轴性高度近视眼白内障术后角膜曲率及屈光变化的初步观察

Preliminary Observation of Corneal Curvature and Refractive Change of Axial High Myopia after Cataract Surgery

摘要: 目的：探讨轴性高度近视眼患者，行白内障超声乳化摘除伴人工晶状体植入术后，角膜曲率及屈光变化趋势做初步观察，对未来轴性高度近视眼患者的屈光手术治疗提供初步思路及设想。方法：收集2015年4月~2016年5月在我院行白内障手术的轴性高度近视眼患者63例93眼，平均年龄66 ± 10.96岁(40~90岁)，其中男33例、女30例。所有研究对象术前均行眼部全面检查，并应用IOL-Master的部分相干干涉测量(partial coherence interferometry, PCI)技术及验光检查测量记录术前及术后角膜曲率及屈光状态，并将其按术前及术后不同时间段进行观察。结果：采用配对资料的t检验对各时间点的角膜曲率及屈光状态进行分析。角膜K1与K2在术前、术后1周、术后6月、术后1年，不同时间段的变化趋势无线性变化(F = 1.720, p = 0.193)、(F = 0.745, p = 0.390)；术后1周、术后6个月和术后1.5年之间屈光值之间两两比较差异无统计学意义(p > 0.0083)；角膜K1、K2与屈光之间的偏相关系数分别为−0.3639 (p < 0.001)、−0.3511 (p < 0.001)；随着时间变化，术前散光值与术后散光值比较有统计学意义(F = 17.295，p < 0.001)；术后1.5年散光值与术后6个月散光值比较，差异有统计学意义(t = 3.277, p = 0.001)。结论：轴性高度近视眼患者，经超声乳化伴人工晶体植入术后散光度数减少且屈光状态稳定，是较理想的治疗手段。

Abstract: Objective: Preliminary observation was carried out on the corneal curvature and refractive change trend of patients with axial high myopia after phacoemulsification with intraocular lens implantation to provide some preliminary ideas and thoughts for the treatment of refractive sur-gery in patients with axial high myopia in the future. Methodology: 63 cases (93 eyes) with high axial myopia, who received caligo lentis surgery in our hospital from April 2015 to May 2016, were enrolled, with the average age of 66 ± 10.96 (40 to 90) years old. There were 33 males and 30 females. All subjects were received overall examinations on their eyes before the surgery, and the length changes of axis oculi were measured and recorded with partial coherence interferometry (PCI) technique of IOL-Master before and after the surgery. Preoperative and postoperative corneal curvature and refractive state were recorded by PCI technique. Optometry check and measurement were observed based on different time periods before and after operation. Result: The corneal curvature and refractive state at each time point were analyzed by paired data t test. The change trends of cornea K1 and K2 had no linear change in different time periods, namely, before operation, 1 week, six months and 1 year after operation (F = 1.720, p = 0.193), (F = 0.745, p = 0.390); there was no statistical significance between the differences of the refractive values 1 week, 6 months and 1.5 years after operation (p > 0.0083); the partial correlation coefficients between corneal K1, K2 and refraction were respectively −0.3639, (p < 0.001), −0.3511 (p < 0.001); there was statistical significance between preoperative astigmatism value and postoperative astigmatism value over time (F = 17.295, p < 0.001); and there was statistical significance between the astigmatism values of 1.5 years and that of 6 months after operation (t = 3.277, p = 0.001). Conclusion: The degree of astigmatism decreases and the refractive state is stable in patients with axial high myopia after phacoemulsification with intraocular lens implantation, which is a relatively ideal treatment.