有晶状体眼后房型人工晶状体V4c植入术矫正高度近视的临床效果

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摘要

目的：观察有晶状体眼后房型人工晶状体（PPC-ICL）V4c植入术矫正高度近视的有效性、安全性及其视觉质量变化。方法：前瞻性临床研究。选择拟行PPC-ICL V4c植入术的高度近视患者32例（58眼）。术前及术后6 个月分别测量裸眼视力（UCVA）、最佳矫正视力（BCVA）、波前像差、对比敏感度和采用屈光矫正者生活质量量表（QIRC）评价手术前后生活质量。采用配对t 检验对数据进行分析。结果：术前及术后6个月患者UCVA（LogMAR）分别为1.54 ± 0.26、-0.04 ± 0.06。术后较术前提高（t =30.94，P < 0.001）。术后6 个月UCVA等于或超过术前BCVA者56 眼（97%），其中术后UCVA较术前BCVA提高1 行及以上者28 眼（48%）。术后6 个月全眼总高阶像差、球差、彗差、三叶草均方根（RMS）值分别为（0.292 ± 0.093）μm、（-0.030 ± 0.050）μm、（0.096 ± 0.090）μm、（0.224 ± 0.091）μm，其中术后全眼球差RMS值较术前下降（t =3.87，P =0.001），术后全眼三叶草RMS值较术前增加（t=-5.47，P < 0.001），高阶像差、彗差与术前差异无统计学意义。术后6 个月时3.0、6.0、12.0、18.0 cpd各频率段对比敏感度值与术前相比有所提高，其中明视3.0 cpd、明视6.0 cpd和暗视6.0 cpd与术前差异有统计学意义（t=-2.12，P=0.047；t=-2.51，P=0.021；t=-3.27，P=0.004），余频率段与术前差异均无统计学意义。患者术后QIRC得分较术前提高（t=-2.41，P=0.039）。结论：PPC-ICL V4c植入术是矫正高度近视的一种安全有效的方法，患者术后视觉质量与生活质量明显提高。

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	王红霞
	周奇志
	高阳

关键词 ：有晶状体眼人工晶状体植入术, 高度近视, 波前像差, 对比敏感度, 视觉质量, 生活质量

Abstract：

Objective: To study the efficacy, safety, and change in visual quality of a phakic posterior chamber implantable collamer lens with centra FLOW (PPC-ICL V4c) for correcting high myopia. Methods: This was a prospective study of 58 eyes of 32 patients who were candidates for PPC-ICL V4c. The following indicators were compared: preoperative and postoperative uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), preoperative aberrations and aberrations 6 months postoperatively, contrast sensitivity, and the Quality of Life Impact of Refractive Correction (QIRC). All patients were followed up for more than 6 months. Data were analyzed using paired t-tests. Results: Preoperative UCVA (LogMAR visual acuity) and UCVA 6 months after surgery was 1.54±0.26 and -0.04±0.06, respectively. Visual acuity 6 months after surgery improved compared to preoperative acuity (t=30.94, P<0.001). Compared to preoperative BCVA, 56 eyes had equal or better BCVA 6 months after surgery, which accounted for 97% of the total number of eyes. There was an increase of 1 row or better for 28 eyes, which accounted for 48% of the total number of eyes. Postoperative higher-order wavefront aberrations, spherical aberrations, coma, and trefoil root mean square (RMS) were 0.292±0.093 μm, -0.030±0.050 μm, 0.096±0.090 μm,and 0.224±0.091 μm, respectively. Total higher-order aberrations increased and coma was reduced, but the differences were not statistically significant. Spherical aberrations were reduced (t=3.87, P=0.001) and trefoil increased (t=-5.47, P<0.001). All contrast sensitivities 6 months after surgery were better than preoperative levels for 3.0, 6.0, 12.0, and 18.0 cycles/degree. There were also significant differences between the photopic 3.0 and 6.0 cycles/degree and mesopic 6 cycles/degree (t=-2.12, P=0.047; t=-2.51,P=0.021; t=-3.27, P=0.004). The QIRC score for patients improved (t=-2.41, P=0.039) after surgery.Conclusions: Implants of PPC-ICL V4c are a safe and effective surgical method for correcting high myopia. All patients are satisfied with the surgery, which can improve visual quality and quality of life.

Key words： phakic intraocular lenses high myopia wavefront aberrations contrast sensitivity visualquality quality of life

收稿日期: 2016-03-25

通讯作者: 周奇志，Email：zhouqizhi6931@sina.com

引用本文:

王红霞,周奇志,高阳. 有晶状体眼后房型人工晶状体V4c植入术矫正高度近视的临床效果[J]. 中华眼视光学与视觉科学杂志, 2017, 19(8): 476-481. Hongxia Wang,Qizhi Zhou,Yang Gao. Clinical Effects of a Phakic Posterior Chamber Implantable Collamer Lenswith Centra FLOW for Correcting High Myopia. Chinese Journal of Optometry Ophthalmology and Visual science, 2017, 19(8): 476-481.

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https://www.cjoovs.com/CN/ 或 https://www.cjoovs.com/CN/Y2017/V19/I8/476

[1]	沈晔, 周天安, 杜持新, 等．有晶状体眼后房型人工晶体植入矫正高度近视的临床评价[J]．中华眼科杂志，2007，43(11)：1000-1004．DOI：10.3760/j.issn:0412-4081.2007.11.009.
[2]	Igarashi A, Shimizu K, Kamiya K. Eight-year follow-up of posterior chamber phakic intraocular lens implantation for moderate
	to high myopia. Am J Ophthalmol, 2014, 157(3): 532-539. e1.DOI: 10.1016/j.ajo.2013.11.006.
[3]	田颖, 文丹, 蒋剑, 等. 有晶状体眼后房型人工晶状体植入术治疗高度近视的稳定性及安全性研究. 中国医师杂志, 2016,18(10): 1450-1454, 1459. DOI: 10.3760/cma.j.issn.1008-1372.
20	16.10.003.
[4]	Huseynova T, Ozaki S, Ishizuka T, et al. Comparative study of 2 types of implantable collamer lenses, 1 with and 1 without a central artificial hole. Am J Ophthalmol, 2014, 157(6): 1136-1143.DOI: 10.1016/j.ajo.2014.01.032.
[5]	Kamiya K, Shimizu K, Ando W, et al. Comparison of vault after implantation of posterior chamber phakic intraocular lens with
	and without a central hole. J Cataract Refract Surg, 2015, 41(1):67-72. DOI: 10.1016/j.jcrs.2014.11.011.
[6]	于春晶, 张立军, 牟亚男, 等. 中央孔型ICL V4c矫治高度近视的临床疗效观察. 中国医学创新, 2016, 13(33): 51-54. DOI:10.3969/j.issn.1674-4985.2016.33.015.
[7]	Pesudovs K, Garamendi E, Elliott DB. The Quality of Life Impact of Refractive Correction (QIRC) Questionnaire: development and validation. Optom Vis Sci, 2004, 81(10): 769-777.
[8]	许毅从, 杨新军, 余野, 等. 屈光矫正者生命质量量表在中国的应用及评价. 眼科研究, 2007, 25(8): 623-626. DOI: 10.3760/cma.j.issn.2095-0160.2007.08.017.
[9]	王晓瑛, 周行涛. 从忽视到重视——可植入式眼内镜的最新进展及发展趋势. 中华眼视光学与视觉科学杂志, 2015, 17(8):449-452. DOI: 10.3760/cma.j.issn.1674-845X.2015.08.001.
[10]	Higueras-Esteban A, Ortiz-Gomariz A, Gutiérrez-Ortega R, et al.Intraocular pressure after implantation of the Visian Implantable Collamer Lens with Centra FLOW without iridotomy. Am J Ophthalmol, 2013, 156(4): 800-805. DOI: 10.1016/j.ajo.
20	13.05.018.[11] Kamiya K, Shimizu K, Igarashi A, et al. Clinical evaluation of optical quality and intraocular scattering after posterior chamber phakic intraocular lens implantation. Invest Ophthalmol Vis Sci,2012, 53(6): 3161-3166. DOI: 10.1167/iovs.12-9650.
[12]	Alfonso JF, Lisa C, Fernández-Vega CL, et al. Clinical outcomes after implantation of a posterior chamber collagen copolymer phakic intraocular lens with a central hole for myopic correction.J Cataract Refract Surg, 2013, 39(6): 915-921. DOI: 10.1016/j.jcrs.2013.01.036.
[13]	王雁, 赵堪兴．波前像差与临床视觉矫正．北京: 人民卫生出版社, 2011: 34．
[14]	Toto L, Vecchiarino L, D'Ugo E, et al. Astigmatism correction with toric IOL: analysis of visual performance, position,and wavefront error. J Refract Surg, 2013, 29(7): 476-483. DOI:10.3928/1081597X-20130617-06.
[15]	王凌飞, 杨瑞波, 赵少贞. CACHET有晶状体眼人工晶状体植入术后视觉质量的临床评价. 眼科新进展, 2013, 33(6):546-550.
[16]	Pesudovs K, Garamendi E, Keeves JP, et al. The activities of Daily Vision Scale for cataract surgery outcomes: re-evaluating validity with Rasch analysis. Invest Ophthalmol Vis Sci, 2003,44(7): 2892-2899.
[17]	凌红. 大学生近视矫正方式的选择原因分析.中国校医, 2006,20(3): 263-264. DOI: 10.3969/j.issn.1001-7062.2006.03.017.
[18]	Pérez-Vives C, Ferrer-Blasco T, Madrid-Costa D, et al. Optical quality comparison of conventional and hole-visian implantable collamer lens at different degrees of decentering. Am J Ophthalmol,2013, 156(1): 69-76. e1. DOI: 10.1016/j.ajo.2013.01.030.
[19]	Shimizu K, Kamiya K, Igarashi A, et al. Intraindividual comparison of visual performance after posterior chamber phakic intraocular lens with and without a central hole implantation for moderate to high myopia. Am J Ophthalmol, 2012, 154(3): 486-494.e1. DOI: 10.1016/j.ajo.2012.04.001.