Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China.
National Clinical Research Center for Eye Diseases, Shanghai, China.
Ophthalmic Res. 2023;66(1):445-456. doi: 10.1159/000528616. Epub 2023 Jan 3.
The aim of the study was to evaluate efficacy and safety outcomes after implantation of the Visian Implantable Collamer Lens (ICL V4c) in myopia patients with shallow anterior chamber depth (ACD).
This retrospective study followed 163 eyes of 94 patients for at least 24 months. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity, intraocular pressure (IOP), manifest refraction, vault, endothelial cell density (ECD), anterior chamber angle (ACA), anterior chamber volume, and the distance from the corneal endothelium to the central ICL (C-ICL) were measured during follow-ups. Spearman's correlation and logistic regression were used to identify variables correlated with changes in ECD and potential risk factors for ineffective outcomes, respectively.
All surgeries were performed safely. High IOP of 9 eyes and anterior capsular opacity of 5 eyes were observed. The last follow-up ACA had a significant difference between the high and normal IOP groups (p = 0.0003). The mean ECD and vault were 2,855.76 ± 270.82 cells/mm2 and 388.01 ± 135.28 μm at the last follow-up, respectively. The vault and C-ICL were significantly associated with ΔECD (all p < 0.05). Furthermore, the vault was most responsible for the ECD loss. Twenty-two eyes had unsatisfactory postoperative UDVA, and the low vault at the last follow-up was a significant risk factor for this ineffective outcome (p < 0.001, OR = 14.739).
ICL V4c implantation in patients with shallow ACD achieved stable visual outcomes. The vault is related to postoperative visual acuity and ECD loss, which needs to be paid attention during follow-up.
本研究旨在评估在浅前房深度（ACD）的近视患者中植入 Visian 可植入 Collamer 透镜（ICL V4c）的疗效和安全性结果。
本回顾性研究随访了 94 例患者的 163 只眼至少 24 个月。在随访期间测量了未矫正的远视力（UDVA）、矫正的远视力、眼压（IOP）、显式折射、拱高、内皮细胞密度（ECD）、前房角（ACA）、前房容积以及角膜内皮至中央 ICL（C-ICL）的距离。采用 Spearman 相关分析和逻辑回归分别确定与 ECD 变化相关的变量和无效结果的潜在危险因素。
所有手术均安全进行。观察到 9 只眼眼压升高和 5 只眼前囊混浊。最后一次随访时，高眼压组和正常眼压组的 ACA 有显著差异（p = 0.0003）。最后一次随访时，平均 ECD 和拱高分别为 2855.76 ± 270.82 个/平方毫米和 388.01 ± 135.28 微米。拱高和 C-ICL 与 ΔECD 显著相关（均 p < 0.05）。此外，拱高是 ECD 丧失的主要原因。22 只眼术后 UDVA 不满意，最后一次随访时拱高低是该无效结果的显著危险因素（p < 0.001，OR = 14.739）。
在浅 ACD 患者中植入 ICL V4c 可获得稳定的视力结果。拱高与术后视力和 ECD 丧失有关，在随访期间需要注意。
