人工晶状体植入术后晶状体拱高和前房参数对拱高的影响。

Effects of crystalline lens rise and anterior chamber parameters on vault after implantable collamer lens placement.

机构信息

Department of Center of Refraction, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medicine University, Xuzhou, Jiangsu Province, P. R. China.

出版信息

PLoS One. 2024 Mar 21;19(3):e0296811. doi: 10.1371/journal.pone.0296811. eCollection 2024.

DOI:10.1371/journal.pone.0296811

PMID:38512912

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10956874/

Abstract

BACKGROUND

To analyze vault effects of crystalline lens rise (CLR) and anterior chamber parameters (recorded by Pentacam) in highly myopic patients receiving implantable collamer lenses (ICLs), which may avoid subsequent complications such as glaucoma and cataract caused by the abnormal vault.

METHODS

We collected clinical data of 137 patients with highly myopic vision, who were all subsequent recipients of V4c ICLs between June 2020 and January 2021. Horizontal ciliary sulcus-to-sulcus diameter (hSTS) and CLR were measured by ultrasonic biomicroscopy (UBM), and a Pentacam anterior segment analyzer was used to measure horizontal white-to-white diameter (hWTW), anterior chamber depth (ACD), anterior chamber angle (ACA), anterior chamber volume (ACV), CLR, and postoperative vault (Year 1 and Month 1). The lens thickness (LT) was determined by optical biometry (IOL Master instrument). The predictive model was generated through multiple linear regression analyses of influential factors, such as hSTS, CLR, hWTW, ACD, ACA, ACV, ICL size, and LT. The predictive performance of the multivariate model on vault after ICL was assessed using the receiver operating characteristic (ROC) curve with area under the curve (AUC) as well as the point of tangency.

RESULTS

Average CLR assessed by UBM was lower than the average value obtained by Pentacam (0.561 vs. 0.683). Bland-Altman analysis showed a good consistency in the two measurement methods and substantial correlation (r = 0.316; P = 0.000). The ROC curve of Model 1 (postoperative Year 1) displayed an AUC of 0.847 (95% confidence interval [CI]: 74.19-95.27), with optimal threshold of 0.581 (sensitivity, 0.857; specificity, 0.724). In addition, respective values for Model 2 (postoperative Month 1) were 0.783 (95% CI: 64.94-91.64) and 0.522 (sensitivity, 0.917; specificity, 0.605).

CONCLUSION

CLR and anterior chamber parameters are important determinants of postoperative vault after ICL placement. The multivariate regression model we constructed may serve in large part as a predictive gauge, effectively avoid postoperative complication.

摘要

背景

分析植入性 Collamer 透镜（ICL）治疗高度近视患者晶状体上升（CLR）和前房参数（Pentacam 记录）的拱顶效应，这可能避免因拱顶异常引起的青光眼和白内障等后续并发症。

方法

我们收集了 2020 年 6 月至 2021 年 1 月期间，137 名接受 V4c ICL 的高度近视患者的临床资料。通过超声生物显微镜（UBM）测量水平睫状突-睫状突直径（hSTS）和 CLR，使用 Pentacam 眼前节分析仪测量水平白到白直径（hWTW）、前房深度（ACD）、前房角（ACA）、前房容积（ACV）、CLR 和术后拱顶（术后 1 年和术后 1 个月）。通过光学生物测量仪（IOL Master 仪器）确定晶状体厚度（LT）。通过多线性回归分析 hSTS、CLR、hWTW、ACD、ACA、ACV、ICL 大小和 LT 等影响因素，生成预测模型。使用接收器操作特征（ROC）曲线评估多变量模型对 ICL 术后拱顶的预测性能，以曲线下面积（AUC）和切点表示。

结果

UBM 评估的平均 CLR 低于 Pentacam 获得的平均水平（0.561 比 0.683）。Bland-Altman 分析显示两种测量方法具有良好的一致性和高度相关性（r = 0.316；P = 0.000）。模型 1（术后 1 年）的 ROC 曲线显示 AUC 为 0.847（95%置信区间 [CI]：74.19-95.27），最佳阈值为 0.581（灵敏度，0.857；特异性，0.724）。此外，模型 2（术后 1 个月）的相应值分别为 0.783（95%CI：64.94-91.64）和 0.522（灵敏度，0.917；特异性，0.605）。