有晶状体眼人工晶状体后房方位与拱高的相关性

doi:10.3760/cma.j.cn115909-20200401-00127

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Abstract Objective: To study the relationship between the posterior chamber position and vault after implantation of the implantable collamer lens (ICL). Methods: This was a retrospective case series study. From June 2017 to June 2019, 32 cases of middle and high myopia with ICLs in the horizontal or vertical position were selected in Chongqing Aier Maige Ophthalmology Hospital because the vault of one eye was higher than 750 μm and an ICL at the same length was placed in the vertical position in the contralateral eye. The preoperative examination included the measurement of white-to-white (WTW) diameter under a slit lamp microscope, anterior chamber depth (ACD), sulcus-to-sulcus (STS) horizontal diameter, STS vertical diameter and lens thickness (LT) measured by ultrasound biomicroscopy (UBM). The vault was also measured by UBM. The data were analyzed by a paired t test,multiple linear regression and the receiver operating characteristic (ROC) curve. Results: The vault of the ICL in the vertical position decreased significantly (280±205 μm) compared with that in the horizontal position (t=5.375, P<0.001), and the horizontal-vertical diameter difference in the STS in both eyes was 0.42±0.21 mm. Multiple linear regression showed that the difference in vault was significantly related to the difference in the STS horizontal-vertical diameter (adjusted R2 =0.545, F=10.30, P<0.001), but not related to WTW, ACD or LT. The ROC curve was drawn for the horizontal-vertical diameter difference in STS in both eyes according to the standard of the vertical ICL vault falling into the ideal range (250-750 μm). The area under the curve (AUC) was 0.917, 95%CI 0.764-0.985, P<0.001. The optimal cut-off value was 0.3, the sensitivity was 83.33%, and the specificity was 100%. The ROC curve was drawn for the horizontal-vertical diameter difference in STS in both eyes according to the standard of vault difference in both eyes 100, 200 and 300 μm and above: AUC≥100 μm was 0.859, P≥100 μm=0.007, the optimal cut-off value was 0.3, sensitivity was 76.92%, specificity was 100%; AUC≥200 μm was 0.778, P≥200 μm=0.008,the optimal cut-off value was 0.36, sensitivity was 77.78%, specificity was 71.43%; AUC≥300 μm was 0.754, P≥300 μm=0.015, the optimal cut-off value was 0.36, sensitivity was 85.71%, specificity was 66.67%. Conclusions: In the case of a high vault in the horizontal position, if the horizontal-vertical diameter difference is STS>0.3 mm, there is a high probability that the vault of the ICL in the vertical position can be reduced to the ideal range.

Key words： vault phakic intraocular lenses ultrasound biomicroscopy sulcus-to-sulcus

Received: 01 April 2020

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Corresponding Authors: Yanli Peng, Chongqing Aier Maige Ophthalmology Hospital, Chongqing 400060, China (Email: pengyanli@aierchina.com)

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