Changes of dysfunctional lens index before and after implantable collamer lens V4c implantation in patients with moderate-to-high myopia.
Changes of dysfunctional lens index before and after implantable collamer lens V4c implantation in patients with moderate-to-high myopia.
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DOI：
10.1007/s10792-023-02812-0
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发表时间：
2023-11
影响因子：
1.6
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中科院分区：
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在人工晶状体植入术后，功能失调性晶状体指数（DLI）的改变很少被报道。在本研究中，我们希望通过射线示踪像差法研究中高近视患者后房型有中心人工孔人工晶状体植入术前后的DLI变化。本回顾性观察性病例系列包括104例接受ICL V4c植入术的中度至高度近视患者206只眼。收集术前、术后1天、1、3、6个月的眼部指标数据。使用i-Trace视觉功能分析仪评估DLI测量。安全性指数和有效性指数的总体值均大于1。术前206只眼的平均球面等效度（SE）为−10.77±3.46屈光度(D)。术后1天，平均SE为- 0.22±0.55 D，术后1天至6个月基本没有变化。虽然术前和术后内皮参数无显著差异，但6个月时内皮细胞的平均损失为0.74±0.98%。对于拱顶，每次随访之间有显著差异（P < 0.001）。术后1天至6个月，拱顶平均下降109.6±13.5µm。术后1、3、6个月DLI值分别为3.70、9.26、10.00、9.68 (P < 0.001)，术后1、3、6个月DLI值差异无统计学意义（P < 0.05）。术前lnDLI与术前球形当量（SE）呈显著的线性正相关（r = 0.621, P < 0.001）。lnDLI与眼轴长度（r = - 0.462, P < 0.001）、角膜厚度（r = - 0.207, P = 0.003）、术前LogMAR UDVA （r = - 0.189, P = 0.006）、术前LogMAR CDVA （r = - 0.306, P < 0.001）呈负相关。术后半年屈光参数的有效性、可预测性和稳定性均较好。中高近视患者在ICL V4c植入术后，DLI有明显改善，并在随访期间表现出良好的稳定性。DLI值得在临床服务中得到更全面的认识和应用。
Dysfunctional lens index (DLI) changing is rarely reported after implantable collamer lens (ICL) implantation. In the current research, we hope to investigate the changes of DLI by ray-tracing aberrometry before and after implantation of the posterior chamber phakic implantable collamer lens with a central artificial hole for patients with moderate-to-high myopia. This retrospective, observational case series included 206 eyes of 104 patients with moderate-to-high myopia who underwent ICL V4c implantation. Data were collected on ocular indicators preoperatively and at 1 day, 1, 3, and 6 months postoperatively. The i-Trace Visual Functional Analyzer was used to assess the DLI measurement. The overall values of safety index and efficacy index were both more than 1. Preoperatively, the mean spherical equivalent (SE) of included 206 eyes was − 10.77 ± 3.46 diopter (D). Then at 1-day postoperation, the mean SE was − 0.22 ± 0.55 D, and barely changed from 1 day to 6 months postoperatively. Although the endothelial parameters had no significant differences between preoperation and postoperation, the mean loss of endothelial cells was 0.74 ± 0.98% at 6 months. Regarding the vault, there was a significant difference between each time of follow-up (P < 0.001). The mean of the vault decreased 109.6 ± 13.5 µm from 1-day post-op to 6 months post-op. The DLI values were 3.70, 9.26, 10.00, and 9.68 at baseline, 1, 3, and 6 months, respectively (P < 0.001), but no significant differences were found between 1, 3, and 6 months postoperatively (P > 0.05). The preoperative lnDLI showed a significant positive linear correlation (r = 0.621, P < 0.001) with the preoperative spherical equivalent (SE). The lnDLI was negatively correlated with the axial length (r = − 0.462, P < 0.001), corneal thickness (r = − 0.207, P = 0.003), preoperative LogMAR UDVA (r = − 0.189, P = 0.006), and preoperative LogMAR CDVA (r = − 0.306, P < 0.001). The postoperative refractive parameters were confirmed excellent in efficacy, predictability, and stability in half a year. The DLI was significantly improved after the ICL V4c implantation in patients with moderate-to-high myopia and showed good stability during the follow-up periods. The DLI deserves a more comprehensive understanding and application in clinical services.