Zhu Manhui, Zhu Linling, Zhu Qiujian, Xu Cailian, Yu Peng, Xiao Haiyang, Wang Ying, Yuan You
Department of Ophthalmology, Lixiang Eye Hospital of Soochow University, Suzhou, Jiangsu, China.
Department of Ophthalmology, Suzhou Municipal Hospital, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, Jiangsu, China.
J Ophthalmol. 2020 Dec 14;2020:3095302. doi: 10.1155/2020/3095302. eCollection 2020.
To investigate the clinical outcomes and possible risk factors associated with rotational stability after the implantation of a V4c toric implantable Collamer lens (TICL) for the correction of moderate to high myopic astigmatism.
A total of 112 eyes of 66 patients with moderate to high myopic astigmatism underwent TICL implantation. All patients were followed up for more than 1 year. The uncorrected and best-corrected visual acuity (UCVA and BCVA), astigmatism and spherical equivalent, intraocular pressure, vault, endothelial cell morphometry, and rotation of the TICL axis were assessed at l day, 1 week, 1 month, 3 months, 6 months, and 12 months postoperatively. Postoperative rotation was defined as the angle between the intended axis and the achieved axis. Regression analysis was used to investigate the possible risk factors for TICL rotation postoperatively.
The mean efficacy index and safety index 12 months postoperatively were 1.03 ± 0.09 and 1.05 ± 0.10, respectively. All patients had the same or better visual acuity than preoperatively. The mean astigmatism value decreased from -1.86 ± 0.79 D preoperatively to -0.37 ± 0.35 D. The mean absolute axis deviation of the TICL at the last follow-up was 2.75 ± 2.04° (range, 0°∼11°). The mean manifest refraction spherical equivalent (MRSE) changed from -9.04 ± 2.67 D preoperatively to -0.67 ± 0.51 D postoperatively. The logistic regression demonstrated that the absolute degree of TICL rotation had a significant association with the fixation angle of the TICL and the size of the lens (=0.003, =0.026, resp.).
The results of our study support that TICL implantation is safe, effective, and predictable in the treatment of moderate to high myopic astigmatism, with relatively good postoperative rotational stability.
探讨植入V4c环曲面可植入式角膜接触镜（TICL）矫正中高度近视散光后与旋转稳定性相关的临床结果及可能的危险因素。
66例中高度近视散光患者的112只眼接受了TICL植入术。所有患者均随访1年以上。在术后1天、1周、1个月、3个月、6个月和12个月评估未矫正和最佳矫正视力（UCVA和BCVA）、散光和等效球镜度、眼压、前房深度、内皮细胞形态学以及TICL轴的旋转情况。术后旋转定义为预期轴与实际轴之间的夹角。采用回归分析探讨TICL术后旋转的可能危险因素。
术后12个月的平均疗效指数和安全指数分别为1.03±0.09和1.05±0.10。所有患者的视力均与术前相同或更好。平均散光值从术前的-1.86±0.79 D降至-0.37±0.35 D。末次随访时TICL的平均绝对轴偏差为2.75±2.04°（范围0°至11°）。平均显验光等效球镜度（MRSE）从术前的-9.04±2.67 D变为术后的-0.67±0.51 D。逻辑回归显示，TICL旋转的绝对程度与TICL的固定角度和镜片大小显著相关（分别为P=0.003，P=0.026）。
我们的研究结果支持TICL植入术在治疗中高度近视散光方面是安全、有效且可预测的，术后旋转稳定性相对较好。
