{"title":"囊膜张力环对高度近视白内障患者人工晶状体稳定性和视力的影响：包括两种类型的人工晶状体的队列研究。","authors":"Yilin Sun, Yiwen Hu, Chen Wang, Fang Liu","doi":"10.1097/j.jcrs.0000000000001689","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate capsular tension ring (CTR) impact on toric intraocular lens (IOL) stability in high axial myopia (AL≥26 mm).</p><p><strong>Setting: </strong>10th People's Hospital Affiliated to Tongji University, Shanghai, China.</p><p><strong>Design: </strong>Ambispective cohort study.</p><p><strong>Methods: </strong>90 eyes (68 patients) received CTR with toric IOL (CTR group, n=55) or toric IOL alone (control, n=35). Outcomes included rotational stability, decentration, tilt, residual astigmatism, and visual acuity at 1 week and 3 months. Statistical analyses incorporated t-tests, Kaplan-Meier survival analysis, and generalized estimating equations (GEE).</p><p><strong>Results: </strong>CTR improved early rotational stability (3.20±5.23° vs 4.26±3.68°, p=0.03) and reduced ≥10° rotation incidence (1.8% vs 12.9%, p=0.04). At 3 months, CTR decreased decentration (0.28±0.14mm vs 0.43±0.37mm, p=0.04) without affecting tilt. In AL≥30 mm subgroup, CTR reduced residual astigmatism (1 week: p=0.04) and delayed ≥10° rotation onset (p=0.003). Plate-haptic IOLs had higher rotation risk than C-loop designs (RR=6.613, p=0.01), but CTR reduced tilt in plate-haptic subgroup (0.96° vs 2.03°, p=0.005). Advanced age independently lowered rotation risk (RR=0.89, p=0.004).</p><p><strong>Conclusion: </strong>CTR enhances rotational stability and reduces decentration in high myopia, particularly for AL≥30 mm eyes. C-loop IOLs outperform plate-haptic designs in rotation resistance. Age is a protective factor against rotation. These findings support CTR use with plate-haptic IOLs in elongated eyes to optimize outcomes.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":3.2000,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effect of Capsular Tension Ring on Toric IOL Stability and Visual Outcomes in Cataract Patients with High Myopia:A Cohort Study including Two Types of Toric IOL.\",\"authors\":\"Yilin Sun, Yiwen Hu, Chen Wang, Fang Liu\",\"doi\":\"10.1097/j.jcrs.0000000000001689\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To evaluate capsular tension ring (CTR) impact on toric intraocular lens (IOL) stability in high axial myopia (AL≥26 mm).</p><p><strong>Setting: </strong>10th People's Hospital Affiliated to Tongji University, Shanghai, China.</p><p><strong>Design: </strong>Ambispective cohort study.</p><p><strong>Methods: </strong>90 eyes (68 patients) received CTR with toric IOL (CTR group, n=55) or toric IOL alone (control, n=35). Outcomes included rotational stability, decentration, tilt, residual astigmatism, and visual acuity at 1 week and 3 months. Statistical analyses incorporated t-tests, Kaplan-Meier survival analysis, and generalized estimating equations (GEE).</p><p><strong>Results: </strong>CTR improved early rotational stability (3.20±5.23° vs 4.26±3.68°, p=0.03) and reduced ≥10° rotation incidence (1.8% vs 12.9%, p=0.04). At 3 months, CTR decreased decentration (0.28±0.14mm vs 0.43±0.37mm, p=0.04) without affecting tilt. In AL≥30 mm subgroup, CTR reduced residual astigmatism (1 week: p=0.04) and delayed ≥10° rotation onset (p=0.003). Plate-haptic IOLs had higher rotation risk than C-loop designs (RR=6.613, p=0.01), but CTR reduced tilt in plate-haptic subgroup (0.96° vs 2.03°, p=0.005). Advanced age independently lowered rotation risk (RR=0.89, p=0.004).</p><p><strong>Conclusion: </strong>CTR enhances rotational stability and reduces decentration in high myopia, particularly for AL≥30 mm eyes. C-loop IOLs outperform plate-haptic designs in rotation resistance. Age is a protective factor against rotation. These findings support CTR use with plate-haptic IOLs in elongated eyes to optimize outcomes.</p>\",\"PeriodicalId\":15214,\"journal\":{\"name\":\"Journal of cataract and refractive surgery\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.2000,\"publicationDate\":\"2025-06-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of cataract and refractive surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/j.jcrs.0000000000001689\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"OPHTHALMOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of cataract and refractive surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/j.jcrs.0000000000001689","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的：评价高轴型近视（AL≥26 mm）患者晶状体张力环（CTR）对环型人工晶状体（IOL）稳定性的影响。单位：上海市同济大学附属第十人民医院。设计：双视角队列研究。方法：90眼（68例）行CTR联合环状体人工晶状体（CTR组，n=55）或单纯环状体人工晶状体（对照组，n=35）。结果包括旋转稳定性、分散、倾斜、残余散光和1周和3个月的视力。统计分析包括t检验、Kaplan-Meier生存分析和广义估计方程（GEE）。结果：CTR改善了早期旋转稳定性（3.20±5.23°vs 4.26±3.68°，p=0.03），降低了≥10°的旋转发生率（1.8% vs 12.9%, p=0.04）。在3个月时，CTR降低了偏心（0.28±0.14mm vs 0.43±0.37mm, p=0.04），而不影响倾斜。在AL≥30 mm亚组中，CTR降低了残余散光（1周：p=0.04），延迟了≥10°旋转发作（p=0.003）。触觉钢板iol的倾斜风险高于c环设计（RR=6.613, p=0.01），但CTR降低了触觉钢板iol的倾斜（0.96°vs 2.03°，p=0.005）。高龄独立降低轮换风险（RR=0.89, p=0.004）。结论：CTR可提高高度近视患者的旋转稳定性，并可减少角膜离体，尤其是AL≥30 mm眼。c环iol在旋转阻力方面优于板触觉设计。年龄是防止轮换的一个保护因素。这些发现支持CTR与板触觉人工晶体在细长眼中的应用以优化结果。
Effect of Capsular Tension Ring on Toric IOL Stability and Visual Outcomes in Cataract Patients with High Myopia:A Cohort Study including Two Types of Toric IOL.
Purpose: To evaluate capsular tension ring (CTR) impact on toric intraocular lens (IOL) stability in high axial myopia (AL≥26 mm).
Setting: 10th People's Hospital Affiliated to Tongji University, Shanghai, China.
Design: Ambispective cohort study.
Methods: 90 eyes (68 patients) received CTR with toric IOL (CTR group, n=55) or toric IOL alone (control, n=35). Outcomes included rotational stability, decentration, tilt, residual astigmatism, and visual acuity at 1 week and 3 months. Statistical analyses incorporated t-tests, Kaplan-Meier survival analysis, and generalized estimating equations (GEE).
Results: CTR improved early rotational stability (3.20±5.23° vs 4.26±3.68°, p=0.03) and reduced ≥10° rotation incidence (1.8% vs 12.9%, p=0.04). At 3 months, CTR decreased decentration (0.28±0.14mm vs 0.43±0.37mm, p=0.04) without affecting tilt. In AL≥30 mm subgroup, CTR reduced residual astigmatism (1 week: p=0.04) and delayed ≥10° rotation onset (p=0.003). Plate-haptic IOLs had higher rotation risk than C-loop designs (RR=6.613, p=0.01), but CTR reduced tilt in plate-haptic subgroup (0.96° vs 2.03°, p=0.005). Advanced age independently lowered rotation risk (RR=0.89, p=0.004).
Conclusion: CTR enhances rotational stability and reduces decentration in high myopia, particularly for AL≥30 mm eyes. C-loop IOLs outperform plate-haptic designs in rotation resistance. Age is a protective factor against rotation. These findings support CTR use with plate-haptic IOLs in elongated eyes to optimize outcomes.
期刊介绍：
The Journal of Cataract & Refractive Surgery (JCRS), a preeminent peer-reviewed monthly ophthalmology publication, is the official journal of the American Society of Cataract and Refractive Surgery (ASCRS) and the European Society of Cataract and Refractive Surgeons (ESCRS).
JCRS publishes high quality articles on all aspects of anterior segment surgery. In addition to original clinical studies, the journal features a consultation section, practical techniques, important cases, and reviews as well as basic science articles.
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