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A1-UV非球面人工晶状体植入术后5年的安全性和有效性

[Safety and efficacy of A1-UV aspheric intraocular lens implantation over the postoperative 5 years].

作者信息

Song X D, Hao Y S, Li X R, Zhang H, Ye J, Sun Y X, Wang N L

机构信息

Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Institute of Ophthalmology, Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing 100730, China.

Peking University Third Hospital, Beijing 100191, China.

出版信息

Zhonghua Yan Ke Za Zhi. 2021 Jan 11;57(1):41-47. doi: 10.3760/cma.j.cn112142-20200227-00120.

Abstract

To evaluate the clinical safety and efficacy of A1-UV aspheric intraocular lens (IOL) implantation over the postoperative 5 years. Prospective cohort study. The subjects came from a finished multicenter, randomized and controlled clinical trial with a follow-up period of 1 year from April to November 2012. The clinical research centers were Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Peking University Third Hospital, Tianjin Medical University Eye Hospital, and Daping Hospital of Army Medical University. Cataract patients in the experimental group were implanted with A1-UV type IOL, while cataract patients in the control group were implanted with SN60WF type IOL, and monocular patients were enrolled. From April to May 2018, patients enrolled in the previous study were recalled for follow-up and continued observation. The visual acuity, spherical equivalent, postoperative complications, non-contact intraocular pressure and subjective evaluation results were statistically analyzed preoperatively, at 1 to 2 days, 1 week, 1 month, 3 months, 6 months, 1 year and 5 years after operation. The main statistical methods included Mann Whitney test, Wilcoxon signed rank test, independent sample test, chi square test and Fisher exact test. A total of 42 subjects (22 in the experimental group and 20 in the control group) completed 5-year continuous observation. Among the 42 subjects, 28 were female and 14 were male. The age was (70±9) years, and the time from surgery to recall was (5.77±0.19) years. The age, gender distribution, left/right eye distribution, axial length, IOL power and nucleus hardness classification data of the experimental group and the control group were balanced and comparable (all >0.05). At different visiting time points, there was no significant difference in the best corrected distance visual acuity (BCDVA), best corrected near visual acuity (BCNVA), uncorrected distance visual acuity (UCDVA) and uncorrected near visual acuity (UCNVA) between the groups (all >0.05). At 5 years after operation, the UCDVA, BCDVA and BCNVA of the two groups were significantly improved compared with the baseline [all <0.01; UCDVA was improved from 0.75 (0.30 to 1.30) to 0.10 (-0.10 to 0.70) in the experimental group and from 0.75 (0.30 to 1.60) to 0.20 (-0.10 to 0.80) in the control group; BCDVA was from 0.60 (0.10 to 1.00) to 0.00 (-0.10 to 0.54) in the experimental group and from 0.60 (0.10 to 1.60) to 0.10 (-0.10 to 0.50) in the control group; BCNVA was from 0.55 (0.00 to 1.10) to 0.10 (-0.10 to 0.60) in the experimental group and from 0.55 (0.10 to 1.60) to 0.10 (-0.20 to 0.60) in the control group], but there was no significant change in the UCNVA (both >0.05). There were no significant differences in the spherical equivalent, intraocular pressure, subjective evaluation of visual adverse symptoms, distance vision spectacle independence and comprehensive evaluation of satisfaction between the groups (all >0.05). In the experimental group, one eye (4.5%) had an abnormal pupil, one eye (4.5%) had an abnormal IOL with a few particles on the surface of the IOL but no glistening, and 3 eyes (13.6%) had posterior capsular opacification (PCO); in the control group, one eye (5.0%) had an abnormal cornea, five eyes (25.0%) had abnormal IOLs [one eye (5.0%) had IOL calcification, and four eyes (20.0%) had IOL glistening], and one eye (5.0%) had PCO with posterior capsular folds and IOL tilt. There was no significant difference in PCO and IOL abnormality between the two groups (both >0.05), but there was significant difference in the occurrence of IOL glistening (=0.04). The long-term effect of A1-UV aspheric IOL on improving the UCDVA is stable and good, with high subjective satisfaction of patients, a low incidence of PCO, no glistening and good biocompatibility, over the postoperative 5 years. .

摘要

评估A1-UV非球面人工晶状体(IOL)植入术后5年的临床安全性和有效性。前瞻性队列研究。研究对象来自一项已完成的多中心、随机对照临床试验,随访期为2012年4月至11月的1年。临床研究中心包括首都医科大学附属北京同仁医院眼科中心、北京同仁医院、北京大学第三医院、天津医科大学眼科医院和陆军军医大学大坪医院。实验组白内障患者植入A1-UV型IOL,对照组白内障患者植入SN60WF型IOL,纳入单眼患者。2018年4月至5月,召回先前研究中纳入的患者进行随访和继续观察。对术前、术后1至2天、1周、1个月、3个月、6个月、1年和5年的视力、等效球镜度、术后并发症、非接触眼压和主观评估结果进行统计分析。主要统计方法包括Mann Whitney检验、Wilcoxon符号秩检验、独立样本检验、卡方检验和Fisher确切检验。共有42名受试者(实验组22名,对照组20名)完成了5年的连续观察。42名受试者中,女性28名,男性14名。年龄为(70±9)岁,手术至召回的时间为(5.77±0.19)年。实验组和对照组的年龄、性别分布、左右眼分布、眼轴长度、IOL度数和晶状体核硬度分级数据均衡且具有可比性(均>0.05)。在不同访视点,两组间最佳矫正远视力(BCDVA)、最佳矫正近视力(BCNVA)、未矫正远视力(UCDVA)和未矫正近视力(UCNVA)均无显著差异(均>0.05)。术后5年,两组的UCDVA、BCDVA和BCNVA较基线均显著提高[均<0.01;实验组UCDVA从0.75(0.30至1.30)提高到0.10(-0.10至0.70),对照组从0.75(0.30至1.60)提高到0.20(-0.10至0.80);实验组BCDVA从0.60(0.10至1.00)提高到0.00(-0.10至0.54),对照组从0.60(0.10至1.60)提高到

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