Zhang Qian, Zhao Bo, Yang Xue-Fei, Liu Zhang-Lin, Huang Yue
Refractive Surgery Department, Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China.
Refractive Surgery Department, Aier Eye Hospital, Tianjin University, Tianjin 300190, China.
Int J Ophthalmol. 2024 Sep 18;17(9):1654-1658. doi: 10.18240/ijo.2024.09.12. eCollection 2024.
To observe early clinical outcome with lens position adjustment following the implantable collamer lens (ICL) surgery.
Sixty patients were selected for this retrospective study. One eye from each patient received Toric ICL for astigmatism correction, and the other received non-astigmatic ICL surgery using horizontal position. Patients with higher postoperative arch height were selected, and their non-astigmatic eye clinical outcome were observed after ICL surgery at 1wk, 1, and 3mo. The clinical measurements included uncorrected visual acuity (UCVA), intraocular pressure (IOP), refractive state, corneal endothelium cell count, and arch height. Three months later, the ICL in each patient's non-astigmatic eye was adjusted to the vertical from the horizontal position. The results were compared before and 1wk, 1, and 3mo after adjustment.
UCVA and IOP were significantly reduced 1wk after position adjustment compared to 1wk after ICL implantation (<0.05). The patients demonstrated significantly reduced arch height and corneal endothelium cell count 1wk, 1, and 3mo after adjusting position compared to 1wk, 1, and 3mo after ICL implantation (<0.05). However, there was no significant difference in refraction between 1wk, 1, and 3mo after ICL implantation and position adjustment (>0.05).
Early positioning adjustment post-phakic ICL implantation can benefit patients with adjusted arch height or higher IOP. Despite the good clinical effects, the doctors should pay attention to the potential for adverse effects on UCVA and corneal endothelium cells following early position adjustment after posterior chamber phakic ICL implantation.
观察可植入式接触镜(ICL)手术后晶状体位置调整的早期临床效果。
选取60例患者进行这项回顾性研究。每位患者的一只眼睛接受用于矫正散光的散光型ICL植入,另一只眼睛接受水平位非散光型ICL手术。选取术后拱高较高的患者,观察其非散光眼在ICL手术后1周、1个月和3个月时的临床效果。临床测量指标包括裸眼视力(UCVA)、眼压(IOP)、屈光状态、角膜内皮细胞计数和拱高。3个月后,将每位患者非散光眼中的ICL从水平位调整为垂直位。比较调整前以及调整后1周、1个月和3个月时的结果。
与ICL植入后1周相比,位置调整后1周时UCVA和IOP显著降低(<0.05)。与ICL植入后1周、1个月和3个月相比,位置调整后1周、1个月和3个月时患者的拱高和角膜内皮细胞计数显著降低(<0.05)。然而,ICL植入后1周、1个月和3个月与位置调整后1周、1个月和3个月时的屈光度数无显著差异(>0.05)。
有晶状体眼ICL植入术后早期进行位置调整可使拱高调整或眼压较高的患者受益。尽管临床效果良好,但医生应注意有晶状体眼后房型ICL植入术后早期位置调整对UCVA和角膜内皮细胞可能产生的不良影响。