不同屈光度近视患者睫状沟直径的特征与ICL选型策略:基于UBM的双子午线测量OA
Characteristics of sulcus-to-sulcus diameter and intraocularcollamer lens sizing strategy in myopic patients with different diopters:a dual-meridian measurement based on ultrasound biomicroscopy
目的 探讨睫状沟水平直径(hSTS)与睫状沟垂直直径(vSTS)在不同屈光度近视人群中的分布、差异及相关性,为有晶状体眼后房型人工晶状体(ICL)的个性化尺寸选择提供依据.方法 回顾性临床研究.纳入行ICL植入术的近视患者122例244眼,根据等效球镜度(SE)分为中度近视组(-6.00 D＜SE≤-3.00 D,45眼)、高度近视组(-10.00 D＜SE≤-6.00 D,150眼)和超高度近视组(SE≤-10.00 D,49眼).使用超声生物显微镜(UBM)测量所有患者的hSTS与vSTS,比较组间差异并进行相关性分析.结果 整体睫状沟形态以垂直椭圆为主(vSTS＞hSTS).超高度近视组患眼的hSTS和vSTS均显著大于中度、高度近视组(均为P＜0.05),且其vSTS-hSTS的差值[(0.63±0.38)mm]也显著更大(均为P＜0.05).vSTS-hSTS差值＞0.50 mm的比例在超高度近视组患者中最高(57.14％).相关性分析结果显示,SE与hSTS、vSTS呈极弱或弱的负相关(r=-0.18,P=0.006;r=-0.24,P＜0.001),而 hSTS 与 vSTS 呈显著正相关(r=0.78,P＜0.001).进一步分析发现,眼轴长度及角膜曲率是影响STS的关键解剖因素(均为P＜0.05).多元线性回归分析表明,即使在控制所有混杂因素后,SE仍与反映垂直椭圆程度的hSTS/vSTS比值独立相关(β=0.16,P=0.039).结论 近视屈光度越高,睫状沟的垂直椭圆形态越显著.在ICL术前评估中,尤其对于高度及超高度近视患者,需常规测量vSTS和hSTS,以优化ICL尺寸选择与拱高可预测性.
Objective To investigate the distribution,differences,and correlations of horizontal and vertical sulcus-to-sulcus(hSTS/vSTS)diameters in myopic populations with different diopters,thereby providing a basis for the personal-ized sizing of intraocular collamer lenses(ICL).Methods A retrospective clinical study was conducted.Totally 122 my-opic patients(244 eyes)who underwent ICL implantation were enrolled,and according to spherical equivalent(SE),they were divided into the moderate myopia group(-6.00 D＜SE≤-3.00 D,45 eyes),high myopia group(-10.00 D＜SE≤-6.00 D,150 eyes),and ultra-high myopia group(SE≤-10.00 D,49 eyes).Ultrasound biomicroscopy was used to meas-ure hSTS and vSTS in all patients,followed by intergroup comparison and correlation analysis.Results The overall ciliary sulcus morphology was predominantly vertically elliptical(vSTS＞hSTS).Both hSTS and vSTS in eyes with ultra-high myo-pia were significantly larger than those in the moderate and high myopia groups(all P＜0.05),and the vSTS-hSTS differ-ence[(0.63±0.38)mm]was also significantly greater(all P＜0.05).The proportion of eyes with a vSTS-hSTS difference＞0.50 mm was highest in the ultra-high myopia group(57.14％).Correlation analysis revealed that SE exhibited an extremely weak or weak negative correlation with both hSTS and vSTS(r=-0.18,P=0.006;r=-0.24,P＜0.001),whereas hSTS was significantly positively correlated with vSTS(r=0.78,P＜0.001).Further analysis revealed that axial length(AL)and cor-neal curvature were key anatomical factors influencing STS(all P＜0.05).Multiple linear regression analysis showed that even after adjusting for all confounding factors,SE remained independently associated with the hSTS/vSTS ratio,which reflects the degree of vertical ellipticity(β=0.16,P=0.039).Conclusion Higher myopic diopters are associated with a more pronounced vertically elliptical morphology of the ciliary sulcus.In preoperative evaluation for ICL implantation,routine measurement of vSTS and hSTS is required,especially in patients with high and ultra-high myopia,to optimize ICL size selection and vault predictability.
祝泽宇;刁淼;张桂营;祝莹;李军
110034 辽宁省沈阳市,沈阳何氏眼科医院||116000 辽宁省大连市,大连医科大学第二附属医院眼科110034 辽宁省沈阳市,沈阳何氏眼科医院110034 辽宁省沈阳市,沈阳何氏眼科医院||116000 辽宁省大连市,大连医科大学第二附属医院眼科116000 辽宁省大连市,大连理工大学附属大连第三人民医院眼科,大连市眼科医院,辽宁省角膜与眼表疾病重点实验室,辽宁省验光技术工程研究中心110034 辽宁省沈阳市,沈阳何氏眼科医院
医药卫生
有晶状体眼后房型人工晶状体睫状沟直径近视超声生物显微镜个性化手术
intraocular collamer lenssulcus-to-sulcus diametermyopiaultrasound biomicroscopypersonalized sur-gery
《眼科新进展》 2026 (6)
459-463,5
大连市科技局医工交叉合作重点项目(编号:2024ZDJH01PT052)
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