比较已植入眼和未植入眼的虹膜固定型有晶状体眼人工晶状体长期植入后的生物测量学特征。
Comparison of the Biometric Characteristics After Long-term Implantation of Iris-fixated Phakic Intraocular Lens in Explanted and Nonexplanted Groups of Eyes.
机构信息
From the Research Department, Oftalmosalud Institute of Eyes, Lima, Perú (L.I., F.C.I. P.L., M.A.H.); Universidad Nacional Mayor de San Marcos, Lima, Perú (L.I.).
From the Research Department, Oftalmosalud Institute of Eyes, Lima, Perú (L.I., F.C.I. P.L., M.A.H.).
出版信息
Am J Ophthalmol. 2024 Sep;265:54-60. doi: 10.1016/j.ajo.2024.02.011. Epub 2024 Feb 22.
PURPOSE
To evaluate and compare the biometric characteristics of the anterior chamber of a group of patients with significant endothelial cell loss (ECL) who required phakic intraocular lens (pIOL) explantation and a group of patients who did not fulfill the explantation criteria related to corneal decompensation.
DESIGN
Retrospective, consecutive, interventional case series.
METHODS
The study included all consecutive patients receiving a pIOL implantation at Oftalmosalud Instituto de Ojos, Lima, Peru, between 2001 and 2012. The explanted group (E group) consisted of eyes in which the pIOLs were explanted due to ECL, and the nonexplanted group (NE group) consisted of eyes randomly selected in which the pIOL was not explanted with a minimum follow-up time of 8 years. Slit-lamp biomicroscopy, visual acuity, refraction, endothelial cell count, and anterior segment optical coherence tomography were assessed at the preoperative evaluation for both groups and before explantation in the E group and 8 years post-implantation in the NE group.
RESULTS
pIOLs were implanted in 265 eyes. The annual percentage of ECL was 1.47% and 5.55% in the NE group and E group, respectively (P < .001). The mean minimum endothelial lens distance (ELD) was 1.44 ± 0.22 mm and 1.05 ± 0.23 mm in the NE group and E group, respectively (P < 0.001). The mean time for explantation was 12.58 ± 3.79 years for the E group. Annual ECL could accurately discriminate between the NE group and E group; a cutoff point of 3.5 (%/year) or 86.5 (cells/years) had a 100% sensitivity and specificity. A cutoff of 1.21 mm in the minimum ELD has a 91% sensitivity and 79% specificity to discriminate between the E group and NE group.
CONCLUSIONS
pIOL explantation due to ECL occurs in eyes with a significantly postoperative lower minimum ELD. Annual ECL and minimum ELC can effectively discriminate between the E and NE groups.
目的
评估和比较一组因明显内皮细胞丢失（ECL）而需要取出有晶状体眼人工晶状体（pIOL）的患者和一组未达到与角膜失代偿相关的取出标准的患者的前房生物测量特征。
设计
回顾性、连续、干预性病例系列研究。
方法
该研究纳入了 2001 年至 2012 年期间在秘鲁利马的 Oftalmosalud Instituto de Ojos 接受 pIOL 植入的所有连续患者。取出组（E 组）由因 ECL 而取出 pIOL 的眼睛组成，未取出组（NE 组）由随机选择的未取出 pIOL 的眼睛组成，随访时间至少 8 年。在两组的术前评估中以及 E 组的取出前和 NE 组的植入后 8 年进行裂隙灯生物显微镜检查、视力、屈光、内皮细胞计数和眼前节光学相干断层扫描。
结果
共植入 265 只眼。NE 组和 E 组的 ECL 年发生率分别为 1.47%和 5.55%（P<0.001）。NE 组和 E 组的平均最小内皮晶状体距离（ELD）分别为 1.44±0.22mm 和 1.05±0.23mm（P<0.001）。E 组的平均取出时间为 12.58±3.79 年。每年 ECL 能准确区分 NE 组和 E 组；截断值为 3.5（%/年）或 86.5（细胞/年），具有 100%的敏感性和特异性。最小 ELD 的截断值为 1.21mm 时，对区分 E 组和 NE 组具有 91%的敏感性和 79%的特异性。
结论
因 ECL 而取出 pIOL 发生在术后最小 ELD 明显较低的眼睛中。每年 ECL 和最小 ELC 可以有效地区分 E 组和 NE 组。
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