Clinically Significant Intraocular Lens Decentration and Tilt in Highly Myopic Eyes: A Swept-Source Optical Coherence Tomography Study
Clinically Significant Intraocular Lens Decentration and Tilt in Highly Myopic Eyes: A Swept-Source Optical Coherence Tomography Study
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DOI：
10.1016/j.ajo.2021.08.017
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发表时间：
2021-11-27
影响因子：
4.2
通讯作者：
Liu, Yizhi
中科院分区：
文献类型：
--
作者：
Wang, Lanhua;Jin, Guangming;Liu, Yizhi
目得：采用扫描源眼前段光学相干断层扫描（SS-AS-OCT）技术，研究高度近视眼内透镜（IOL）偏心和倾斜的发生率及其危险因素。设计：横断面研究。方法：本研究纳入334例（334眼）高度近视患者，定义为眼轴长度（AL）≥ 26 mm，行超声乳化白内障吸除联合IOL植入术。通过SS AS OCT评估IOL的偏心和倾斜。临床上显著的IOL偏心和倾斜定义为偏心>= 0. 4 mm和倾斜>= 7 °。常规术前和术后检查包括视力，屈光，生物测量使用IOLMaster 700（卡尔蔡司Meditec），和客观的视觉质量评价OPD-Scan III（Nidek Technologies）。结果：在334高度近视的参与者，71（21.3%）有临床意义的IOL偏心，26（7.78%）有临床意义的IOL倾斜。AL >= 30 mm患者中具有临床意义的IOL偏心（37.1% vs 14.0%，P <0.001）和倾斜（16.2% vs 3.90%，P <0.001）的比例显著高于AL = 30 mm患者，与具有临床意义的IOL偏心相关（比值比，1.65; P = 0.002）。校正混杂因素后，AL >= 30 mm（比值比，2.09; P = .001）是具有临床意义的IOL倾斜的独立风险因素。AL >= 30.3mm可有效预测IOL偏心>= 0.6mm（曲线下面积0.802）。结论：AL >30 mm的受试者有较高的临床显著IOL偏心和倾斜风险，因此对这些患者应谨慎植入多焦点或散光矫正型IOL。(C)2021爱思唯尔公司All rights reserved.
PURPOSE: To investigate the occurrence and risk factors of clinically significant intraocular lens (IOL) decentration and tilt in highly myopic eyes using swept-source anterior segment optical coherence tomography (SS-AS-OCT).DESIGN: Cross-sectional study.METHODS: This study included 334 participants (334 eyes) with high myopia, defined as axial length (AL) >= 26 mm, who underwent phacoemulsification with IOL implantation. Decentration and tilt of IOL were assessed by SS-AS-OCT. Clinically significant IOL decentration and tilt was defined as decentration >= 0.4 mm and tilt >= 7 degrees. Routine preoperative and postoperative examinations included visual acuity, refraction, biometric measurement using IOLMaster 700 (Carl Zeiss Meditec), and objective visual quality evaluated by OPD-Scan III (Nidek Technologies).RESULTS: Among the 334 highly myopic participants, 71 (21.3%) had clinically significant IOL decentration, and 26 (7.78%) had clinically significant IOL tilt. The proportion of clinically significant IOL decentration (37.1% vs 14.0%, P < .001) and tilt (16.2% vs 3.90%, P < .001) in those with AL >= 30 mm was significantly higher than in those with AL = 30 mm was associated with clinically significant IOL decentration (odds ratio, 1.65; P = .002). AL >= 30 mm (odds ratio, 2.09; P = .001) was an independent risk factor for clinically significant IOL tilt after adjusting for confounders. AL >= 30.3 mm could effectively predict IOL decentration >= 0.6 mm (area under the curve, 0.802).CONCLUSIONS: Participants with AL >30 mm have a higher risk of clinically significant IOL decentration and tilt, thus caution should be taken to implant multifocal or toric IOL for these patients.(C) 2021 Elsevier Inc. All rights reserved.