眼科 ›› 2023, Vol. 32 ›› Issue (3): 245-250.doi: 10.13281/j.cnki.issn.1004-4469.2023.03.012

• 论著 • 上一篇    下一篇

眼内镜植入术后再次眼内镜相关手术的原因及处理

穆延潇 乔明超 李琰 王开芳 王晓明   

  1. 济南明水眼科医院 250200
  • 收稿日期:2022-10-25 出版日期:2023-05-25 发布日期:2023-06-09
  • 通讯作者: 王晓明,Email:15908084280@163.com E-mail:15908084280@163.com
  • 基金资助:
    济南市卫生健康委员会科技计划项目(2021-2-138)

Causes and management of reoperation after implantable collamer lens implantation

Mu Yanxiao, Qiao Mingchao, Li Yan, Wang Kaifang, Wang Xiaoming   

  1. Jinan Mingshui Eye Hospital, Jinan 250200, China
  • Received:2022-10-25 Online:2023-05-25 Published:2023-06-09
  • Contact: Wang Xiaoming, Email: 15908084280@163.com E-mail:15908084280@163.com
  • Supported by:
    Science and Technology Project of Jinan Health Commission (2021-2-138)

摘要: 目的 总结分析眼内镜,即有晶状体眼后房型人工晶状体(PPC-ICL)植入术后行再次手术的原因,并探讨治疗及预防对策。设计 回顾性病例系列。研究对象 2019年7月至2022年4月在济南明水眼科医院行PPC-ICL植入手术的患者342例(669眼)中因各种原因行再次ICL相关手术的患者8例(11眼)。方法 回顾上述8例(11眼)患者的病历资料,对患者一般情况及屈光度、前房深度、角膜直径、睫状沟直径等眼部数据、ICL数据、拱高、再次手术原因、时机、处理方式、预后等进行描述。分析患者行再次手术的原因,并探讨治疗及预防对策。主要指标 再次手术的原因、时机、处理方式和预后。结果 再次手术的11眼中ICL 5眼,复曲面型ICL(TICL)6眼,均为水平位植入。再次手术原因包括旋转和拱高异常。3眼TICL发生旋转,行调位手术。拱高过高的7眼中,行ICL调位4眼,由水平位调位至垂直位,行ICL置换1眼,行TICL置换2眼,均选择小一号尺寸的ICL/TICL,术前平均拱高(1.28±0.14)mm,术后平均拱高(0.73±0.12)mm(P<0.05)。拱高过低1眼,行ICL置换术,选择大一号尺寸的ICL,但术后拱高变化不明显。结论 PPC-ICL植入术后再次手术的常见原因为术后拱高异常或ICL旋转,行调位或置换手术是有效的。术前精准、多仪器测量、提高拱高预测性、选择合适的ICL型号,避免意外伤害可能是预防再次手术的可能对策。(眼科,2023, 32: 245-250)

关键词: 有晶状体眼后房型人工晶状体, 拱高, 旋转, 再次手术

Abstract: Objective To observe the causes leading to reoperation after the implantation of phakic posterior chamber implantable collamer lens (PPC-ICL), also known as implantable collamer lens(ICL), and to explore the potential treatment options and preventive measures. Design Retrospective case series. Participants 8 patients (11 eyes) required reoperation due to a variety of reasons, whom out of 342 patients (669 eyes) who underwent PPC-ICL implantation at Jinan Mingshui Eye Hospital from July 2019 to April 2022. Methods The medical records were reviewed, and the examining general conditions and ocular data including refractive error, anterior chamber depth, corneal diameter, ciliary sulcus diameter, ICL data, vault hight, and reasons for reoperation were recorded. The time, management, and prognosis of these reoperations were also assessed. The reasons for reoperation, potential treatment options and preventive measures were discussed. Main Outcome Measures The reasons for reoperation, the time of reoperation, treatment methods, and prognosis. Results In the 11 reoperated eyes, five were implanted of regular ICLs and six were implanted of Toric ICLs (TICLs), which were all implanted horizontally. The reasons for the reoperation were the ICL rotation and the abnormal vault hight. Three TICLs experienced rotation and had to be repositioned. The mean vault hight measured before the reoperation was (1.28±0.14) mm, which subsequently decreased to (0.73±0.12) mm post-reoperation (P<0.05). In one particular case, a lower vault was executed and a larger size ICL was chosen in the reoperation. However, there was not a significant change in the vault after the operation. Conclusion The common reasons prompting reoperation after PPC-ICL implantation includes abnormal postoperative vault height and ICL rotation, for which alignment or replacement surgery proves effective. Preoperative accurate examination and measurement, combining multiple examination results, improving the predictability of vault height, selecting the appropriate ICL size, and avoiding accidental injury may be the possible countermeasures to prevent the reoperation. (Ophthalmol CHN, 2023, 32: 245-250)

Key words: phakic posterior chamber implantable collamer lens, vault height, rotation, reoperation