目的:研究高度近视患者植入带中心孔的植入式collamer晶状体(ICL V4c)后眼前节参数的早期结果. 方法:纳入2019-02/2022-09在我院行ICL V4c植入术且随访1 a的高度近视患者82例160眼,其中男42例82眼,女40例78眼,年龄26.0±4.6(21-37)岁.术前检测患者的眼前节一般特征:球镜度数、平均角膜水平曲率、水平角膜直径(WTW)和轴向长度(AL);术前,术后1 d,1 wk,1、3、6 mo测量患者的眼内压(IOP)、内皮细胞密度(ECD)、中央前房深度(CACD)、前房容积(ACV)、前房角(ACA);术后 1 d,1 wk,1、6 mo,1 a 测量患者 ICL V4c 光学区后表面中心到晶状体前表面的距离(拱高). 结果:患者术前平均球镜度数为-7.56±2.55 D,平均角膜水平曲率为 42.89±1.47 D,WTW 为 11.64±0.37 mm,AL 为26.64±0.93 mm.眼压基线为 15.97±2.13 mmHg,ICL V4c植入后各时间点眼压与术前相比无差异(F=0.875,P=0.504);ECD 基线为 2989.30±140.78 cell/mm2,ICL V4c 植入后6 mo的ECD与术前相比无差异(t=1.475,P=0.142);CACD 基线为 3.19±0.21 mm,ACV 基线为 210.30± 27.7 mm3,术后各时间点CACD、ACV均显著低于术前(F=111.10、288.38,均 P<0.001);ACA 基线为 35.44°± 11.27°,ICL V4c植入后各时间点ACA显著低于术前(F=21.23,P<0.001).术后 1 d 拱高为 665.32±184.03 μm,术后1 wk,1、6 mo,1 a与术后1 d相比,拱高继续显著减少(F=52.10,P<0.001),但在术后6 mo,1 a时保持稳定,与1 mo时相比均无差异(P>0.05). 结论:ICL V4c在术后1 a的随访中具有一定安全性和有效性,植入后早期眼前节参数趋于稳定.
AIM:To study the early outcomes of anterior segment parameters after implantation of an implantable collamer lens with a central hole(ICL V4c)in patients with high myopia. METHODS:A total of 82 cases(160 eyes)with high myopia,including 42 males(82 eyes)and 40 females(78 eyes),aged 26.0±4.6(21 to 37)years,who underwent ICL V4c implantation at our institution from February 2019 to September 2022 and were followed up for 1 a,were included.The general characteristics of the anterior segment of the eye were measured preoperatively:spherical equivalent,mean horizontal corneal curvature,white-to-white(WTW),and axial length(AL);intraocular pressure(IOP),endothelial cell density(ECD),central anterior chamber depth(CACD),anterior chamber volume(ACV)and anterior chamber angle(ACA)were measured preoperatively and at 1 d,1 wk,1,3 and 6 mo postoperatively.Furthermore,the distance from the centre of the posterior surface of the ICL V4c optical zone to the anterior surface of the lens(vault)was measured at 1 d,1 wk,1,6 mo,and 1 a after surgery. RESULTS:The mean preoperative spherical equivalent of the patients was-7.56±2.55 D,mean horizontal corneal curvature was 42.89±1.47 D,WTW was 11.64±0.37 mm,and AL was 26.64±0.93 mm.The baseline IOP was 15.97± 2.13 mmHg,and the differences in IOP at each time point after ICL V4c implantation compared to preoperative were not statistically significant(F=0.875,P=0.504);ECD was 2 989.30±140.78 cells/mm2 at baseline,and ECD at 6 mo after ICL V4c implantation was not statistically significant compared with preoperative ECD(t=1.475,P=0.142);CACD was 3.19±0.21 mm at baseline,and ACV was 210.30±27.7 mm3,and CACD and ACV were significantly lower than preoperative at all postoperative time points(F=111.10,288.38,all P<0.001).The baseline ACA was 35.44°±11.27°,and the ACA at each time point after ICL V4c implantation was significantly lower than preoperatively(F=21.23,P<0.001).The vault was 665.32± 184.03 μm at 1 d postoperatively,and continued to be significantly reduced at 1 wk,1,6 mo,and 1 a postoperatively compared with 1 d(F=52.10,P<0.001).However,it remained stable at 6 mo and 1 a postoperatively,and the difference was not statistically significant compared with vault at 1 mo postoperatively(P>0.05). CONCLUSION:ICL V4c has certain safety and efficiency in 1 a postoperative follow-up,and the parameters of the anterior segment of the eye stabilized in the early period.