表面改良型人工晶体中 PC-IOL 光学定位的长期评估及其对 Nd:YAG 包囊切除率和视觉质量的影响。

IF 4.1 1区医学 Q1 OPHTHALMOLOGY

American Journal of Ophthalmology Pub Date : 2024-09-28 DOI:10.1016/j.ajo.2024.09.029

Manpreet Kaur, Jeewan S. Titiyal, Jyoti Rawat

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引用次数: 0

摘要

目的：评估紫外线（UV）/臭氧表面改良型人工晶体后囊（PC）与眼内晶状体（IOL）光学元件的贴合情况及其对掺钕钇铝石榴石（Nd:YAG）激光切囊率和视觉质量的影响：设计：前瞻性介入病例系列方法：该研究共纳入了 100 只在超声乳化术中植入紫外线/臭氧表面改性疏水性丙烯酸人工晶体的眼睛。主要结果是前段光学相干断层扫描（ASOCT）上的PC-光学排列。次要结果是 Nd:YAG 包膜切开术和视觉质量（射线追踪像差法）。术后第1天、1个月、3个月、6个月、1年和2年进行随访：结果：术后第 1 天，4% 的病例观察到 PC 与视网膜完全贴合，2 年后这一比例增至 75%。在 ASOCT 上，PC-optic nonapposition 病例的 PC 构型为光滑（34.4%）或波浪形（65.6%）；最初的光滑 PC 与 2 年后 PC-optic apposition 的发生率显著增加有关（P=0.028）。2 年后，就 Strehl 比值（p=0.029）、调制传递函数（MTF）（p=0.016）、均方根像差（RMS）（p=0.024）和高阶像差（HOA）（p=0.043）而言，PC-光学完全贴合的病例视觉质量明显更好。界面液高度与总均方根像差[皮尔逊相关系数 0.221；p=0.027]和高阶像差[皮尔逊相关系数 0.198；p=0.048]之间呈显著正相关。7%的患者（7/100）出现 PCO；其中 6 例出现持续的 PC 角膜不贴合。3%的病例（3/100）需要进行 Nd:YAG 激光晶体囊切开术；所有这些病例的 PC 角膜都持续不贴合：结论：植入紫外线/臭氧表面改良型人工晶体的 75% 病例可观察到 PC 与光学完全贴合。PC-光学完全贴合与较低的 Nd:YAG 包囊切除率和较好的视觉质量有关。

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Long-Term Assessment of PC–IOL Optic Apposition in Surface-Modified IOL and Its Impact on Nd:YAG Capsulotomy Rate and Visual Quality

Purpose

To assess apposition of posterior capsule (PC) to intraocular lens (IOL) optic in ultraviolet (UV)/ozone surface modified IOL and its impact on neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy rate and visual quality.

Design

Prospective interventional case series.

Methods

The study enrolled 100 eyes implanted with UV/ozone surface modified hydrophobic acrylic IOL during phacoemulsification. The primary outcome measure was PC–optic apposition on anterior segment optical coherence tomography (ASOCT). Secondary outcomes were Nd:YAG capsulotomy and visual quality (ray-tracing aberrometry). Follow-up was performed on postoperative day (POD) 1, at 1, 3, and 6 months, and 1 and 2 years.

Results

Complete PC–optic apposition was observed in 4% of cases on POD1, which increased to 75% at 2 years. PC configuration in cases with PC–optic non-apposition was smooth (34.4%) or wavy (65.6%) on ASOCT; initial smooth PC was associated with significantly higher incidence of PC–optic apposition at 2 years (p=0.028). At 2 years, visual quality was significantly better in cases with complete PC–optic apposition in terms of Strehl ratio (P = .029), modulation transfer function (MTF) (P = 0.016), root mean square (RMS) aberrations (P = .024) and higher order aberrations (HOAs) (P = 0.043). A significant positive correlation was observed between height of interface fluid and total RMS (Pearson correlation coefficient 0.221; P = .027) and HOAs (Pearson correlation coefficient 0.198; P = .048). PCO developed in 7% of cases (7/100); of these, 6 cases had persistent PC–optic non-apposition. Nd:YAG laser capsulotomy was required in 3% (3/100) cases; all of these cases had persistent PC–optic non-apposition.

Conclusions

Long-term complete PC–optic apposition was observed in 75% of patients implanted with UV/ozone surface-modified IOLs. Complete PC–optic apposition is associated with lower Nd:YAG capsulotomy rate and superior visual quality.

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来源期刊

American Journal of Ophthalmology 医学-眼科学

CiteScore

9.20

自引率

7.10%

发文量

406

审稿时长

36 days

期刊介绍： The American Journal of Ophthalmology is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and visual science specialists describing clinical investigations, clinical observations, and clinically relevant laboratory investigations. Published monthly since 1884, the full text of the American Journal of Ophthalmology and supplementary material are also presented online at www.AJO.com and on ScienceDirect. The American Journal of Ophthalmology publishes Full-Length Articles, Perspectives, Editorials, Correspondences, Books Reports and Announcements. Brief Reports and Case Reports are no longer published. We recommend submitting Brief Reports and Case Reports to our companion publication, the American Journal of Ophthalmology Case Reports. Manuscripts are accepted with the understanding that they have not been and will not be published elsewhere substantially in any format, and that there are no ethical problems with the content or data collection. Authors may be requested to produce the data upon which the manuscript is based and to answer expeditiously any questions about the manuscript or its authors.