Sinha Ayushi, Sinha Rajesh, Gupta Vinay, Agarwal Rinky, Maharana Prafulla K, Agarwal Tushar, Sharma Namrata, Titiyal Jeewan Singh
Department of Ophthalmology, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
Eye Contact Lens. 2022 Jan 1;48(1):38-44. doi: 10.1097/ICL.0000000000000854.
To evaluate and compare the visual outcomes of two phakic intraocular lenses in high myopia.
A prospective comparative study was undertaken on 50 eyes of 26 patients {age ≥21 years and divided into two groups (implantable collamer lens [ICL] V4c, n=25 eyes and refractive implantable lens [RIL], n=25 eyes)}. Patients were evaluated for uncorrected distance visual acuity (UCVA), best-corrected distance visual acuity, manifest refractive spherical equivalent (MRSE), contrast sensitivity, intraocular pressure, dilated fundus examination, trabecular-iris angle (TIA), anterior chamber depth, horizontal white-to-white diameter, wavefront aberrometry, and endothelial cell (EC) count. All patients were followed up until 6 months and additionally evaluated for anterior chamber inflammation, cataract, and lens vault.
The baseline parameters (UCVA, MRSE, and EC count) and postoperative improvement in UCVA, contrast sensitivity, MRSE, EC loss, safety index, and efficacy index were comparable between both the lenses. The improvement in aberrometric profile was significantly better in the ICL group. The mean postoperative vault was higher in RIL group (434.88±162.48 μm vs. 547.24±159.83 μm, P=0.0173); however, the vault was within normal range in both the groups. The decrease in mean TIA was significantly higher in RIL group (8.58 vs. 13.45 μm, P=0.0073).
Acrylic phakic lens can be considered as a suitable alternative to collamer lens for refractive correction of high myopia. The collamer lenses showed slight superiority in some qualitative visual parameters; however, collamer lenses do not present with subjective complaints in the patients.
评估和比较两种有晶状体眼人工晶状体用于高度近视的视觉效果。
对26例患者（年龄≥21岁）的50只眼进行前瞻性对照研究，分为两组（可植入式角膜接触镜[ICL] V4c，25只眼；屈光性可植入晶状体[RIL]，25只眼）。对患者进行未矫正远视力（UCVA）、最佳矫正远视力、明显屈光球镜等效度（MRSE）、对比敏感度、眼压、散瞳眼底检查、小梁虹膜夹角（TIA）、前房深度、水平白对白直径、波前像差测量及内皮细胞（EC）计数评估。所有患者随访至6个月，并额外评估前房炎症、白内障及晶状体拱高。
两种晶状体的基线参数（UCVA、MRSE及EC计数）以及术后UCVA、对比敏感度、MRSE、EC损失、安全指数及疗效指数的改善情况相当。ICL组像差测量曲线的改善明显更好。RIL组术后平均拱高更高（434.88±162.48μm对547.24±159.83μm，P = 0.0173）；然而，两组的拱高均在正常范围内。RIL组平均TIA的降低明显更高（8.58对13.45μm，P = 0.0073）。
丙烯酸有晶状体眼人工晶状体可被视为用于高度近视屈光矫正的合适替代物，替代可植入式角膜接触镜。可植入式角膜接触镜在一些定性视觉参数上显示出轻微优势；然而，可植入式角膜接触镜未给患者带来主观不适。
