Instituto Oftalmológico Fernández-Vega, Avda. Dres. Fernández-Vega 114, 33012, Oviedo, Spain.
Graefes Arch Clin Exp Ophthalmol. 2010 Dec;248(12):1827-35. doi: 10.1007/s00417-010-1322-0. Epub 2010 Mar 24.
To evaluate changes of subjective vault during a period of 36 months after implantation of phakic posterior chamber implantable collamer lens (ICL) for myopia correction.
Nine hundred and sixty four myopic eyes of 531 patients, 353 females (66.5%) and 178 (33.5%) males, who received a Visian ICL (model V4, Staar Surgical Inc.) implantation were included in the study. Subjective vault classified in five levels (0, 1, 2, 3 and 4) was assessed at each of the follow-up visits by a trained ophthalmologist during a period of 36 months.
Mean vault decreased from 2.30 ± 0.87 immediately after surgery to 2.10 ± 0.92 at 12 months and to 2.06 ± 1.05 at 36 months. For patients presenting vault 2, 3, and 4 post-operatively, there was a decrease with time, with changes becoming statistically significant (p < 0.05) after the 3-month follow-up visit. The few eyes developing anterior subcapsular cataract (ASC) were older, had a tendency to vault 2 or lower post-operative, shallower anterior chamber depth and smaller ICL size. Eyes with acute increase in intraocular pressure (IOP) were significantly more myopic, had smaller white-to-white diameter and had larger photopic pupil diameters.
Decrease in subjective vault after ICL implantation became statistically significant after the third month postoperatively. Several patients and lens-related factors have been identified as potential predictors of ASC or acute increase in IOP. A tight follow-up during the critical post-operative period should be considered in those particular cases.
评估有晶状体眼后房型可植入 Collamer 透镜（ICL）矫正近视后 36 个月期间主观前房深度的变化。
本研究纳入了 531 名患者的 964 只近视眼，其中女性 353 只（66.5%），男性 178 只（33.5%），均接受了 Visian ICL（型号 V4，Staar Surgical Inc.）植入。术后随访期间，由一位受过训练的眼科医生对主观前房深度进行评估，主观前房深度分为 5 个等级（0、1、2、3 和 4 级）。
术后即刻平均前房深度从 2.30 ± 0.87 降至 12 个月时的 2.10 ± 0.92，术后 36 个月时降至 2.06 ± 1.05。术后前房深度为 2、3 和 4 级的患者，随时间推移前房深度逐渐降低，术后 3 个月随访后变化具有统计学意义（p < 0.05）。少数发生前囊下白内障（ASC）的患者年龄较大，术后前房深度为 2 级或更低，前房深度较浅，ICL 尺寸较小。急性眼压升高（IOP）的患者近视程度更高，瞳孔直径在明视时更大。
术后 3 个月后，ICL 植入术后主观前房深度的下降具有统计学意义。已确定一些患者和镜片相关因素可能是 ASC 或急性 IOP 升高的潜在预测因素。在这些特殊情况下，应考虑在关键的术后期间进行严密的随访。
