白内障摘除术中植入的不同型号IOL术后居中性的测量及比较

目的 测量并比较白内障摘除术中不同型号人工晶状体（IOL）植入后在眼内的居中性。设计 回顾性病例系列。研究对象 连续收集2019年12月在北京同仁医院眼科进行白内障摘除IOL植入术后6个月复诊的患者120例（120眼）。方法 根据所植入IOL的型号不同分为A、B、C三组，每组40例。对术眼进行前段扫频OCT（AS-SS-OCT）检查。同一轴线上IOL中心与巩膜突连线中点的距离为IOL偏心度，IOL平面与巩膜突平面间的夹角为IOL倾斜度。分别测量水平方向和垂直方向的偏心度和倾斜度，并进行组间比较。主要指标 IOL在水平方向和垂直方向的偏中心度和倾斜度。结果 A组水平方向偏心度为（0.24±0.07）mm （0.11~0.39 mm），倾斜角度为（1.41±0.64）° （0.48~2.68°），垂直方向偏心度为（0.23±0.08）mm （0.11~0.47mm），倾斜角度为（1.79±0.91）° （1.02-4.72°）。B组水平方向偏心度为（0.23±0.08）mm （0.11~0.43 mm），倾斜角度为（1.59±1.19）° （0.44~3.61°），垂直方向偏心度为（0.23±0.07）mm （0.14~0.41 mm），倾斜角度为（2.09±1.31）° （0.56~5.04°）。C组水平方向偏心度为（0.28±0.12）mm （0.13~0.49 mm），倾斜角度为（1.86±1.21）° （0.26~3.71°），垂直方向偏心度为（0.31±0.17）mm （0.23~0.46 mm），倾斜角度为（2.01±1.01）° （0.61~4.86°）。三组间水平和垂直方向的偏心程度和倾斜角度差异均无显著性 （P均>0.05）。三组患者在充分矫正屈光不正后，均未出现炫光等不适主诉。结论 白内障摘除IOL植入术后IOL偏中心的发生与所植入IOL的类型可能无关；在IOL偏中性度<0.5 mm、倾斜度<5°的情况未导致术后的不良视觉现象。

Measuring and comparing of decentration and tilt of different types of IOLs implantated after cataract extraction

Objective To measure and compare the position of different designed intraocular lens (IOL) location in the capsular bag after implantation. Design Retrospective case series. Participants A total of 120 eyes （120 cases）were continuously acquired in Dec 2019, six months after cataract surgery. All these cases were operated in Beijing Tongren Eye Center. Methods According to the different design of the implanted IOL, the patients were divided into A, B and C group, with 40 patients (40 eyes) in each group. Uncorrected visual acurity (UCVA) and best corrected visual acurity (BCVA) was measured. The IOL decentration and the degree of IOL tilt was measured using anterior segment sweep source optical coherence tomography(AS-SS-OCT). The distance between the IOL center and the middle point of the line between the scleral process is the IOL decentration, and the angle between the IOL plane and the plane of the scleral process is the degree of IOL tilt. Main Outcome Measures Decentration and tilt of IOLs in horizontal and vertical position. Results In group A, the horizontal decentration distance was (0.24±0.07) mm (0.11~0.39 mm) and horizontal tilt angle was (1.41±0.64)° (0.48~2.68°); the vertical decentration distance was (0.23±0.08) mm (0.11~0.47 mm) and vertical tilt angle was (1.79±0.91)° (1.02~4.72°). In group B, the horizontal decentration distance was (0.23±0.08) mm (0.11~0.43 mm) and horizontal tilt angle was (1.59±1.19)° (0.44~3.61°); the vertical decentration distance was (0.23±0.07) mm (0.14~0.41 mm) and vertical tilt angle was (2.09±1.31)° (0.56~5.04°). In group C, the horizontal decentration distance was (0.28±0.12) mm (0.13~0.49 mm) and horizontal tilt angle was (1.86±1.21)° (0.26~3.71°); the vertical decentration distance was (0.31±0.17) mm (0.23~0.46 mm) and vertical tilt angle was (2.01±1.01)° (0.61~4.86°). All the data showed no significant difference in two groups (all P>0.05). The UCVA and BCVA showed no significant difference in three groups, and no case complained glare or holes. Conclusion The decentration and tilt of IOL might not be related to the type of IOL implanted. It did not lead to adverse visual effects under the conditions with the IOL decentration <0.5 mm and the tilt degree <5°.