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利用超长扫描深度光学相干断层扫描评估高度近视眼中的人工晶状体囊袋黏附。

Capsular adhesion to intraocular lens in highly myopic eyes evaluated in vivo using ultralong-scan-depth optical coherence tomography.

机构信息

School of Ophthalmology and Optometry and Affiliated Eye Hospital, Wenzhou Medical College, Wenzhou, Zhejiang, China.

出版信息

Am J Ophthalmol. 2013 Mar;155(3):484-491.e1. doi: 10.1016/j.ajo.2012.08.019. Epub 2012 Dec 4.

DOI:10.1016/j.ajo.2012.08.019
PMID:23218694
Abstract

PURPOSE

To evaluate the in vivo capsular apposition to the intraocular lens (IOL) in subjects with high myopia by ultralong-scan-depth optical coherence tomography (OCT).

DESIGN

Prospective observational case series.

METHODS

Forty eyes from 40 cataract patients scheduled for phacoemulsification surgery at the Affiliated Eye Hospital, Wenzhou Medical College were studied, of which 20 eyes were highly myopic (axial length >26 mm) and 20 eyes were emmetropic (22 mm < axial length <24.5 mm). All eyes were examined with a custom-built ultralong-scan-depth OCT at 4 hours, 1 day, 7 days, 14 days, and 28 days after surgery.

RESULTS

Anterior capsule contact with the IOL was significantly delayed in highly myopic eyes. Complete apposition of the posterior capsule with the IOL was significantly less common among highly myopic eyes than in emmetropic eyes (4 vs 16 eyes; P = .001). Posterior capsule adhesion to the IOL was inversely correlated with axial length (r = -0.494, P < .001, nonparametric Spearman test). The 3 types of complete adhesive capsular bend configurations observed were classified as anterior adhesion, middle adhesion, and posterior adhesion. Incomplete adhesion patterns were classified as funnel adhesion, parallel adhesion, and furcate adhesion. Five highly myopic eyes had slight posterior capsule opacification (PCO) at the last follow-up, as did 1 emmetropic eye.

CONCLUSIONS

Ultralong-scan-depth OCT revealed weak capsular adhesion and incompletely adhesive types of capsular bend in highly myopic eyes. These features presumably increase the likelihood of PCO during the early postoperative period.

摘要

目的

通过超长扫描深度光学相干断层扫描(OCT)评估高度近视患者眼内晶状体(IOL)的囊袋贴合情况。

设计

前瞻性观察性病例系列。

方法

本研究纳入温州医科大学附属眼视光医院拟行白内障超声乳化手术的 40 例(40 只眼)白内障患者,其中 20 只眼为高度近视(眼轴长度>26mm),20 只眼为正视眼(22mm<眼轴长度<24.5mm)。所有患者术后 4 小时、1 天、7 天、14 天和 28 天分别使用定制的超长扫描深度 OCT 进行检查。

结果

高度近视眼的前囊与 IOL 接触明显延迟。后囊与 IOL 完全贴合在高度近视眼中明显少于正视眼中(4 眼与 16 眼;P=0.001)。后囊与 IOL 粘连与眼轴长度呈负相关(r=-0.494,P<0.001,非参数 Spearman 检验)。观察到的 3 种完全粘连性囊袋弯曲类型分别为前粘连、中粘连和后粘连。不完全粘连模式分为漏斗状粘连、平行粘连和分叉状粘连。5 只高度近视眼在最后一次随访时出现轻微后发性白内障(PCO),1 只正视眼也出现了这种情况。

结论

超长扫描深度 OCT 显示高度近视眼囊袋附着较弱,囊袋弯曲类型为不完全粘连。这些特征可能会增加术后早期发生 PCO 的可能性。

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