indices were 1.37 and 1.31,respectively.The mean UCVA in TICL group was 1.0 or better in 86.11%.The UCVA of 32 eyes (96.97%) was more than BCVA before operation.The mean SE was (0.08±0.84) D,63.89% of 23 eyes were within ±0.50 D.And the mean CE was (-0.34±0.54) D,66.67% of 24 eyes were within±0.50D.The safety and efficacy indices were 1.32 and 1.30,respectively.The postoperative contrast sensitivity values in two groups were found significantly higher than those of the preoperative eyes.The IOP remained stable over time.Conclusion Implantation of the posterior chamber ICL with a central hole is effective,safe,predictable,and stable for the correction of high myopia.