国际眼科纵览 ›› 2025, Vol. 49 ›› Issue (5): 378-386.doi: 10.3760/cma.i.cn115500-20250404-25509

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影响有晶状体眼人工晶状体植入术后效果的相关因素

杨楚茨 高萌蔓 郭秀瑾   

  1. 河北医科大学第二医院眼科,石家庄 050000 
  • 收稿日期:2025-05-20 出版日期:2025-10-22 发布日期:2025-10-16
  • 通讯作者: 郭秀瑾,Email: guoxiujin2003@163.com

Factors influencing the postoperative outcomes of phakic intraocular lens implantation

Yang Chuci, Gao Mengman, Guo Xiujin   

  1. Department of Ophthalmology, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, China
  • Received:2025-05-20 Online:2025-10-22 Published:2025-10-16
  • Contact: Guo Xiujin, Email: guoxiujin2003@163.com

摘要: 有晶状体眼人工晶状体(implantable collamer lens,ICL)植入术适用于角膜薄、超高度近视等不宜行角膜屈光手术的患者。尽管ICL总体安全有效,但其术后矫正效果仍存在个体差异。影响ICL手术效果的关键因素:(1)患者因素,包括眼部解剖参数(如前房深度、角膜内皮细胞密度、瞳孔直径)、屈光状态(特别是超高度近视和散光的个性化矫正)、全身及其他眼部疾病、患者年龄及调节功能等;(2)手术因素,包括ICL度数的计算和选择(如V4c、V5型ICL的特点及计算公式的演进)、手术技术(如微切口设计)、术后管理(如糖皮质激素的使用、拱高监测、ICL位置稳定性)等。随着V5型ICL等新型设计的应用、人工智能辅助计算模型的开发以及手术技术的精细化,ICL的精准性与安全性显著提升。术前精准评估、个性化方案制定及术后规范随访对优化视觉结局非常重要。

关键词: 有晶状体眼人工晶状体, 屈光手术, 矫正效果, 影响因素

Abstract: Phakic intraocular lens (implantable collamer lens, ICL) implantation is suitable for patients who are not ideal candidates for corneal refractive surgery, such as those with thin corneas or extreme myopia. Although ICL implantation is generally safe and effective, individual differences in postoperative corrective outcomes exist. Key factors influencing the surgical outcomes of ICL include: (1) Patient-related factors, such as ocular anatomical parameters (e.g., anterior chamber depth, corneal endothelial cell density, pupil diameter), refractive status (particularly the personalized correction of extreme myopia and astigmatism), systemic and other ocular diseases, patient age, and accommodative function; (2) Surgical factors, including ICL power calculation and selection (e.g., characteristics of V4c and V5 ICLs and the evolution of calculation formulas), surgical techniques (e.g., micro-incision design), and postoperative management (e.g., use of corticosteroids, vault monitoring, and ICL position stability). With the application of new designs such as the V5 ICL, the development of artificial intelligence-assisted calculation models, and the refinement of surgical techniques, the precision and safety of ICL implantation have significantly improved. Preoperative accurate evaluation, personalized treatment planning, and standardized postoperative follow-up are crucial for optimizing visual outcomes.

Key words: Phakic intraocular lens, Refractive surgery, Corrective effect, Influencing factors