超高度近视合并白内障患者术后ACD和晶状体悬韧带的变化及相关影响因素

Postoperative changes of anterior chamber depth and lens suspensory ligament in patients with ultra-high myopia and cataract and related influencing factors

摘要:

目的：探讨超高度近视合并白内障患者超声乳化白内障摘除联合人工晶状体植入术后前房深度(ACD)和晶状体悬韧带变化及相关影响因素。

方法：选取2016-10/2022-12我院超高度近视合并白内障患者45例60眼，均接受超声乳化白内障摘除联合人工晶状体植入术。随机数字表法分为植入组和未植组，植入组术中联合囊袋张力环(CTR)植入，未植组术中未植入CTR。比较所有患者手术前后ACD和晶状体悬韧带长度变化，并行相关性分析。观察两组手术前后ACD和晶状体悬韧带长度变化的差异。

结果：超高度近视合并白内障患者术后1、3mo ACD均高于术前(均P<0.05)。超高度近视合并白内障患者白内障术后1、3mo 3：00位、6：00位、9：00位、12：00位及平均晶状体悬韧带长度均低于术前(均P<0.05)； 术后3mo 3：00位、6：00位、9：00位、12：00位及平均晶状体悬韧带长度与术后1mo比较无差异(均P>0.05)。超高度近视合并白内障术前平均晶状体悬韧带长度与眼轴和术前ACD均呈正相关关系(均P<0.05)。植入组和未植组术前，术后1、3mo ACD组间比较均无差异(P>0.05)。植入组和未植组术前，术后1mo 6：00晶状体悬韧带长度组间比较均无差异(P>0.05)，术后3mo 6：00晶状体悬韧带长度组间比较有差异(P<0.05)。植入组和未植组术前，术后1、3mo 3：00位、9：00位、12：00位和平均晶状体悬韧带长度组间比较均无差异(P>0.05)。

结论：超高度近视合并白内障患者超声乳化白内障摘除术后前房加深，晶状体悬韧带缩短； 联用CTR会影响晶状体悬韧带长度的变化。

Abstract:

AIM:To investigate the changes of anterior chamber depth(ACD)and lens suspensory ligament after phacoemulsification and intraocular lens(IOL)implantation in patients with ultra-high myopia cataract and related influencing factors.

METHODS: A total of 45 patients(60 eyes)with ultra-high myopia and cataract in our hospital from October 2016 to December 2022 were selected. All patients received phacoemulsification and IOL implantation. The patients were randomly divided into implantation group and non-implantation group. Implantation group was combined with capsular tension ring(CTR)implantation, and non-implantation group did not implant CTR during operation. The changes of ACD and lens suspensory ligament length before and after operation were compared and the correlation was analyzed. To observe the differences of ACD and the length of lens suspensory ligament between the two groups before and after operation.

RESULTS: The ACD of patients with ultra-high myopia complicated with cataract at 1 and 3mo after operation was higher than that before operation(all P<0.05). The positions of 3:00, 6:00, 9:00, 12:00 and the average length of lens suspensory ligament at 1 and 3mo post-operation were shorter than those pre-operation(all P<0.05). There was no significant difference in the positions of 3:00, 6:00, 9:00, 12:00 and average length of suspensory ligament between 1mo and 3mo after operation(all P>0.05). The preoperative average length of lens suspensory ligament in patients with ultra-high myopia cataract was positively correlated with the ocular axis and the preoperative ACD(all P<0.05). There was no significant difference in ACD between the implantation group and the non-implantation before and at 1 and 3mo after operation(P>0.05). There was no significant difference in the length of lens suspensory ligament between implantation group and non-implantation group at the position of 6:00 before operation and 1mo after operation(P>0.05), but there was difference in lens suspensory ligament between groups at 3mo after operation and the position of 6:00(P<0.05). Furthermore, there was no significant difference at the positions of 3:00, 9:00, 12:00 and the average length of lens suspensory ligament between the implantation group and non-implantation group before and at 1 and 3mo after operation(P>0.05).

CONCLUSION: The ACD deepen and lens suspensory ligament shortened in patients with ultra-high myopia and cataract after phacoemulsification; the length of lens suspensory ligament was affected by the combined use of CTR.