■囊袋张力环(CTRs)可以支持弱小带并抑制囊袋收缩,从而潜在地减少人工晶状体(IOL)的偏心和倾斜。然而,CTR是否可以减少高度近视眼的IOL偏心和倾斜,以及CTR植入是否对所有高度近视眼都是必要的,一直存在争议.
■评估CTR植入对高度近视的IOL偏心和倾斜的影响。
■这项随机临床试验于2021年11月至2023年9月在中山眼科中心进行,广州,中国。纳入患有白内障且轴向长度(AL)为26mm或更长的患者。
■根据AL将参与者分为3组(地层1,26mm≤AL<28mm;地层2,28mm≤AL<30mm;地层3,AL≥30mm),并在每个层内进一步随机分配到CTR组(C环IOL结合CTR)或对照组(仅C环IOL)。
■使用眼前节光学相干断层扫描评估白内障手术后3个月的IOL偏心。
■186名参与者共186只眼睛(平均[SD]年龄,57.3[10.9]岁;118名女性[63.4%])被随机分为CTR组(93[50%])或对照组(93[50%]),87只眼(93.6%)和92只眼(98.9%)在3个月完成随访,分别。CTR组显示较小的IOL偏心(0.19mmvs0.23mm;差异,-0.04毫米;95%CI,-0.07至-0.01毫米;P=.02)并在3个月时倾斜,与对照组相比,3个月时临床上显着的IOL偏心(≥0.4mm)和倾斜(≥7°)的比例较低。类似的结果仅在AL为30mm或更长的眼睛中发现(IOL偏心:0.20mmvs0.28mm;差异,-0.08毫米;95%CI,-0.14至-0.02毫米;P=0.01)。此外,CTR组从1周到3个月显示IOL分散的变化较小,更高的预测精度,以及更好的视觉质量和患者满意度。在AL小于30mm的眼睛中,在CTR组和对照组之间没有观察到差异。
■CTR植入减少了C环IOL的偏心和倾斜,增加位置稳定性,改善AL为30mm或更长的眼睛的视觉质量。这些发现支持在AL为30mm或更长的眼睛中使用CTR植入并植入C环IOL。
■ClinicalTrials.gov标识符:NCT05161520。
UNASSIGNED: Capsular tension rings (CTRs) can support weak zonules and inhibit capsular shrinkage, thus potentially reducing intraocular lens (IOL) decentration and tilt. However, it has been debated whether CTRs can reduce IOL decentration and tilt in highly myopic eyes and whether CTR implantation is necessary for all highly myopic eyes.
UNASSIGNED: To evaluate the influence of CTR implantation on IOL decentration and tilt in highly myopic eyes.
UNASSIGNED: This randomized clinical trial was conducted between November 2021 and September 2023 at the Zhongshan Ophthalmic Center, Guangzhou, China. Patients with cataract and an axial length (AL) of 26 mm or longer were enrolled.
UNASSIGNED: Participants were stratified into 3 groups based on the AL (stratum 1, 26 mm ≤ AL <28 mm; stratum 2, 28 mm ≤ AL <30mm; stratum 3, AL ≥30 mm), and further randomly assigned to the CTR group (a C-loop IOL combined with a CTR) or the control group (only a C-loop IOL) within each stratum.
UNASSIGNED: IOL decentration at 3 months after cataract surgery was evaluated using anterior segment optical coherence tomography.
UNASSIGNED: A total of 186 eyes of 186 participants (mean [SD] age, 57.3 [10.9] years; 118 female [63.4%]) were randomized into the CTR group (93 [50%]) or control group (93 [50%]), with 87 eyes (93.6%) and 92 eyes (98.9%) completing follow-up at 3 months, respectively. The CTR group showed smaller IOL decentration (0.19 mm vs 0.23 mm; difference, -0.04 mm; 95% CI, -0.07 to -0.01 mm; P = .02) and tilt at 3 months, and lower proportions of clinically significant IOL decentration (≥0.4 mm) and tilt (≥7°) at 3 months compared with the control group. Similar results were only found in eyes with an AL of 30 mm or longer (IOL decentration: 0.20 mm vs 0.28 mm; difference, -0.08 mm; 95% CI, -0.14 to -0.02 mm; P = .01). Additionally, the CTR group showed a smaller change in IOL decentration from 1 week to 3 months, higher prediction accuracy, and better visual quality and patient satisfaction in this stratum. No differences were observed between the CTR and control groups in eyes with an AL less than 30 mm.
UNASSIGNED: CTR implantation reduced C-loop IOL decentration and tilt, increased position stability, and improved visual quality in eyes with an AL of 30 mm or longer. These findings support use of CTR implantation in eyes with an AL of 30 mm or longer and implanted with C-loop IOLs.
UNASSIGNED: ClinicalTrials.gov Identifier: NCT05161520.