目的：分析年龄相关性白内障(ARC)合并特发性黄斑前膜(IMEM)患者超声乳化人工晶状体(IOL)植入联合23G玻璃体切割术后屈光误差及其相关因素。

方法：选取2017-02/2019-09在我院行白内障超声乳化IOL植入联合玻璃体切割术治疗的ARC合并IMEM患者25例25眼作为观察组，行白内障超声乳化IOL植入术治疗的单纯性ARC患者25例25眼作为对照组，比较手术前后两组患者最佳矫正视力(BCVA)、等效球镜度(SEQ)、角膜屈光力(CRP)、前房深度(ACD)、眼轴长度(AL)及黄斑中心凹厚度(CFT)变化情况。

结果：术后3mo，观察组和对照组BCVA(0.284±0.177、0.016±0.085)均较术前(0.572±0.199、0.568±0.191)显著改善，ACD均较术前显著增大(均P<0.001)，但两组CRP和AL较术前均无明显变化(P>0.05)，且两组之间术后ACD、CRP、AL均无差异(P>0.05)。术后3mo，观察组实际SEQ值(-0.426±0.146D)较术前预期SEQ值(-0.122±0.037D)和对照组实际SEQ值(-0.127±0.050D)显著增加(均P<0.001)，观察组屈光误差为-0.304±0.142D； 观察组CFT值(331.1±67.2μm)较术前(444.8±72.1μm)显著下降，但高于对照组术后CFT值(224.7±16.6μm)，观察组CFT变化值为113.7±32.2μm。相关性分析显示，观察组术后3mo屈光误差与CFT变化值呈正相关(r=0.447，P=0.025)。

结论：超声乳化人工晶状体植入联合23G玻璃体切割术后屈光误差与CFT变化值呈正相关。

METHODS: From February 2017 to September 2019,25 cases(25 eyes)of arc patients with IMEM who underwent phacoemulsification and IOL implantation combined with vitrectomy were selected as the observation group, and 25 cases(25 eyes)of simple arc patients treated with cataract phacoemulsification and IOL implantation were selected as the control group. The best corrected visual acuity(BCVA ), spherical equivalent(SEQ), corneal refractive power(CRP), anterior chamber depth(ACD), axial length(AL)and macular central foveal thickness(CFT)of the two groups before and after the operation were compared.

RESULTS:At 3mo after operation, BCVA(0.284±0.177, 0.016±0.085)in observation group and control group were significantly improved compared with those before operation(0.572±0.199, 0.568±0.191), ACD was significantly increased(all P<0.001), but CRP and AL had no significant changes in both groups(P>0.05), and there was no difference in ACD, CRP and AL between the two groups(P>0.05). At 3mo after operation, the actual SEQ value in the observation group(-0.426±0.146D)was significantly higher than that before operation(-0.122±0.037D)and that of the control group(-0.127±0.050D)(all P<0.001). The refractive error of the observation group was -0.304±0.142D; the CFT value of the observation group(331.1±67.2μm)was significantly lower than that before operation(444.8±72.1μm), but higher than that of the control group(224.7±16.6μm)The change of CFT in observation group was 113.7±32.2μm. Correlation analysis showed that the refractive error was positively correlated with the change of CFT at 3mo after operation in the observation group(r=0.447, P=0.025).

CONCLUSION: There was a positive correlation between myopic RE and CFT after Phacoemulsification and intraocular lens(IOL)implantation combined with 23G vitrectomy(PPV).