Abstract：
To evaluate the actual lens positions (ALPs) of three intraocular lenses (IOLs) in highly myopic eyes and to identify relevant factors using ultrasound biomicroscopy (UBM).
Ninety-three highly myopic eyes (93 patients) that underwent uneventful cataract surgery were included: 36 eyes were implanted with Zeiss 409MP IOLs, 27 with Rayner 920H IOLs and 30 with HumanOptics MCX11 IOLs. The prediction error (PE), ALP determined by UBM and the factors associated with ALP at 3 months after surgery were evaluated.
The eyes in the MCX11 IOL group had a more hyperopic PE (0.67±0.45 diopters (D)) and greater ALP (4.86±0.39 mm) than those in the 409MP and 920H IOL groups at 3 months after surgery (PE: -0.25±0.54 and -0.16±0.65 D, respectively; ALP: 4.34±0.26 and 4.14±0.32 mm, respectively). The MCX11 IOLs showed more backward bending deformation after surgery than 409MP and 920H IOLs. The radius of curvature of the IOL was negatively correlated with ALP (r=-0.532, p=0.002) in the MCX11 IOL group, but not in the other two groups. Multivariate analysis showed that MCX11 IOLs were more prone to bending in highly myopic eyes with a smaller anterior capsular opening (β=0.236, p=0.023) and lower implanted power (β=0.542, p=0.001).
In highly myopic eyes, IOLs with good capsular support show less backward bending, which result in a more stable lens position and refractive status postoperatively. Severe capsular contraction and low implanted power are risk factors for bending of certain IOLs.
Ninety-three highly myopic eyes (93 patients) that underwent uneventful cataract surgery were included: 36 eyes were implanted with Zeiss 409MP IOLs, 27 with Rayner 920H IOLs and 30 with HumanOptics MCX11 IOLs. The prediction error (PE), ALP determined by UBM and the factors associated with ALP at 3 months after surgery were evaluated.
The eyes in the MCX11 IOL group had a more hyperopic PE (0.67±0.45 diopters (D)) and greater ALP (4.86±0.39 mm) than those in the 409MP and 920H IOL groups at 3 months after surgery (PE: -0.25±0.54 and -0.16±0.65 D, respectively; ALP: 4.34±0.26 and 4.14±0.32 mm, respectively). The MCX11 IOLs showed more backward bending deformation after surgery than 409MP and 920H IOLs. The radius of curvature of the IOL was negatively correlated with ALP (r=-0.532, p=0.002) in the MCX11 IOL group, but not in the other two groups. Multivariate analysis showed that MCX11 IOLs were more prone to bending in highly myopic eyes with a smaller anterior capsular opening (β=0.236, p=0.023) and lower implanted power (β=0.542, p=0.001).
In highly myopic eyes, IOLs with good capsular support show less backward bending, which result in a more stable lens position and refractive status postoperatively. Severe capsular contraction and low implanted power are risk factors for bending of certain IOLs.
摘要：
目的：评估高度近视眼中三个人工晶状体（IOL）的实际晶状体位置（ALP），并使用超声生物显微镜（UBM）确定相关因素。
方法：共93只高度近视眼（93例）接受了顺利的白内障手术：36只眼植入蔡司409MPIOL，27与Rayner920HIOL和30与HumanOpicsMCX11IOL。预测误差(PE)，评价UBM测定ALP及术后3个月ALP相关因素。
结果：MCX11IOL组的眼睛远视PE（0.67±0.45屈光度（D））和ALP（4.86±0.39mm）高于409MP和920HIOL组术后3个月（PE：-0.25±0.54和-0.16±0.65D，ALP分别为4.34±0.26和4.14±0.32mm,分别)。与409MP和920HIOL相比，MCX11IOL在手术后显示出更多的向后弯曲变形。MCX11组IOL的曲率半径与ALP呈负相关(r=-0.532,p=0.002),但不是在其他两组。多因素分析显示，MCX11人工晶状体在前囊开口较小（β=0.236，p=0.023）和植入功率较低（β=0.542，p=0.001）的高度近视眼中更容易弯曲。
结论：在高度近视的眼睛中，具有良好囊支撑的IOL显示较少的向后弯曲，这导致更稳定的晶状体位置和屈光状态。严重的囊膜收缩和低植入功率是某些IOL弯曲的危险因素。
方法：共93只高度近视眼（93例）接受了顺利的白内障手术：36只眼植入蔡司409MPIOL，27与Rayner920HIOL和30与HumanOpicsMCX11IOL。预测误差(PE)，评价UBM测定ALP及术后3个月ALP相关因素。
结果：MCX11IOL组的眼睛远视PE（0.67±0.45屈光度（D））和ALP（4.86±0.39mm）高于409MP和920HIOL组术后3个月（PE：-0.25±0.54和-0.16±0.65D，ALP分别为4.34±0.26和4.14±0.32mm,分别)。与409MP和920HIOL相比，MCX11IOL在手术后显示出更多的向后弯曲变形。MCX11组IOL的曲率半径与ALP呈负相关(r=-0.532,p=0.002),但不是在其他两组。多因素分析显示，MCX11人工晶状体在前囊开口较小（β=0.236，p=0.023）和植入功率较低（β=0.542，p=0.001）的高度近视眼中更容易弯曲。
结论：在高度近视的眼睛中，具有良好囊支撑的IOL显示较少的向后弯曲，这导致更稳定的晶状体位置和屈光状态。严重的囊膜收缩和低植入功率是某些IOL弯曲的危险因素。
