目的：评估囊袋张力环(CTR)对Barrett universal Ⅱ人工晶状体(IOL)计算公式在高度近视合并白内障患者术后屈光状态的稳定性与准确性的影响。

方法：本研究为前瞻性研究。选取2022-01/06于我院就诊的高度近视白内障患者40例80眼。采用随机数字表法分为CTR组和空白组，每组40眼，所有患者均用IOL Master测量，并按照Barrett universal Ⅱ公式计算实际植入IOL屈光度及预测术后屈光度。记录患者术后6 mo的裸眼视力(UCVA)、最佳矫正视力(BCVA)，比较术后6 mo两组平均绝对屈光误差(MAE)，评估术后屈光状态的稳定性及预测术后屈光度与CTR的关系。

结果：术后6 mo两组患者UCVA、BCVA均较术前改善(P>0.05)，不同时间点两组UCVA、BCVA比较无差异(均P>0.05)； 80眼按照Barrett universal Ⅱ公式植入IOL后，CTR组预计术后屈光度为-2.01±0.71 D，术后实际屈光度为-1.64±0.88 D，MAE为0.37±0.98 D； 空白组预计术后屈光度为-2.12±0.64 D，术后实际屈光度为-1.54±0.88 D，MAE为0.58±0.31 D，组间比较有差异(P<0.05)。根据眼轴长度进行分组，对于任意眼轴长度CTR的植入均能有效地减少屈光误差(P>0.05)。随着眼轴的增长，MAE的值越大，眼轴≥30 mm的患者术后MAE值比较两组间有差异(P<0.05)。CTR组、空白组中出现远视漂移的比例分别是18%(7/40)、30%(12/40)，组间比较有差异(P<0.05)。

结论：对高度近视合并白内障患者，Barrett universal Ⅱ公式在预测术后屈光度方面具有较高的准确性，术中植入CTR既能够保持囊袋的形态，有效防止术中晶状体悬韧带断裂，使IOL居中性更佳，又能有利于白内障患者术后屈光度的早期稳定，并提供更加稳定的屈光结果，减少屈光漂移。对于术中考虑植入CTR的近视患者，建议术前增加-0.50 D的预留屈光度，以达到理想屈光状态。

METHODS:Prospective study. A total of 40 cases(80 eyes)of high myopia and cataract that visited our hospital from January to June 2022 were selected. The patients were divided into CTR group and blank group by random number table method, with 40 eyes in each group. All patients were measured by IOL Master, and the actual implanted IOL power and predicted postoperative power were calculated according to Barrett universal Ⅱ formula. The uncorrected visual acuity(UCVA)and best corrected visual acuity(BCVA)at 6 mo after surgery were recorded, and the mean absolute error(MAE)was compared at 6 mo after surgery. Furthermore, the stability of postoperative refractive status and the relationship between the predicted postoperative diopter and CTR were evaluated.

RESULTS:The UCVA and BCVA of the two groups were improved at 6 mo after operation(P>0.05), and there was no significant difference in UCVA and BCVA between the two groups at each time point(all P>0.05). After the implantation of IOL in 80 eyes based on the Barrett universal Ⅱ formula, the predicted postoperative diopter was -2.01±0.71 D, the actual postoperative diopter was -1.64±0.88 D, and the MAE was 0.37±0.98 D in the CTR group; in the blank group, the predicted diopter was -2.12±0.64 D, the actual diopter was -1.54±0.88 D, and the MAE was 0.58±0.31 D. The difference between the two groups was statistically significant(P<0.05). According to the axial length, CTR implantation can effectively reduce refractive error for any axial length(P>0.05). With the grouth of axial length, the MAE value increased. The postoperative MAE value of patients with axial length ≥30 mm was statistically different between the two groups(P<0.05).The proportion of hyperopic drift was 18%(7/40)in the CTR group and 30%(12/40)in the blank group, respectively, with a significant difference between the two groups(P<0.05).

CONCLUSION: For patients with high myopia and cataract, the Barrett universal Ⅱ formula has high accuracy in predicting postoperative diopter. Intraoperative implantation of CTR can not only maintain the shape of the capsule bag, effectively prevent the intraoperative rupture of the suspensory ligament of the lens and make the IOL more neutral, but also is conducive to the early stability of postoperative diopter of cataract patients. It also provides more stable refractive results and reduces refractive drift. For myopic patients considering CTR implantation, it is recommended to increase the preoperative reserve diopter of -0.50 D to achieve the ideal refractive state.