年龄相关性白内障合并浅前房患者超声乳化术后的屈光状态分析

Analysis of the refractive status in patients with age-related cataract and shallow anterior chamber after phacoemulsification

摘要:

目的：探讨年龄相关性白内障合并浅前房患者超声乳化术后屈光变化特点。

方法：回顾性研究。将2018-03/2019-06我院收治的96例112眼年龄相关性白内障患者按前房深度(ACD)分为浅前房组(ACD≤2.20mm，52例62眼)和对照组(ACD 2.21～2.90mm，44例50眼)，均接受白内障超声乳化手术治疗，于术前，术后1d，3mo测定屈光度、ACD、前房容积(ACV)的变化，Pearson线性相关法分析年龄相关性白内障合并浅前房患者超声乳化术后屈光状态与前房参数的关系。

结果：浅前房组术后3mo屈光误差较对照组高(P<0.001)； 浅前房组术前，术后1d，3mo较术前ACD、ACV变化值均高于对照组(P<0.001)； 对照组术后1d，3mo屈光误差与术前ACD、术前ACV及术后不同时间ACD、ACV较术前变化值均无明显相关性(P>0.05)； 浅前房组术后3mo屈光误差与术前ACD呈负相关(P<0.05)，术后3mo 屈光误差与术后1d，3mo较术前ACD变化值均呈正相关(P<0.05)，但与术后1d，3mo较术前ACV变化值无明显相关性(P>0.05)。

结论：年龄相关性白内障合并浅前房患者超声乳化手术后存在远视漂移现象，且远视漂移程度与术前ACD呈负相关，与术后ACD呈正相关，即术前ACD越浅，术后ACD增加越高，远视漂移程度越高。

Abstract:

AIM: To explore the characteristics of refractive changes in patients with age-related cataract and shallow anterior chamber after phacoemulsification.

METHODS: A retrospective study was conducted. 96 patients(112 affected eyes)with age-related cataract who were admitted to the hospital between March 2018 and June 2019 were divided into the shallow anterior chamber group(ACD≤2.20mm, 52 patients with 62 affected eyes)and the control group(ACD between 2.21 and 2.90 mm, 44 cases with 50 affected eyes)according to the anterior chamber depth(ACD). All subjects were treated with phacoemulsification. The diopter, ACD and anterior chamber volume(ACV)were measured before surgery, at 1d and 3mo after surgery. Pearson linear correlation analysis was performed to analyze the relationship between the refractive status and anterior chamber parameters in patients with age-related cataract and shallow anterior chamber after phacoemulsification.

RESULTS: The diopter error in the shallow anterior chamber group was higher than that in the control group at 3mo after surgery(P<0.001). The variations of ACD and ACV in the shallow anterior chamber group before surgery, at 1d and 3mo after surgery were higher than those in the control group(P<0.001). In the control group, there was no obvious correlation between the diopter error at 1d, 3mo after surgery and preoperative ACD, preoperative ACV, variations of ACD or ACV at different time after surgery(P>0.05). In the shallow anterior chamber group, the diopter error at 3mo after surgery was negatively correlated with preoperative ACD(P<0.05). The diopter error of at 3mo after surgery was positively correlated with variations of ACD at 1d and 3mo after surgery(P<0.05), but there was no obvious correlation with variations of ACV(P>0.05).

CONCLUSION: There is hyperopic shift in patients with age-related cataract and shallow anterior chamber after phacoemulsification. The degree of hyperopic shift is negatively correlated with preoperative ACD and positively correlated with postoperative ACD, namely, the smaller the preoperative ACD, the larger the postoperative ACD, the severer hyperopic shift.