Liu Shengtao, Cheng Mingrui, Liu Fang, Lin Feng, Xiao Yichen, Wang Xiaoying, Zhou Xingtao
From the Department of Ophthalmology and Optometry, Eye and ENT Hospital, Fudan University, Shanghai, China (S. Liu, Cheng, F. Liu, Lin, Xiao, Wang, Zhou); NHC Key Laboratory of Myopia, Fudan University, Shanghai, China (S. Liu, Cheng, F. Liu, Lin, Xiao, Wang, Zhou); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China (S. Liu, Cheng, F. Liu, Lin, Xiao, Wang, Zhou); Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China (S. Liu, Cheng, F. Liu, Lin, Xiao, Wang, Zhou).
J Cataract Refract Surg. 2025 Mar 1;51(3):236-242. doi: 10.1097/j.jcrs.0000000000001593.
To investigate the pharmacological accommodative changes of the anterior segment and its impact on the circumferential anterior chamber angle (ACA) after implantable collamer lens (ICL) implantation using swept-source optical coherence tomography (SS-OCT).
Eye and ENT Hospital, Fudan University, Shanghai, China.
Prospective randomized contralateral eye study.
8 men and 24 women (mean age, 28.2 ± 5.8 years; range, 19 to 42 years); 64 eyes were included at 3 months after ICL implantation. One eye per patient was randomly assigned to undergo tropicamide instillation (mydriasis group), and the contralateral eye underwent pilocarpine instillation (miosis group). SS-OCT examinations were performed before and after instillation to measure angle parameters. Trabecular-iris angle 500 (TIA 500 ), angle opening distance 500 (AOD 500 ), trabecular-iris space area (TISA 500 ), angle opening distance circumference area 500 (AODA 500 ), trabecular-iris circumference volume 500 (TICV 500 ), and central vault (ICL to crystalline lens [ICL-L]) were evaluated.
Relative to baseline levels, TIA 500 , AOD 500 , and TISA 500 values all increased significantly in both groups (all P < .01). AODA 500 and TICV 500 values increased by 19.7% and 12.1%, respectively, in the mydriasis group (all P < .001), and these values similarly increased by 23.4% and 27.7%, respectively, in the miosis group (all P < .001). After instillation, the ICL-L decrease in the miosis group was significantly larger than that in the mydriasis group ( P = .004). Mean AOD 500 , TISA 500 , and TICV 500 in the miosis group were significantly larger than those in the mydriasis group (all P ≤ .036), especially at 8 and 10 o'clock (all P ≤ .014). Correlation analyses indicated that the increase in ACA parameters was positively correlated with the change in ICL-L for both groups.
Pilocarpine induced a more significant increase in ACA than tropicamide, because of a different mechanism of anterior segment changes. A circumferential meridian scan to assess angle status is recommended.
使用扫频光学相干断层扫描（SS-OCT）研究可植入式胶原晶状体（ICL）植入术后眼前节的药理学调节变化及其对周边前房角（ACA）的影响。
中国上海复旦大学附属眼耳鼻喉科医院。
前瞻性随机对侧眼研究。
8名男性和24名女性（平均年龄28.2±5.8岁；范围19至42岁）；ICL植入术后3个月纳入64只眼。每位患者的一只眼随机分配接受托吡卡胺滴眼（散瞳组），对侧眼接受毛果芸香碱滴眼（缩瞳组）。滴眼前后进行SS-OCT检查以测量房角参数。评估小梁-虹膜角500（TIA 500）、房角开放距离500（AOD 500）、小梁-虹膜间隙面积（TISA 500）、房角开放距离周边面积500（AODA 500）、小梁-虹膜周边体积500（TICV 500）和中央拱高（ICL至晶状体[ICL-L]）。
相对于基线水平，两组的TIA 500、AOD 500和TISA 500值均显著增加（均P<.01）。散瞳组的AODA 500和TICV 500值分别增加了19.7%和12.1%（均P<.001），缩瞳组的这些值分别同样增加了23.4%和27.7%（均P<.001）。滴眼后缩瞳组的ICL-L下降显著大于散瞳组（P=.004）。缩瞳组的平均AOD 500、TISA 500和TICV 500显著大于散瞳组（均P≤.036），尤其是在8点和10点处（均P≤.014）。相关性分析表明，两组的ACA参数增加均与ICL-L的变化呈正相关。
由于眼前节变化机制不同，毛果芸香碱比托吡卡胺引起的ACA增加更显著。建议进行周边子午线扫描以评估房角状态。
