Changes in Endothelial Cell Count Up to Three Years After Implantation of Toric Implantable Collamer Lenses
Changes in Endothelial Cell Count Up to Three Years After Implantation of Toric Implantable Collamer Lenses
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DOI：
10.1097/ico.0000000000001914
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发表时间：
2019-07-01
期刊：
影响因子：
2.8
通讯作者：
Patel, Sudi
中科院分区：
文献类型：
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作者：
Bohac, Maja;Jagic, Mateja;Patel, Sudi
目的：探讨TICL植入和植入位置对术后36个月角膜内皮细胞密度(ECD)的影响。方法：收集符合TICL的病例(VTICMO，VTICM5；STAAR Surgical，Nidau)的资料。术前屈光度(球镜和柱镜)-1.00~-22.25，柱镜20.50~-5.50。结果：术前平均ECD(6SD，95%可信区间)为2720个/mm(2,620~2820个/mm(2))，术后36个月降至2372个/mm(+/-325,2250~2490个/mm(2)，P<0.001)。直线回归分析显示：(1)术后2年ECD变化的对数(y(1))与术前ECD的对数(x(1))显著相关，y(1)=2.513x(1)-6.2816(n=62，r=0.3503，P=0.005)，(2)平均ECD(y(2))与对数时间(月x(2))，y(2)=2.513x(2)-38.99x(2)2(r=20.9654，n=7，P=0.0004)；(3)晶状体前表面至晶状体后表面的平均轴向距离(Y3)和术后时间(以月为单位，x(3))，y(3)=0.1035x3 225.2808x(3)+473.18(r=0.8512，n=7，P=0.015)。平均而言，植入后3年以上，(1)ECD开始迅速下降，随后细胞丢失率逐渐下降；(2)术后2年，TICL与晶状体之间的距离逐渐减小，然后在第3年逆转。
Purpose: To determine the temporal effect of toric implantable collamer lens (TICL) implantation and location on corneal endothelial cell density (ECD) over a period of 36 months after surgery.Methods: ECD [number of cells per square millimeter estimated using the Specular Microscope SP-1P (Topcon Europe Medical B. V., Netherlands)] data were collected from cases deemed suitable for the TICL (VTICMO, VTICM5; STAAR Surgical, Nidau, Switzerland). The preoperative refractive error (sphere and cylinder) ranged from -1.00 to -22.25 diopter sphere and from 20.50 to -5.50 diopter cylinder. ECD was evaluated at preoperative and all postoperative sessions.Results: Key findings were as follows: the mean ECD (6SD, 95% confidence interval) was 2720 cells/mm(2) (6272, 2620-2820 cells/mm(2)) preoperatively, which was reduced to 2372 cells/mm(2) (+/-325, 2250-2490 cells/mm(2)) at 36 months postoperatively (P, 0.001). Linear regression revealed the following significant correlations between the (1) log of the change in ECD (y(1)) and log of preoperative ECD (x(1)) at 2 years postoperatively, y(1) =2.513x(1)-6.2816 (n=62, r=0.3503, P =0.005); (2) mean ECD (y(2)) and log time (in months, x(2)), y(2)=2543.7-36.997x(2)-38.99x(2) 2 (r=20.9654, n =7, P = 0.0004); and (3) mean axial distance between the front surface of the crystalline lens and the TICL back surface (y3) and time postoperatively (in months, x(3)), y(3) =0.1035x3 225.2808x(3) + 473.18 (r =0.8512, n =7, P =0.015).Conclusions: Expected ECD loss after TICL implantation by 2 years postoperatively is predictable. On average, over 3 years after implantation, there is (1) an initial rapid decline in ECD, followed by a gradual fall in the rate of cell loss, and (2) a gradual fall in the distance between the TICL and the crystalline lens by 2 years postoperatively, followed by a reversal by the third year.