Wei Qiaoling, Zhou Xianjin, Chang Weiteng, Jiang Rui, Zhou Xingtao, Yu Zhiqiang
Department of Ophthalmology, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai 200031, China.
Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai 200031, China.
Diagnostics (Basel). 2023 Sep 29;13(19):3097. doi: 10.3390/diagnostics13193097.
This prospective study aimed to evaluate the impact of Visian Implantable Collamer Lens (ICL) V4c implantation on retinal and choroidal morphology in patients with high myopia. A total of 97 eyes from 52 high myopic patients who underwent ICL V4c implantation were followed up for 12 months. Preoperative and postoperative evaluations included comprehensive ophthalmic assessments and enhanced depth imaging optical coherence tomography (EDI-OCT) to analyze changes in central retinal thickness (CRT), retinal volume (CRV), choroidal thickness (ChT), total choroidal area (TCA), luminal area (LA), and choroidal vascular index (CVI). Repeated measures mixed-effects models were used for comparing pre- and postoperative measurement variables and exploring relationships among age, axial length (AL), spherical equivalent refraction (SER), and postoperative retinal and choroidal changes, with statistical significance set at < 0.05. Follow-up assessments were conducted at various time points, with participation rates ranging from 21% to 98%. Baseline characteristics showed a median age of 26.7 years, -10.14 diopters of SER, and an AL of 27.44 mm. Throughout the 12-month follow-up, CRT and 3.0 mm CRV consistently increased compared to the baseline, with statistically significant rises observed at postoperative day 1, week 1, and month 12. Most ChT measurements, including subfoveal ChT, declined over the 12 months, except at postoperative 6 months. Horizontal and vertical TCA and LA values significantly increased throughout the follow-up, except for month 6. After surgery, both horizontal and vertical CVI parameters exhibited an increase compared to the baseline, with some changes reaching statistical significance. Correlation analysis performed by repeated measures mixed-effects models showed that no relationship was found between age, AL, and SER and changes in postoperative retinal parameters and CVI parameters. However, postoperative changes in ChT and choroidal area parameters showed a negative correlation with AL and a positive correlation with SER. Our research demonstrated that ICL V4c implantation resulted in noteworthy alterations in retinal and choroidal morphology over a 1-year follow-up period. Moreover, in patients with high myopia, individuals with longer AL and higher degrees of myopia exhibited more pronounced postoperative changes in the choroid and retina. Further studies with extended follow-up durations are necessary to comprehensively understand the long-term effects of ICL implantation on retinal and choroidal morphology and function.
这项前瞻性研究旨在评估Visian可植入式接触镜(ICL)V4c植入术对高度近视患者视网膜和脉络膜形态的影响。对52例接受ICL V4c植入术的高度近视患者的97只眼进行了为期12个月的随访。术前和术后评估包括全面的眼科检查以及增强深度成像光学相干断层扫描(EDI-OCT),以分析中心视网膜厚度(CRT)、视网膜体积(CRV)、脉络膜厚度(ChT)、脉络膜总面积(TCA)、管腔面积(LA)和脉络膜血管指数(CVI)的变化。采用重复测量混合效应模型比较术前和术后的测量变量,并探讨年龄、眼轴长度(AL)、等效球镜度(SER)与术后视网膜和脉络膜变化之间的关系,设定统计学显著性水平为<0.05。在不同时间点进行随访评估,参与率在21%至98%之间。基线特征显示,年龄中位数为26.7岁,SER为-10.14屈光度,AL为27.44毫米。在整个12个月的随访期间,与基线相比,CRT和3.0毫米CRV持续增加,在术后第1天、第1周和第1个月观察到有统计学意义的升高。除术后6个月外,大多数ChT测量值,包括黄斑下ChT,在12个月内均下降。除第6个月外,水平和垂直TCA及LA值在整个随访期间均显著增加。术后,水平和垂直CVI参数均较基线有所增加,部分变化具有统计学意义。重复测量混合效应模型进行的相关性分析表明,年龄、AL和SER与术后视网膜参数和CVI参数的变化之间无相关性。然而,ChT和脉络膜面积参数的术后变化与AL呈负相关,与SER呈正相关。我们的研究表明,在1年的随访期内,ICL V4c植入术导致视网膜和脉络膜形态发生了显著改变。此外,在高度近视患者中,AL较长和近视度数较高的个体术后脉络膜和视网膜的变化更为明显。有必要进行更长随访期的进一步研究,以全面了解ICL植入术对视网膜和脉络膜形态及功能的长期影响。