UBM量化观察有晶状体眼后房型人工晶状体植入术前后眼前节形态的变化

目的 应用超声生物显微镜(UBM)对比观察有晶状体眼后房型人工晶状体(ICL)植入术前后的多项眼前节指标变化,旨在评价ICL的安全性及稳定性。方法 前瞻性研究。收集2008年9月至2010年8月实施ICL植入矫正高度近视眼的患者30例（30只眼）,利用UBM观察并测量手术前、术后3个月及术后1年的中央前房深度(ACD)、小梁与虹膜夹角(TIA)、前房角开放距离（AOD500）、小梁与睫状体距离(TCPD)和虹膜与睫状体距离(ICPD),同时记录术后ICL距晶状体中央前表面的距离、ICL周边部距晶状体的距离及眼压等数据,并用裂隙灯显微镜随访检查。ICL周边部距晶状体的距离采用One-way ANOVA处理,余手术前后数据采用重复测量单因素方差分析及Bonferroni检验处理。结果 术前与术后3个月、术后1年ACD分别为(3.16±0.08) mm、(2.76±0.13) mm、(2.74±0.14) mm;AOD500分别为(0.45±0.04) mm、(0.41±0.04) mm、(0.41±0.03) mm;TIA(12点位)分别为35.0°±3.24°、32.47°±3.56°、32.40°±3.23°,三者术前与术后两时段相比差异均有统计学意义(P＜0.05);术后两时段相比差异无统计学意义(P＞0.05),TCPD、ICPD 术前、术后3个月和术后1年相比差异均无统计学意义(F=0.49,F=0.57;P＞0.05)。结论 应用UBM观察到的ICL手术前后眼前节形态结构的变化主要表现在ACD变浅、TIA及AOD的变窄,但尚在安全范围内,且经过1年多随访观察显示ICL术后眼前节形态结构的变化稳定且未发生相关并发症,但远期效果尚有待进一步随访。

Quantitative observation on changes of anterior segment by ultrasound biomicroscopy after posterior chamber phakic intraocular lens implantation

ObjectiveThe objective is to study the safety and effectiveness of implantation of posterior chamber phakic intraocular contact lens (ICL) by observing the changes in anterior segment using ultrasound biomicroscopy (UBM). Methods It was a perspective study. The study sampled 30 high myopia patients (30 eyes) who were treated with posterior chamber phakic ICL implant. Central anterior chamber depth (ACD), trabecular-iris angle (TIA), angle opening distance (AOD500), trabecular-ciliary processes distance (TCPD) and iris-ciliary processes distance (ICPD) were measured using UBM preoperatively,3 months and 1 year postoperatively. The distance from ICL to the central surface of lens and peripheral lens and intra-ocular pressure were measured postoperatively and examined using slit-lamp biomicroscope. Oneway ANOVA was used to analyze the distance between peripheral surface of ICL and the lens. One-way repeated measures ANOVA and Bonferroni were conducted. Results Preoperatively, 3 months and 1 year postoperatively, ACD were(3. 16 ± 0. 08 ) mm, ( 2. 76 ± 0. 13 ) mm, (2. 74 ± 0. 14) mm; AOD500 were (0.45 + 0.04) mm, (0.41 ± 0.04) mm, (0.41 ±0.03) mm; TIA were (35.00 ±3. 24)°, (32.47 ±3.56) °, (32. 40 ± 3. 23 ) °, respectively. There were significant difference in TIA, ACD and AOD ( P ＜0. 05) between preoperative and postoperative data. There was no significant difference between the two postoperative periods tested. TCPD and ICPD showed no significant difference between various time points ( F =0. 49, F =0. 57 ; P ＞ 0. 05 ). Conclusions The decrease in ACD depth and correction in TIA and AOD were the noticeable changes observed in morphological structure of the ocular anterior segment after the ICL treatment. The incidence of complication did not increase as the result of the minor changes in morph structure during the course of the study. However, the long-term effects would require further long-term observation.