摘要
目的:评估有晶状体眼人工晶状体(ICL)植入手术患者术后早期非计划再次手术率及再次手术的原因、处理方法及转归。方法:回顾性临床研究。选择2020年4月至2021年3月在北京协和医院眼科行ICL植入手术的患者744例(1483眼),对其中行非计划再次手术的患者进行手术原因及处理方法分析。将因拱高异常进行非计划再次手术者分为低拱高组和高拱高组。使用Kruskal-Wallis检验比较各组的年龄及屈光度;采用方差分析比较各组白到白距离、房角到房角距离、前房深度、晶状体矢高、晶状体厚度、眼轴及拱高;采用t检验比较再次手术前后的拱高、散光度数及裸眼视力。结果:在术后2周内进行非计划再次手术共37眼(2.49%)。其中进行ICL调位术34眼,ICL置换术3眼。最常见的再次手术原因为拱高异常和散光残留。进行ICL调位术的原因为高拱高(13眼)、残留散光(11眼)、低拱高(10眼)。进行ICL置换术的原因为低拱高(2眼)和高拱高(1眼)。通过再次手术,高拱高组的拱高由(974±174)μm降低至(691±120)μm,低拱高组的拱高由(174±49)μm增加至(388±78)μm,散光残留眼的散光由(1.34±0.34)D降至(0.39±0.26)D,手术前后差异均有统计学意义(均P<0.001)。再次手术无手术并发症出现。结论:拱高异常和散光残留是ICL植入术后早期进行非计划再次手术的主要原因,通过再次手术均可获得理想拱高和屈光度。
Objective:To determine the incidence of unplanned reoperation following implantable collamer lens(ICL)implantation in the early postoperative period and analyze the reasons,treatment and prognosis for reoperation.Methods:In this retrospective clinical study,all patients undergoing ICL implantation at Peking Union Medical College Hospital between April 2020 and March 2021 were reviewed.A total of 1483 cases of ICL implantation operations were performed.The reasons,treatment and prognosis for unplanned reoperation were analyzed.The eyes that had unplanned reoperation because of abnormal vault were divided into low vault group and high vault group.Kruskal Wallis test was used to compare the age and diopters of the eyes in each group.Variance analysis was used to compare the white to white distance,angle to angle distance,anterior chamber depth,lens rise,lens thickness,axial length and vault of the eyes in each group.t test was used to compare the vault,astigmatism and uncorrected visual acuity before and after reoperation.Results:Thirty-seven eyes(2.49%)underwent unplanned reoperation within two weeks after the ICL implantaion.Among them,ICL rotation was performed on 34 eyes and ICL exchange on 3 eyes.The most common reasons for reoperation were abnormal vault and residual astigmatism.The reasons for the ICL rotation were high vault(13 eyes),residual astigmatism(11 eyes),and low vault(10 eyes).The reasons for the 3 eyes of ICL exchange were low vault(2 eyes)and high vault(1 eye).After reoperation,the vault of the high vault group was decreased from 974±174μm to 691±120μm,the vault of the low vault group was increased from 174±49μm to 388±78μm,the astigmatism of the residual astigmatism group was drecreased from 1.34±0.34 D to 0.39±0.26 D,and all the changes were statistically significant(P<0.001).No complications were encountered during reoperation.Conclusions:Abnormal vault and residual astigmatism were the main reasons for unplanned reoperation.The desired vault and diopter could be achieved through reop
作者
杨治坤
罗岩
Zhikun Yang;Yan Luo(Department of Ophthalmology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Beijing 100730,China)
出处
《中华眼视光学与视觉科学杂志》
CAS
CSCD
2022年第10期746-751,共6页
Chinese Journal Of Optometry Ophthalmology And Visual Science
关键词
ICL植入术
非计划再次手术
拱高
残留散光
implantable collamer lens implantation
unplanned reoperation
vault
residual astigmatism
