Huang Ting, Zhang Hongyan, Li Ke
Department of Ophthalmology, Daping Hospital of Army Medical University, PLA, Chongqing, 400042, China.
Heliyon. 2024 Oct 31;10(22):e39791. doi: 10.1016/j.heliyon.2024.e39791. eCollection 2024 Nov 30.
To investigate the clinical effect and safety of Implantable Collamer Lens (ICL) implantation in myopic patients with relatively shallow anterior chamber depth (ACD).
Retrospective analysis, comparative, non-interventional case series. Patients with myopia who underwent ICL implantation were included in the study and were categorized into two groups: one with a relatively shallow ACD (2.60 mm ≤ ACD ＜ 2.80 mm) and the other with a normal ACD (ACD ≥2.80 mm). Each group comprised 51 eyes and were reviewed for at least 6 months. To evaluate preoperative and postoperative visual acuity, intraocular pressure (IOP), central vault, ACD, endothelial cell density (ECD) and anterior chamber angle parameters [ trabecular iris angle (TIA), angle opening distance at 500 μm and 750 μm (AOD500, AOD750), trabecular iris space area at 500 μm and 750 μm (TISA500, TISA750) ]. Analyze the trend of postoperative data changes of 1 week, 1 month, 3 months, and at least 6 months. Patients in relatively shallow ACD with vault <100 μm or >1000 μm were performed detailed follow-up.
The postoperative uncorrected distance visual acuity (UDVA) and best corrected visual acuity (BCVA) surpassed the preoperative BCVA in two groups. The group differences of effectiveness index (EI) was = 0.409 and of safety index (SI) was = 0.563. The EI were 1.07 and 1.09, SI were1.10 and 1.21. Postoperative vision and refractive error were effectively corrected. The preoperative and postoperative IOP and ECD values of the two groups were within the normal range, and the preoperative and postoperative differences and the group differences of IOP and ECD were = 0.649, = 0.501, = 0.222, = 0.276. The ACD in two groups were reduced by approximately 25 % and 26 %, the nasal and temporal TIA were reduced to 45 % and 50 % approximately. The nasal and temporal AOD500, AOD750, TISA500, and TISA750 in the relatively shallow ACD group were reduced 40 % approximately and in the normal ACD group were reduced to 30 % approximately. All the preoperative and postoperative differences and the group differences of anterior segment parameters were statistically significant (all < 0.01), with more significant anterior segment changes in normal ACD group.The postoperative data in two groups showed that when the follow-up time was prolonged, the central vault was decreasing, and the postoperative ACD was increasing, the postoperative TIA increased slowly in relatively shallow ACD group and decreased slowly in normal ACD group, temporal TIA were greater than nasal TIA, with no significant variation. There were four eyes in the relatively shallow ACD group in the remarkable abnormal postoperative central vault. Three eyes had second operation: one eye had an ICL alignment, and two eyes had ICL replacement.
Patients with relatively shallow ACD who underwent ICL implantation had fine postoperative clinical efficacy and safety.
探讨可植入式胶原晶状体（ICL）植入术在浅前房深度（ACD）近视患者中的临床疗效及安全性。
回顾性分析、对比、非干预性病例系列研究。纳入接受ICL植入术的近视患者，并分为两组：一组为浅ACD（2.60 mm≤ACD＜2.80 mm），另一组为正常ACD（ACD≥2.80 mm）。每组各51只眼，随访至少6个月。评估术前及术后视力、眼压（IOP）、中央拱高、ACD、内皮细胞密度（ECD）及前房角参数[小梁虹膜夹角（TIA）、500μm和750μm处的房角开放距离（AOD500、AOD750）、500μm和750μm处的小梁虹膜间隙面积（TISA500、TISA750）]。分析术后1周、1个月、3个月及至少6个月数据变化趋势。对拱高＜100μm或＞1000μm的浅ACD患者进行详细随访。
两组术后裸眼远视力（UDVA）及最佳矫正视力（BCVA）均超过术前BCVA。有效指数（EI）组间差异为=0.409，安全指数（SI）组间差异为=0.563。EI分别为1.07和1.09，SI分别为1.10和1.21。术后视力及屈光不正得到有效矫正。两组术前及术后IOP和ECD值均在正常范围内，IOP和ECD的术前与术后差异及组间差异分别为=0.649、=0.501、=0.222、=0.276。两组ACD均降低约25%和26%，鼻侧和颞侧TIA分别降低至约45%和50%。浅ACD组鼻侧和颞侧AOD500、AOD750、TISA500和TISA750降低约40%，正常ACD组降低至约30%。所有眼前节参数的术前与术后差异及组间差异均有统计学意义（均＜0.01），正常ACD组眼前节变化更显著。两组术后数据显示，随着随访时间延长，中央拱高降低，术后ACD增加，浅ACD组术后TIA缓慢增加，正常ACD组缓慢降低，颞侧TIA大于鼻侧TIA，差异无统计学意义。浅ACD组有4只眼术后中央拱高明显异常。3只眼进行了二次手术：1只眼进行了ICL调整，2只眼进行了ICL置换。
接受ICL植入术的浅ACD患者术后临床疗效及安全性良好。
