Clinical observations of EVO-ICL implantation and changes in corneal astigmatism using a modified technique.
Clinical observations of EVO-ICL implantation and changes in corneal astigmatism using a modified technique.
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DOI：
10.1186/s12886-022-02603-8
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发表时间：
2022-09-23
影响因子：
2
通讯作者：
Zhao, Shaozhen
中科院分区：
文献类型：
--
作者：
Wang, Ying;Yang, Ruibo;Huang, Yue;Zhang, Chen;Liu, Hui;Jia, Zhe;Zhao, Shaozhen
关键词：
植入性胶原性晶状体(ICL)手术技术正在不断进步。本研究的目的是探讨改良手术技术在EVO-ICL手术中的应用效果及其对角膜散光变化的影响。对2018年7月至2020年5月收治的81例153眼近视患者进行回顾性队列数据分析。采用改良手术方法植入EVO-ICL(改良手术组：41例80眼)和标准术式(标准手术组：40例73眼)。分别于术后2、24小时监测眼压，分别于术后1、6、12个月测量眼压、矫正远视力(CDVA)、裸眼远视力(UDVA)、房顶及前房深度(ACD)。术后6个月和12个月监测角膜内皮细胞密度(ECD)。术后1个月分析总、前、后角膜表面的手术源性散光(SIA)。未发现严重并发症。在任何时间点，两组患者的视力、ICL值和ACD值均无差异(P >； 0.05)。术后2小时，改良术组眼压(16.22 ± 2.22比18.37 ± 1.92 mm Hg，P <； 0.05)明显低于标准术组。术后24小时眼压逐渐下降至术前水平。术后眼压在12个月内保持稳定。两组6个月和12个月的ECD值差异无统计学意义(P >； 0.05)。在术后1个月，两组间的总角膜表面、前表面和后表面的SIA在临床上没有显著差异(P >； 0.05)。改进后的技术是有效和安全的，产生了类似的视觉和结构结果，而不会对ECD产生不利影响，并减少了术后早期的眼压波动。标准技术中的辅助切口不会增加角膜SIA，这也是没有经验的外科医生要考虑的一个因素。
Implantable collamer lens (ICL) surgery techniques are constantly progressing. The purpose of this study was to investigate the application effect of the modified technique and its impact on the change in corneal astigmatism in EVO-ICL surgery. The analysis of retrospective cohort data included 153 eyes of 81 patients with myopia from July 2018 to May 2020. An EVO-ICL was inserted by modified surgical skills, including a single 3.0 mm corneal incision and no ophthalmic viscosurgical device (OVD) before the insertion of the ICL (modified technique group: 41 cases, 80 eyes) and standard procedure (standard technique group: 40 cases, 73 eyes). Early postoperative intraocular pressure (IOP) was monitored at 2 and 24 h. IOP, corrected distance visual acuity (CDVA), uncorrected distance visual acuity (UDVA), vault, and anterior chamber depth (ACD) were measured 1, 6, and 12 months following the initial examination. The corneal endothelial cell density (ECD) was monitored at 6 and 12 months after the operation. Surgically induced astigmatism (SIA) in the total, anterior, and posterior corneal surfaces was analysed 1 month after the operation. No serious complications were detected. The two groups had no difference in visual outcomes, ICL vaults, or ACD at any time point (P > 0.05). Two hours postoperatively, IOP was significantly lower in the modified technique group (16.22 ± 2.22 vs. 18.37 ± 1.92 mmHg, P < 0.05) than in the standard technique group. IOP decreased gradually after 24 h to preoperative levels. The postoperative IOP remained stable over a 12-month period. The ECD at 6 and 12 months was not significantly different between the groups (P > 0.05). SIA in the total, anterior, and posterior corneal surfaces were assumed to have no clinically meaningful differences between groups at one month after operation (P > 0.05). The modified technique is efficient and safe, producing comparable visual and structural outcomes without adversely affecting ECD, and reduces fluctuations in IOP at the early postoperative stages. The auxiliary incision in the standard technique does not increase corneal SIA, which is also a factor to consider for inexperienced surgeons.
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影响因子：
3.7
作者：
Senthil S;Choudhari NS;Vaddavalli PK;Murthy S;Reddy JC;Garudadri CS
通讯作者：
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影响因子：
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