| Objective:To observe the effects of corneal biomechanics after ICL implantation through upper transparent corneal incision and temporal transparent corneal incision by Corvis ST.Methods:Prospective comparative clinical study.33 cases(66 eyes)who had received ICL implantation in the ophthalmology department of the Affiliated Hospital of Guizhou Medical University from August 2019 to December 2020 were divided into upper transparent corneal incision group(15 cases,30 eyes)and temporal transparent corneal incision group(18 cases,36 eyes)according to the position of corneal incision.The corneal biomechanical parameters were compared and observed at preoperation,postoperative first day,first week,first month and second month:biomechanically corrected intraocular pressure(bIOP)、central corneal thickness(CCT)、first applanation time(1stA-time)、first applanation velocity(Vin)、first applanation length(1stA-length)、second applanation velocity(Vout)、highest concavity time(HC time)、deformation amplitude(DA)、peak distance(PD)、highest concavity radius(HC radius).The data were statistically analyzed by SPSS 26.0 software,and the measurement data were expressed as x±s.Repeated measurement analysis of variance was performed on the parameter data at each time point in the two groups,and LSD test was used for pairwise comparison after the event.Independent sample t-test was used to compare the parameters at the same time point between the two groups.The difference was statistically significant at P<0.05.Results:①bIOP:bIOP in both groups at 1 week after operation was significantly higher than that before operation and 1 day after operation,and then decreased gradually,and was lower than that before operation and at 1 month after operation(P>0.05).At 2 months after operation,it was lower than that before operation(P<0.05 in upper corneal incision group and P>0.05 in temporal corneal incision group).There was no statistical significance at each time point between the two groups.②1stA-time:In the upper corneal incision group,1stA-time increased significantly at 1 week after operation compared with that before operation and 1 day after operation(P<0.05),and then decreased.It was lower than the preoperative level at 1 month after operation(P>0.05),and decreased at 2 months after operation(P<0.05).In temporal corneal incision group,1stA-time increased at 1 week after operation compared with that before operation and 1 day after operation(P>0.05).At 1 month after operation,it decreased and was lower than the preoperative level(P>0.05),and slightly increased at 2 months after operation,but still lower than that before operation(P>0.05).The comparison of each time point between the two groups was statistically significant only at 2 months after operation.③Vin:In the upper corneal incision group,the Vin at 1 week after operation was lower than that before operation and 1 day after operation,which was significantly lower than that before operation.It increased and returned to the preoperative level at 1 month after operation(P>0.05),and increased further than that at 2 months after operation(P<0.05).In the temporal corneal incision group,Vin increased slightly at 1 day after operation,decreased to the preoperative level at 1 week after operation(P>0.05),then increased gradually,exceeded the preoperative level at 1 month after operation(P>0.05),and further increased at 2 months after operation(P<0.05).There was no statistical significance at each time point between the two groups.④Vout:There was no significant difference at each time point in the upper corneal incision group.In temporal corneal incision group,Vout decreased at 1 week after operation compared with that before operation and 1 day after operation(P>0.05),then increased gradually,exceeded the preoperative level at 1 month after operation(P>0.05),and further increased at 2 months after operation(P<0.05).There were significant differences between the two groups at 1 day,1 week,1 month and 2 months after operation.⑤HC time:There was no significant difference at each time point in the upper corneal incision group.The HC-time of temporal corneal incision group showed an upward trend as a whole,and reached the maximum at 2 months after operation,which was significantly different from that before operation,1 day after operation and 1 week after operation.There was no statistical significance at each time point between the two groups.⑥DA:In the upper corneal incision group,the DA value decreased gradually within 1 week after operation and reached the lowest value at 1 week after operation,which was significantly lower than that before operation,and then increased gradually and exceeded the preoperative level at 1 month after operation(P>0.05).At 2 months after operation,it was further higher than that before operation(P<0.05).In the temporal corneal incision group,it decreased gradually within 1 week after operation and reached the lowest value at 1 week after operation,which was not significantly different from that before operation,and then increased gradually and exceeded the preoperative level at 1 month after operation(P<0.05).At 2 months after operation,it was further higher than that before operation(P<0.05).There was no statistical significance at each time point between the two groups.⑦PD:The PD value of both groups decreased gradually within 1 week after operation,reached the lowest value at 1 week after operation,and was lower than the preoperative level(P<0.05),then increased gradually and exceeded the preoperative level at 1 month after operation(P>0.05).At 2 months after operation,it was further lower than the preoperative level(P>0.05 in upper corneal incision group and P<0.05 in temporal corneal incision group).⑧1stA-length、HC radius and CCT:There was no significant difference at each time point in each group.There was no significant difference at each time point between the two groups.Conclusions:Both upper transparent corneal incision and temporal transparent corneal incision during ICL implantation have different effects on corneal biomechanics,and temporal transparent corneal incision will change more and have more influence on corneal biomechanical parameters.Until 2 months after operation,the biomechanical properties of the two groups had not returned to the preoperative level. |
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