白内障手术后人工晶状体偏心的相关危险因素。
Risk Factors Associated With Intraocular Lens Decentration After Cataract Surgery.
机构信息
From the Department of Ophthalmology (J.X., P.M.L., S.H.Z., Y.L., T.Y.Z.), Eye and ENT Hospital, Fudan University, Shanghai, China; Eye Institute (J.X., P.M.L., S.H.Z., Y.L., T.Y.Z.), Eye and ENT Hospital , Fudan University, Shanghai, China; Key Laboratory of Myopia, Ministry of Health (J.X., P.M.L., S.H.Z., Y.L., T.Y.Z.), Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration (J.X., P.M.L., S.H.Z., Y.L., T.Y.Z.), Shanghai, China.
From the Department of Ophthalmology (J.X., P.M.L., S.H.Z., Y.L., T.Y.Z.), Eye and ENT Hospital, Fudan University, Shanghai, China; Eye Institute (J.X., P.M.L., S.H.Z., Y.L., T.Y.Z.), Eye and ENT Hospital , Fudan University, Shanghai, China; Key Laboratory of Myopia, Ministry of Health (J.X., P.M.L., S.H.Z., Y.L., T.Y.Z.), Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration (J.X., P.M.L., S.H.Z., Y.L., T.Y.Z.), Shanghai, China.
出版信息
Am J Ophthalmol. 2022 Oct;242:88-95. doi: 10.1016/j.ajo.2022.05.005. Epub 2022 May 18.
PURPOSE
To identify risk factors associated with intraocular lens (IOL) decentration after uneventful phacoemulsification with IOL implantation.
DESIGN
A prospective cohort study.
METHODS
All patients underwent a general ophthalmologic examination. One month postoperatively, the magnitude and orientation of IOL decentration relative to the visual axis center were assessed using an OPD-Scan III aberrometer, and the vertical and horizontal decentration values were determined. Univariate and multivariate linear regression analyses were performed to evaluate the association between the IOL decentration and ocular biometric parameters.
RESULTS
In total, 143 eyes of 143 patients were enrolled. The mean decentration magnitude was 0.27 ± 0.15 mm, and the decentration axis appeared at any orientation, with no orientation tendency. The horizontal and vertical decentration were -0.02 ± 0.22 mm and 0.01 ± 0.22 mm, respectively. Multivariate regression analysis showed that the white-to-white distance and the magnitude of angle α were positively associated with the decentration magnitude (P < .001, adj. R = 0.121), the horizontal angle κ and horizontal angle α were positively associated with the horizontal decentration (P < .001, adj. R = 0.209), and the anterior chamber depth and vertical angle κ were positively associated with the vertical decentration (P < .001, adj. R = 0.152).
CONCLUSIONS
The IOL decentration magnitude was greater in patients with a larger white-to-white distance and a larger angle α, the horizontal decentration was greater in patients with a larger horizontal angle κ and a larger horizontal angle α, and the vertical decentration was greater in patients with a deeper anterior chamber depth and a larger vertical angle κ. In these patients, premium IOLs should be implanted cautiously.
目的
确定与超声乳化白内障吸除术后人工晶状体（IOL）偏心无关的危险因素。
设计
前瞻性队列研究。
方法
所有患者均进行一般眼科检查。术后 1 个月，使用 OPD-Scan III 眼前节分析仪评估 IOL 相对于视轴中心的偏心度大小和方向，并确定垂直和水平偏心值。采用单因素和多因素线性回归分析评估 IOL 偏心与眼生物测量参数之间的关系。
结果
共纳入 143 例（143 只眼）患者。平均偏心度为 0.27±0.15mm，偏心轴出现在任何方向，无定向趋势。水平和垂直偏心分别为-0.02±0.22mm 和 0.01±0.22mm。多因素回归分析显示，白到白距离和角度α的大小与偏心度大小呈正相关（P＜0.001，调整 R²=0.121），水平角 κ 和水平角 α 与水平偏心呈正相关（P＜0.001，调整 R²=0.209），前房深度和垂直角 κ 与垂直偏心呈正相关（P＜0.001，调整 R²=0.152）。
结论
白到白距离较大和角度 α 较大的患者 IOL 偏心度较大，水平角 κ 较大和水平角 α 较大的患者水平偏心度较大，前房深度较大和垂直角 κ 较大的患者垂直偏心度较大。在这些患者中，应谨慎植入高端 IOL。
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