NGENUITY® 3D导航与常规显微镜下有晶状体眼人工晶状体植入术的临床效果比较

doi:10.3760/cma.j.cn115909-20210824-00335

摘要
图/表
参考文献(20)
相关文章 (15)

全文: PDF 719KB HTML (1 KB)
输出: BibTeX | EndNote (RIS) 背景资料

文章导读

摘要

目的：对比分析NGENUITY® 3D导航与常规显微镜下有晶状体眼人工晶状体（ICL）植入术的临床效果。方法：前瞻性随机对照研究。选取2020 年10—11 月在西安爱尔眼科医院屈光与老视晶状体中心行ICL或散光型ICL（TICL）植入术的近视患者60 例（60 眼）。采用随机数字表法分为NGENUITY®3D导航组（3D组）30例和常规显微镜组（常规组）30例。对最小光照明度、ICL植入时间、TICL调位时间、手术总时间等术中操作参数以及手术前后眼压变化、术后随访6 个月的视力变化、等效球镜度（SE）变化、TICL离轴偏差度、结膜下出血率等临床参数进行比较。采用t检验和χ2检验进行数据分析。结果：2 组术前年龄、SE及TICL占比差异均无统计学意义。常规组和3D组最小光照明度分别为（10 800±1 300）lx和（5 000±1 500）lx，ICL植入时间分别为（12.6±3.7）s和（8.7±2.4）s，TICL调位时间分别为（32.4±5.4）s和（16.3±2.4）s，手术总时间分别为（415.4±43.3）s和（331.0±33.7）s，2 组间这些术中操作参数差异均有统计学意义（t=7.31，P=0.003；t=6.32，P=0.001；t=8.34，P=0.001；t=5.83，P=0.002）。常规组、3D组术后3 h眼压值均较术前升高，术后3 h与术前眼压差值分别为（5.24±3.42）mmHg和（3.12±2.15）mmHg（1 mmHg=0.133 kPa），组间差异有统计学意义（t=2.82，P=0.002）。术后6 个月，常规组、3D组离轴旋转度轴位偏差分别为（5.68±0.18）°和（3.23±0.13）°，组间差异有统计学意义（t=3.22，P=0.002）。组间术后结膜下出血率、裸眼视力、最佳矫正视力等差异均无统计学意义。结论：与常规显微镜下ICL手术相比，NGENUITY® 3D导航引导下ICL术中可降低光照亮度、缩短手术时间，术后散光晶状体平均离轴旋转度轴位偏差更小。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	李康寯
	王姗姗
	李青云
	等.

关键词 ：有晶状体眼人工晶状体植入术, 3D显微手术, 临床效果

Abstract：

Objective: To evaluate the operation and clinical applications of the NGENUITY® 3D-guided system

and the binocular microscope visualization system for posterior chamber implantable collamer lens

implantation (ICL). Methods: This was a randomized controlled study. A total of 60 patients (60 eyes) who

underwent ICL or Toric ICL (TICL) surgery in the Xi’an Aier Eye Hospital from October to November

2020 were enrolled and randomly divided into two groups that included 30 patients (30 eyes) in the 3D

group and 30 patients (30 eyes) in the microscope group. The following observation indexes were obtained

during this study: the operation indicators included the minimum light illuminance, ICL implant time, TICL

posit time and total operation time and the clinical outcome indicators that included changes in the patients’

intraocular pressure, visual acuity, manifest refraction spherical equivalent (MRSE), the average off-axis

rotation axial deviation and the rate of subconjunctival hemorrhage. The t test and Chi square test were used

for statistical analysis. Results: There were no significant differences between two groups in age, MRSE

or TICL proportion at baseline. There was a statistically significant difference between the microscope

group and the 3D group in the minimum light illuminance (10 800±1 300 lux, 5 000±1 500 lux),

the ICL implant time (12.6±3.7 s, 8.7±2.4 s), the TICL posit time (32.4±5.4 s, 16.3±2.4 s), and the

total operation time (415.4±43.3 s, 331.0±33.7 s). All differences were statistically significant (t=7.31,

P=0.003; t=6.32, P=0.001; t=8.34, P=0.001; t=5.83, P=0.002). The differences in intraocular pressure

changes 3 hours after surgery (5.24±3.42 mmHg, 3.12±2.15 mmHg) and the average off-axis rotation axial

deviation (5.68±0.18°, 3.23±0.13°). Comparisons were both statistically significant (t=2.82, P=0.002;

t=3.22, P=0.002). There were no significant differences between groups after the operation in the rate of

subconjunctival hemorrhage, uncorrected visual acuity, best corrected visual acuity or residual refractive

error. Conclusions: Compared with the binocular microscopy system ICL, the intraoperative light

illuminance, operative time and the average off-axis rotation axial deviation can be reduced more by the

NGENUITY® 3D-guided system ICL.

Key words： intraocular lens implantation three-dimensional microsurgery clinical effect

收稿日期: 2021-08-24

PACS:

基金资助:

湖南省自然科学基金面上项目（2021JJ30048）；爱尔眼科集团自由探索项目（AF1909D4，AF2009D8）

通讯作者: 湖南省自然科学基金面上项目（2021JJ30048）；爱尔眼科集团自由探索项目（AF1909D4，AF2009D8）

引用本文:

李康寯, 王姗姗, 李青云, 等.. NGENUITY® 3D导航与常规显微镜下有晶状体眼人工晶状体植入术的临床效果比较[J]. 中华眼视光学与视觉科学杂志, 2022, 24(2): 110-115. Kangjun Li, Shanshan Wang, Qinyun Li, et al.

Comparing the Clinical Application Outcomes between the NGENUITY Three-Dimensional and Binocular Microscope Visualization Systems in Posterior Chamber Implantable Collamer Lens Implantation

. Chinese Journal of Optometry Ophthalmology and Visual science, 2022, 24(2): 110-115. DOI: 10.3760/cma.j.cn115909-20210824-00335

链接本文:

https://www.cjoovs.com/CN/10.3760/cma.j.cn115909-20210824-00335 或 https://www.cjoovs.com/CN/Y2022/V24/I2/110

[1]	李康寯, 张凌子, 宋小翠, 等. SMILE和ICL矫正中低度近视术后角膜前后表面和总角膜高阶像差的变化. 国际眼科杂志,2018, 18(12): 2289-2292. DOI: 10.3980/j.issn.1672-5123.2018.12.42.
[2]	Li K, Wang Z, Zhang D, et al. Visual outcomes and corneal biomechanics after V4c implantable collamer lens implantation in subclinical keratoconus. J Cataract Refract Surg, 2020,46(10): 1339-1345. DOI: 10.1097/j.jcrs.0000000000000262.
[3]	Berquet F, Henry A, Barbe C, et al. Comparing heads-up versus binocular microscope visualization systems in anterior and
	posterior segment surgeries: a retrospective study. Ophthalmol,2020, 243(5): 347-354. DOI: 10.1159/000507088.
[4]	Nariai Y, Horiguchi M, Mizuguchi T, et al. Comparison of microscopic illumination between a three-dimensional headsup system and eyepiece in cataract surgery. Eur J Ophthalmol,2021, 31(4): 1817-1821. DOI: 10.1177/1120672120929962.
[5]	Palácios RM, de Carvalho ACM, Maia M, et al. An experimental and clinical study on the initial experiences of Brazilian vitreoretinal surgeons with heads-up surgery. Graefes Arch ClinExp Ophthalmol, 2019, 257(3): 473-483. DOI: 10.1007/s00417-019-04246-w.
[6]	Agranat JS, Miller JB, Douglas VD, et al. The scope of threedimensional digital visualization systems in vitreoretinal surgery. Clin Ophthalmol, 2019(13): 2093-2096. DOI: 10.2147/OPTH.S213834.
[7]	Asani B, Siedlecki J, Schworm B, et al. 3D heads-up display vs.standard operating microscope vitrectomy for rhegmatogenous
	retinal detachment.Front Med, 2020, 12(7): 1010-1017. DOI:10.3389/fmed. 2020.615515.
[8]	Eckardt C, Paulo E. Heads-up surgery for vitreoretinal procedures: an experimental and clinical study. Retina, 2016,36(1): 137-147. DOI: 10.1097/IAE.0000000000000689.
[9]	Postel Eric A. Long-term Follow-up of Iatrogenic Phototoxicity. Arch Ophthalmol, 1998, 116(6): 753-757. DOI: 10.1001/archopht.116.6.753.
[10]	Liu J, Wu D, Ren X, et al. Clinical experience of using the NGENUITY three-dimensional surgery system in ophthalmic surgical procedures. Acta Ophthalmol, 2020, 99(1): e101-e108.DOI: 10.1111 /aos.14518.
[11]	Shaaban Y, Badran T. Three-year effect of phakic intraocular lenses on the corneal endothelial cell density. Clin Ophthalmol,2020, 14(1): 149-155. DOI: 10.2147/OPTH.S236041.
[12]	张可, 王姗姗, 宋小翠, 等. 有晶状体眼后房型人工晶状体水平或垂直植入术后前房角与拱高的变化. 国际眼科杂志,2021, 21(6): 1091-1095. DOI: 10.3980/j.issn.1672-5123.2021.6.31.
[13]	任雁琳, 史春生, 姜波. FS-LASIK矫正不同程度近视术后角膜高阶像差的早期变化. 国际眼科杂志, 2021, 21(5): 796-799.DOI: 10.3980/j.issn.1672-5123.2021.5.09.
[14]	Shin JY, Ahn H, Seo KY, et al . Comparison of higher order aberrations after implantable collamer lens implantation and wavefront-guided LASEK in high myopia. J Refract Surg, 2012,28(2): 106-111. DOI: 10.3928/1081597X-20111018-02.
[15]	Kamiya K, Igarashi A, Shimizu K, et al. Visual performance after posterior chamber phakic intraocular lens implantation and wavefront-guided laser in situ keratomileusis for low to moderate myopia. Am J Ophthalmol, 2012, 153(6): 1178-1186.DOI: 10.1016/j.ajo.2011.12.005.
[16]	Rez-vives CP, Dominguez-Vicent A, Ferrer-Blasco T, et al.Optical quality of hyperopic and myopic phakic intraocular lenses. Indian J Ophthalmol, 2014, 62(4): 437-441. DOI: 10.4103/0301-4738.119423.
[17]	Kayhan B. The effects of implantable collamer lens implantation on higher order aberrations. Int J Ophthalmol, 2019, 12(12):1848-1852. DOI: 10.18240/ijo.2019.12.05.
[18]	Siedlecki J, Schmelter V, Mayer WJ, et al. SMILE versus implantable collamer lens implantation for high myopia: a matched comparative study. J Refract Surg, 2020, 36(3): 150-159. DOI: 10.3928 /1081597X-20200210-02.
[19]	Siedlecki j, Schmelter V, Schworm B, et al. Corneal wavefront aberrations and subjective quality of vision after small incision lenticule extraction. Acta ophthalmologica, 2020, 98(7):e907-e913. DOI: 10. 1111/aos.14420.
[20]	Sun WK, Yang H, Yoon G, et al. Higher-order aberration changes after implantable collamer lens implantation for myopia. Am J Ophthalmol, 2011, 151(4): 653-662. DOI: 10.1016/j.ajo.2010.10.031