目的：对比水平和垂直两种方式有晶状体眼人工晶状体(ICL)植入术后前房角(ACA)及拱高参数的变化差异。

方法：前瞻性随机对照研究。选取2018-01/2019-06于我院眼科行ICL植入术的屈光不正患者83例154眼，采用随机数字表法为水平组(79眼)和垂直组(75眼)。应用Pentacam眼前节分析系统测量并比较两组患者手术前后0°、90°、180°、270°位点ACA并计算其变化量，记录术后拱高值。

结果：术后12mo，水平组ACA在0°、90°、180°、270°方位变化量分别为15.3°±6.1°、13.9°±6.3°、16.5°±5.5°、12.9°±6.0°，垂直组ACA相应方位变化量分别为12.9°±3.7°、14.5°±6.8°、14.3°±5.4°、13.2°±5.9°，两组患者ACA变化量在0°～180°方位有差异(P<0.05)，在90°～270°方位无明显差异(P>0.05)。术后1、3、6、12mo，水平组拱高分别为486±183、422±203、393±198、345±165μm，垂直组拱高分别为432±163、418±138、379±133、328±142μm，两组间不同时间点拱高均无差异(P>0.05)，两组患者术后6、12mo拱高均与同组术后1mo有差异(P<0.05)。

结论：ICL植入水平放置较垂直放置引起0°～180°方位ACA变化更为显著，术后1a拱高具有动态性降低趋势。

METHODS: Randomized controlled study. A total of 83 patients(154 eyes)underwent ICL(V4c, 12.6mm)surgery from 2018 to 2019 were enrolled and divided into two randomly, including into horizontal group(79 eyes)and into vertical group(75 eyes). Pentacam was used to measure the ACA at 0°, 90°, 180°, 270° points before and after implantation and the ACA changes were calculated.

RESULTS: After 12mo, the changes of ACA at 0°, 90°, 180°, 270° position were 15.3°±6.1°, 13.9°±6.3°, 16.5°±5.5° and 12.9°±6.0° in horizontal group while 12.9°±3.7°, 14.5°±6.8°, 14.3°±5.4° and 13.2°±5.9° in vertical group. There was a significant difference in ACA change at 0°-180° position between the two groups(P<0.05). The vault value was 486±183μm, 422±203μm, 393±198μm and 345±165μm in the horizontal group and 432±163μm, 418±138μm, 379±133μm and 328±142μm in the vertical group at 1, 3, 6 and 12mo respectively. The vault value of the horizontal group at 1mo was significantly different from that at 6mo and 12mo after implantation(P>0.05). The vault value of the vertical group at 1mo was significantly different from that at 6mo and 12mo after implantation(P<0.05).

CONCLUSION: During one year after ICL implantation, the ACA changes significantly in horizontal setting than in vertical setting at 0° to 180° points and there is a dynamic decreasing change in vault value.