Lee Hun, Kang David Sung Yong, Choi Jin Young, Ha Byoung Jin, Kim Eung Kweon, Seo Kyoung Yul, Kim Tae-Im
Department of Ophthalmology, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, South Korea.
The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, South Korea.
BMC Ophthalmol. 2018 Jul 6;18(1):163. doi: 10.1186/s12886-018-0835-x.
To evaluate clinical factors affecting postoperative vaulting in eyes that had achieved optimal vaulting within the range of 250-750 μm following implantation of 12.6-mm V4c implantable collamer lenses (ICL).
A total of 236 eyes of 236 patients that had achieved optimal vaulting following implantation of a 12.6-mm V4c ICL were retrospectively analyzed. Associations between postoperative vaulting and age, preoperative anterior chamber depth (ACD), preoperative axial length (AL), preoperative white-to-white diameter, preoperative pupil size, preoperative sulcus-to-sulcus diameter, and preoperative manifest refraction spherical equivalent were investigated using simple regression, stepwise multiple regression, and multinomial logistic regression analyses.
Mean central vaulting at the 6-month follow-up was 519.0 ± 112.8 μm. Variables relevant to postoperative vaulting were, in order of influence, preoperative ACD (β = 0.305, p < 0.001), preoperative pupil size (β = 0.218, p < 0.001), and preoperative AL (β = 0.171, p = 0.006). Low preoperative pupil size was associated with low optimal vaulting (250 to 450 μm), relative to that observed in the mid optimal vaulting group (451 to 550 μm) (odds ratio = 0.532, P = 0.021). Increasing preoperative ACD was associated with high optimal vaulting (551 and 750 μm), relative to that observed the mid optimal vaulting group (odds ratio = 6.340, P = 0.034).
Myopic eyes with greater preoperative ACD, larger pupil size, and longer AL are predisposed to higher postoperative vaulting following 12.6-mm V4c ICL implantation. Therefore, the extremes of these parameters should be considered when choosing V4c ICL size.
评估在植入12.6毫米V4c型可植入胶原晶状体（ICL）后，眼内拱高在250 - 750微米范围内达到最佳拱高的眼睛中，影响术后拱高的临床因素。
回顾性分析236例患者的236只眼，这些眼睛在植入12.6毫米V4c ICL后达到了最佳拱高。使用简单回归、逐步多元回归和多项逻辑回归分析，研究术后拱高与年龄、术前前房深度（ACD）、术前眼轴长度（AL）、术前白对白直径、术前瞳孔大小、术前沟对沟直径以及术前明显屈光球镜等效值之间的关联。
6个月随访时的平均中央拱高为519.0±112.8微米。与术后拱高相关的变量，按影响顺序依次为术前ACD（β = 0.305，p < 0.001）、术前瞳孔大小（β = 0.218，p < 0.001）和术前AL（β = 0.171，p = 0.006）。相对于中等最佳拱高组（451至550微米）观察到的情况，术前瞳孔尺寸小与低最佳拱高（250至450微米）相关（比值比 = 0.532，P = 0.021）。相对于中等最佳拱高组观察到的情况，术前ACD增加与高最佳拱高（551和750微米）相关（比值比 = 6.340，P = 0.034）。
术前ACD较大、瞳孔尺寸较大且AL较长的近视眼睛，在植入12.6毫米V4c ICL后更容易出现较高的术后拱高。因此，在选择V4c ICL尺寸时应考虑这些参数的极值。
