Wang Xiao-yu, Shen Ye, Du Chi-xin, Li Yu-min, Dong Ying
Department of Ophthalmology, The First Affiliated Hospital, Zhejiang University, Hangzhou 310003, China.
Zhonghua Yan Ke Za Zhi. 2009 Oct;45(10):908-12.
To study the changes of anterior chamber and chamber angle structures after implantable contact lens (ICL) implantation in high myopia by using ultrasound biomicroscopy (UBM).
A prospective series case study was conducted on 15 high myopia patients (30 eyes) treated with ICL implant. These patients were followed for one year postoperatively. Intraocular pressure (IOP) was measured by Goldmann applanation tonometer after surgery. All eyes were examined by UBM one year after the surgery. Central anterior chamber depth (ACD), trabecular-iris angle (TIA), the distance between the posterior surface of ICL and the lens and the distance between peripheral surface of ICL and the lens were measured. Nonparametric test was used to compare TIA. One-way ANOVA was used to assess the distance between peripheral surface of ICL and the lens. Repeated Measure ANOVA and Bonferroni test was performed to compare the IOP level before and after surgery. Paired t-test was used to compare ACD.
Intraocular pressure changed from (13.75 +/- 2.27) mm Hg (1 mm Hg = 0.133 kPa) preoperatively to (14.27 +/- 1.70), (14.70 +/- 2.07), (14.07 +/- 2.24), (14.00 +/- 2.69) and (13.97 +/- 2.95) mm Hg at 1 week, 1, 3, 6 and 12 months after the surgery, respectively. There was a statistically significant increase of the IOP one month after the surgery, which was normalized completely at 3 months after surgery. The distances between central posterior surface of the cornea to the ICL and the lens were (2.24 +/- 0.21) and (2.97 +/- 0.11) mm, respectively. There was significant difference between these two data (t = 20.63, P < 0.01). TIA was measured in 12:00, 3:00, 6:00 and 9:00. There were no statistically differences between them. TIA was greater than 30 degree in 55.8% of cases. The distance between the central anterior surface of the ICL to the lens (central section) was (0.63 +/- 0.16) mm. No contact was found between the ICL and the crystalline lens.
Posterior chamber phakic intraocular lens implantation for the surgical correction of high myopia is a safe procedure as evaluated with immediate visual and refractive results. We found that the iridocorneal angle and the anterior chamber depth are decreased after the surgery. There is no contact between the crystalline lens and ICL. The ICL contacts with the posterior iris surface.
采用超声生物显微镜（UBM）研究高度近视患者植入可植入式接触镜（ICL）后前房和房角结构的变化。
对15例接受ICL植入治疗的高度近视患者（30只眼）进行前瞻性系列病例研究。术后对这些患者进行一年的随访。术后用Goldmann压平眼压计测量眼压。术后一年对所有眼进行UBM检查。测量中央前房深度（ACD）、小梁-虹膜角（TIA）、ICL后表面与晶状体之间的距离以及ICL周边表面与晶状体之间的距离。采用非参数检验比较TIA。采用单因素方差分析评估ICL周边表面与晶状体之间的距离。采用重复测量方差分析和Bonferroni检验比较手术前后的眼压水平。采用配对t检验比较ACD。
眼压从术前的（13.75±2.27）mmHg（1mmHg = 0.133kPa）分别变为术后1周、1个月、3个月、6个月和12个月的（14.27±1.70）、（14.70±2.07）、（14.07±2.24）、（14.00±2.69）和（13.97±2.95）mmHg。术后1个月眼压有统计学意义的升高，术后3个月完全恢复正常。角膜中央后表面至ICL和晶状体的距离分别为（2.24±0.21）和（2.97±0.11）mm。这两个数据有显著差异（t = 20.63，P < 0.01）。在12:00、3:00、6:00和9:00测量TIA。它们之间无统计学差异。55.8%的病例TIA大于30度。ICL中央前表面至晶状体（中央截面）的距离为（0.63±0.16）mm。未发现ICL与晶状体接触。
经即时视觉和屈光结果评估，后房型有晶状体眼人工晶状体植入术用于高度近视的手术矫正安全。我们发现术后虹膜角膜角和前房深度减小。晶状体与ICL无接触。ICL与虹膜后表面接触。
