Zhang Zhe, Niu Lingling, Liu Tingting, Shen Yang, Shang Jianmin, Zhao Jing, Wei Ruoyan, Zhou Xingtao, Yao Peijun
Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, 19 Baoqing Road, Xuhui District, Shanghai, China.
NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.
Eye Vis (Lond). 2023 Apr 2;10(1):18. doi: 10.1186/s40662-023-00335-4.
To investigate the morphological changes of concave iris in myopic patients after EVO implantable collamer lens (ICL) implantation.
EVO ICL candidates with posterior bowing iris were observed using ultrasound biometric microscopy (UBM) in this prospective nonrandomized observational study. Forty patients were enrolled, with 20 patients in the concave iris group and the other 20 patients in the control group. None of the patients underwent laser peripheral iridotomy. All patients received preoperative and postoperative examinations, which included uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), subjective manifest refraction and intraocular pressure. UBM was used to observe iris curvature (IC), irido-corneal angle (ICA), posterior chamber angle (PCA), iris-lens contact distance (ILCD), iris-zonule distance (IZD) and ciliary process length (CPL). Anterior chamber angle pigment was observed by gonioscopy. The preoperative and postoperative data were analyzed using SPSS.
The average follow-up period was 13.3 ± 5.3 months. The mean efficacy indices were 1.10 ± 0.13 and 1.07 ± 0.11 (P = 0.58), and the safety indices were 1.19 ± 0.09 and 1.18 ± 0.17 in the control group and the concave iris group (P = 0.93), respectively. The IOP postoperatively were 14.13 ± 2.02 mmHg and 14.69 ± 1.59 mmHg in control and concave iris groups (P = 0.37). Preoperatively, the concave iris group was presented with greater IC (P < 0.0001), longer ILCD (P < 0.0001), wider ICA (P = 0.004), narrower PCA (P = 0.01), and shorter IZD (P = 0.03) than the control group. In the concave iris group, IC, ILCD and ICA were significantly decreased after ICL implantation (P < 0.0001), while PCA and IZD were significantly increased (P = 0.03 and P = 0.04, respectively). Postoperative IC, ILCD, ICA, PCA and IZD were not statistically different between groups (P > 0.05). There was no significant difference in pigment deposition grades between the two groups (P = 0.37).
After EVO ICL implantation, the morphology of concave iris was significantly improved, which may reduce the risk of intraocular pigment dissemination caused by iris concavity. The concave iris has no impact on the safety of EVO ICL surgery during the follow-up.
研究近视患者植入依镜（EVO）可植入式胶原晶状体（ICL）后凹形虹膜的形态变化。
在这项前瞻性非随机观察性研究中，使用超声生物显微镜（UBM）观察有后凸虹膜的EVO ICL植入候选者。共纳入40例患者，其中20例患者为凹形虹膜组，另外20例患者为对照组。所有患者均未接受激光周边虹膜切开术。所有患者均接受术前和术后检查，包括裸眼远视力（UDVA）、矫正远视力（CDVA）、主观显验光和眼压。使用UBM观察虹膜曲率（IC）、虹膜角膜角（ICA）、后房角（PCA）、虹膜晶状体接触距离（ILCD）、虹膜悬韧带距离（IZD）和睫状突长度（CPL）。通过前房角镜观察前房角色素。使用SPSS分析术前和术后数据。
平均随访期为13.3±5.3个月。对照组和凹形虹膜组的平均疗效指数分别为1.10±0.13和1.07±0.11（P=0.58），安全指数分别为1.19±0.09和1.18±0.17（P=0.93）。对照组和凹形虹膜组术后眼压分别为14.13±2.02 mmHg和14.69±1.59 mmHg（P=0.37）。术前，凹形虹膜组的IC更大（P<0.0001）、ILCD更长（P<0.0001）、ICA更宽（P=0.004）、PCA更窄（P=0.01）、IZD更短（P=0.03），均高于对照组。在凹形虹膜组中，ICL植入后IC、ILCD和ICA显著降低（P<0.0001），而PCA和IZD显著增加（分别为P=0.03和P=0.04）。两组术后IC、ILCD、ICA、PCA和IZD差异无统计学意义（P>0.05）。两组色素沉着分级差异无统计学意义（P=0.37）。
EVO ICL植入后，凹形虹膜的形态得到显著改善，这可能降低由虹膜凹陷引起的眼内色素播散的风险。在随访期间，凹形虹膜对EVO ICL手术的安全性没有影响。
