有晶状体眼后房型人工晶状体植入术后眼前节形态学观察

目的 观察有晶状体眼后房型人工晶状体（PPC-ICL）植入术治疗高度近视后眼前节形态学变化，探讨PPC-ICL植入术对前房角、角膜内皮以及邻近组织的影响。方法 前瞻性研究。收集2011年1月至2013年6月在宁夏眼科医院行PPC-ICL植入术的高度近视患者58例（106眼），于术后1、6、12个月进行随访，观察指标包括裸眼视力（UCVA）、最佳矫正视力（BCVA）、眼压（IOP）、角膜内皮细胞计数和超声生物显微镜（UBM）检查。UBM检查包括前房深度（ACD）、拱高（vault）、房角开放距离（AOD500）以及小梁虹膜角（TIA）在2、4、8、10 4个钟点上的变化。采用重复测量方差分析对数据进行处理。结果 所有患者的术后UCVA达到或高于术前BCVA，术前术后IOP和角膜内皮细胞计数相比较差异无统计学意义。UBM检查显示手术前后ACD、AOD500和TIA差异有统计学意义（F=12.372、21.393、22.076、21.154、21.763、19.471、19.823、19.836、19.247，P<0.05），术后1个月时3项指标均比术前显著减小（P<0.05），但术后1个月与6、12个月的ACD、AOD500、TIA和拱高相比差异无统计学意义。随访期内有2例患者（2眼）由于术后拱高过小更换了PPC-ICL，所有患者均未发生瞳孔阻滞性青光眼和晶状体前囊膜下混浊等并发症。结论 PPC-ICL植入术后1年随访期内前房结构稳定，角膜内皮细胞无明显减少。

Changes of ocular anterior segment on morphology after implantation of the implantable collamer lens for high myopia

Objective To assess the effect on anterior chamber angle， corneal endothelial and adjacent tissue after implantation of phakic posterior chamber implantable collamer lens （PPC-ICL） for the correction of high myopia. Methods In this prospective， nonrandomized clinical study， 106 consecutive eyes of 58 patients with high myopic received ICL implantation between January 2011 and June 2013 in the Ningxia Eye Hospital. Uncorrected visual acuity（UCVA）， best corrected visual acuity（BCVA）， intraocular pressure， corneal endothelial cell count were measured preoperatively and at 1 month， 6 months and 12 months postoperatively. The ultrasound biomicroscopy （UBM） was used to observe the depth of anterior chamber （ACD） vault， angle opening distance 500 microns from the scleral spur （AOD500）， trabecular-iris angle （TIA） at point 2， 4， 8 and 10 respectively. The repeated measurement ANOVA was used to analyzed statistical data. Results The postoperative UCVA was equally or higher compare with preoperative BCVA in all patients. Intraocular pressure and corneal endothelial cell count were no statistically significant difference between pre- and postoperative （P>0.05）. The postoperaive ACD， AOD500 and TIA value were decreased significantly than preoperative at 1 month （F=12.372， 21.393， 22.076， 21.154， 21.763， 19.471， 19.823， 19.836， 19.247， P<0.05）. But there were no statistically significant difference of ACD， AOD500， vault and TIA between 1-month and 6-month， 12-month postoperatively. No pupillary block glaucoma or anterior capsule opacification occurred during the follow-up. Conclusion The structure of anterior chamber angle was stable and corneal endothelial cell was no obvious decrease postoperatively during 1 year follow-up.