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[后房型人工晶状体植入术后晶状体拱起的预测]

[Prediction of the vaulting after posterior chamber intraocular lens implantation].

作者信息

Zhu Q J, Chen W J, Zhu W J, Chen Q, Yu P, Shi L L, Ma L, Xiao H X, Yuan Y

机构信息

Lixiang Eye Hospital of Soochow University, Suzhou 215021, China.

出版信息

Zhonghua Yan Ke Za Zhi. 2021 Jul 11;57(7):519-525. doi: 10.3760/cma.j.cn112142-20201222-00837.

Abstract

To investigate the influencing factors on the vaulting one month after implantable collamer lens (ICL) implantation, and to develop and verify a prediction formula. The first half of this study was retrospective case series study, and the second half was cross-sectional stydy. A total of 83 eyes of 83 patients who underwent ICL implantation in the Lixiang Eye Hospital of Soochow University were included in the first half of the study, with an average age of (27±5) years, from August 1, 2019 to December 30, 2019. All patients underwent a complete preoperative examination, including axis length, anterior chamber depth, comprehensive optometry, intraocular pressure, central corneal thickness, white-to-white diameter, horizontal and vertical sulcus-to-sulcus diameter (STS), crystalline lens thickness (LT), corneal curvature, and bright and dark pupil diameter. Multiple linear regression (stepwise) was used to develop a prediction formula. In the validation part, a total of 65 people (65 eyes) were included, with an average age of (26±5) years, from March 1, 2020 to June 1, 2020. The accuracy and reliability of the formula were verified by the intergroup correlation coefficient and Bland-Altman consistency test. At 1 month after surgery, ICL size had the greatest impact on the vaulting (β=0.942, <0.001), followed by horizontal STS (β=-0.517, <0.001), LT (β=-0.376, <0.001), and vertical STS (β=-0.257, =0.017). The influence of other factors was not statistically significant (all >0.05). The regression equation was as follows: the vaulting (μm)=-1 369.05+657.12×ICL size-287.41×horizontal STS-432.50×LT-137.33×vertical STS (the fitting degree =0.813, =0.660, and corrected =0.643). In the verification part, the predicted average vaulting was (497.31±102.75) μm, while the actual vaulting was (514.62±152.99) μm. About 96.92% (63/65) of the patients were fitted in the moderate vault, and 3.08% (2/65) were in the high vault. The intergroup correlation coefficient was 0.581. According to the Bland-Altman test, the actual vaulting was 17.31 μm, higher than the predicted value, and the 95% confidence interval of the difference was -260.28 to 294.90 μm. The ICL size, horizontal and vertical STS and LT are the factors that affect and predict the vaulting one month after ICL implantation, and our prediction formula has good accuracy and reliability. .

摘要

探讨可植入式胶原晶状体(ICL)植入术后1个月拱高的影响因素,并建立和验证预测公式。本研究前半部分为回顾性病例系列研究,后半部分为横断面研究。研究前半部分纳入了苏州大学理想眼科医院83例接受ICL植入术的83只眼,平均年龄(27±5)岁,时间为2019年8月1日至2019年12月30日。所有患者均接受了完整的术前检查,包括眼轴长度、前房深度、综合验光、眼压、中央角膜厚度、白对白直径、水平和垂直沟对沟直径(STS)、晶状体厚度(LT)、角膜曲率以及明暗瞳孔直径。采用多重线性回归(逐步法)建立预测公式。在验证部分,共纳入65人(65只眼),平均年龄(26±5)岁,时间为2020年3月1日至2020年6月1日。通过组间相关系数和Bland-Altman一致性检验验证公式的准确性和可靠性。术后1个月,ICL尺寸对拱高的影响最大(β=0.942,P<0.001),其次是水平STS(β=-0.517,P<0.001)、LT(β=-0.376,P<0.001)和垂直STS(β=-0.257,P=0.017)。其他因素的影响无统计学意义(均P>0.05)。回归方程如下:拱高(μm)=-1369.05+657.12×ICL尺寸-287.41×水平STS-432.50×LT-137.33×垂直STS(拟合度=0.813,R²=0.660,校正R²=0.643)。在验证部分,预测的平均拱高为(497.31±102.75)μm,而实际拱高为(514.62±152.99)μm。约96.92%(63/65)的患者拱高拟合为中度,3.08%(2/65)为高度。组间相关系数为0.581。根据Bland-Altman检验,实际拱高比预测值高17.31μm,差异的95%置信区间为-260.28至294.90μm。ICL尺寸、水平和垂直STS以及LT是影响和预测ICL植入术后1个月拱高的因素,我们的预测公式具有良好的准确性和可靠性。

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