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超 40 岁高度近视患者行 V4c 型可折叠人工晶状体植入术后前房晶状体密度的长期评估

Long-term evaluation of anterior lens density after implantable collamer lens V4c implantation in patients with myopia over 40 years old.

机构信息

Department of Ophthalmology and Optometry, Fudan University Eye Ear Nose and Throat Hospital, Shanghai, China.

Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.

出版信息

Br J Ophthalmol. 2022 Nov;106(11):1508-1513. doi: 10.1136/bjophthalmol-2021-319205. Epub 2021 Jun 28.

Abstract

PURPOSE

To investigate the long-term safety and efficacy of implantable collamer lens (ICL) V4c implantation and changes in the anterior lens density (ALD) in patients with myopia ≥40 years of age.

METHODS

This prospective study included 104 eyes of 52 patients >40 years of age before ICL V4c implantation. Spherical equivalent (SE), uncorrected distance visual acuity, corrected distance visual acuity (CDVA), intraocular pressure, endothelial cell density, anterior chamber depth, anterior chamber volume and anterior chamber angle preoperatively, at 1 and 3 months, and at 3 years postoperatively were recorded. Pentacam HR was used to analyse ALD changes at a depth of 0.5, 1.0 and 1.5 mm within a 3 mm diameter range around the pupil's centre.

RESULTS

The overall follow-up was uneventful at 42±7.1 months; the safety index at last follow-up was 1.26±0.35 and the efficacy index was 0.91±0.41. No eye lost the Snellen line of CDVA, 76% of the eyes had an increase in CDVA for ≥1 line and 62% had an SE within ±0.50 dioptre. The increase in ALD at 0.5, 1 and 1.5 mm was 16.52%±10.46%, 16.72%±9.85% and 17.28%±11.93%, respectively. Preoperative, 1-month and 3-month postoperative ALDs showed correlations with SE and age, and ALD at last follow-up was correlated only with age. There was no correlation between ALD and any other parameters.

CONCLUSION

ICL V4c shows long-term safety and efficacy in people ≥40 years of age. ALD increased in such patients, which may be related to age and SE.

摘要

目的

研究植入性 Collamer 透镜(ICL)V4c 在年龄≥40 岁的近视患者中的长期安全性和疗效,以及前晶状体密度(ALD)的变化。

方法

本前瞻性研究纳入了 52 例年龄≥40 岁的患者(共 104 只眼),在 ICL V4c 植入术前、术后 1 个月、3 个月及 3 年均记录了等效球镜(SE)、未矫正远视力、矫正远视力(CDVA)、眼压、内皮细胞密度、前房深度、前房容积和前房角。Pentacam HR 用于分析瞳孔中心 3mm 直径范围内 0.5、1.0 和 1.5mm 深度处的 ALD 变化。

结果

42±7.1 个月的总体随访结果无不良事件;末次随访时的安全性指数为 1.26±0.35,有效性指数为 0.91±0.41。无 1 只眼丧失 CDVA 视力的 Snellen 行,76%的眼 CDVA 提高≥1 行,62%的眼 SE 在±0.50 屈光度内。0.5、1.0 和 1.5mm 处的 ALD 增加量分别为 16.52%±10.46%、16.72%±9.85%和 17.28%±11.93%。术前、术后 1 个月和 3 个月的 ALD 与 SE 和年龄呈正相关,末次随访时的 ALD 仅与年龄相关。ALD 与其他任何参数均无相关性。

结论

ICL V4c 在年龄≥40 岁的人群中具有长期的安全性和有效性。此类患者的 ALD 增加,这可能与年龄和 SE 有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f4a/9606511/70437dff833c/bjophthalmol-2021-319205f01.jpg

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