散瞳对中心孔型V4c ICL植入术后拱高及前房深度的影响

目的：研究散瞳前后V4c有晶状体眼人工晶状体（ICL）植入术后患者拱高、前房深度（ACD）及前房角（ACA）的变化，探讨V4c ICL植入术的效果及术后患者散瞳的安全性。方法：前瞻性观察研究。 选取2018年2─9月于北京大学深圳医院眼科行V4c ICL植入术的近视患者31例（62）眼，在术前及 术后6个月时，分别测量裸眼视力（UCVA）、最佳矫正视力（BCVA）及屈光度。在术后6个月时，使用Sirius眼前节分析系统测量散瞳前后的拱高、ACD及ACA。采用配对t检验对数据进行分析。结 果：术前及术后6个月患者UCVA（LogMAR）分别为1.61±0.14、0.16±0.04，差异有统计学意义 （t=12.844，P<0.001）。术前及术后6个月患者BCVA（LogMAR）分别为0.02±0.05、0.01±0.03，差异 具有统计学意义（t=25.429，P<0.001）。散瞳前后拱高分别为（465±123）μm、（515±135）μm（t=-8.704， P<0.001），散瞳前后ACD分别为（2 966±83）μm、（3 009±89）μm（t=-9.899，P<0.001），差异均有 统计学意义。散瞳后3点位及9点位的ACA较散瞳前明显变宽，差异均具有统计学意义（t=-15.306， P<0.001；t=-15.163，P<0.001；）。结论：V4c ICL植入术是矫正近视的一种有效方法，术后散瞳会使拱高升高及ACD加深，同时ACA宽度增加，术后6个月时对V4c ICL植入患者执行术后散瞳是安全的。

The Effect of Mydriasis on Vaults and Anterior Chamber Depths in Myopic Eyes Implanted with V4c Implantable Collamer Lenses

Objective: To compare visual acuity and refractive status after V4c implantable collamer lens (ICL) implantation; to study the changes in vault, anterior chamber depth (ACD) and anterior chamber angle (ACA) after mydriasis; and to evaluate the safety of mydriasis after V4c ICL implantation. Methods: This was a prospective observational study. Thirty-one myopic patients (a total of 62 eyes) who had undergone V4c ICL implantation surgery from February 2018 to September 2018 at the Department of Ophthalmology in Peking University Shenzhen were chosen for this study. Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA) and refractive status were evaluated preoperatively and at 6 months postoperatively. The vault, ACD and ACA of patients undergoing V4c ICL implantation were measured by the Sirius anterior segment analysis system before and after mydriasis. Data were analyzed with a paired-samples t test. Results: At 6 months after V4c ICL implantation, the UCVA and BCVA were significantly better than preoperation (t=12.844, t=25.429, respectively, P<0.001 for both). The vaults before and after mydriasis were 465±123 μm and 515±135 μm (t=-8.704, P<0.001), respectively. In addition, the ACD and ACA at 3 and 9 o'clock after mydriasis was significantly deeper than those before mydriasis (t=-9.899, P<0.001; t=-15.306, P<0.001; t=-15.163, P<0.001). Conclusions: V4c ICL implantation is an effective surgery to correct myopia. Using mydriasis after V4c ICL implantation will increase the vault, deepen ACD and widen ACA. Thus, mydriasis is a safe procedure at 6 months after the surgery.