目的：评估高度近视眼患者白内障手术前眼球生物参数特征及角膜散光(CA)分布特点。

方法：前瞻性横断面研究，连续性纳入2022年1月至2024年12月在我院拟行白内障手术的高度近视眼\〖眼轴长度(AL)≥26.00 mm\〗患者695例695眼，将同期在我院行白内障手术的正常AL(22.00 mm≤AL≤25.00 mm)患者纳入对照组695例695眼。两组患者若双眼均合格仅选取右眼进行分析，术前均采用IOL Master 700进行双眼眼球生物参数测量，记录并收集两组患者的病历资料和眼球生物参数数据。

结果：两组患者性别、年龄、角膜直径、中央角膜厚度比较均无差异(均P>0.05)。高度近视眼组患者AL的平均值为29.20±2.61 mm，252眼(34.1%)AL≥30.00 mm(超高度近视眼)。高度近视眼组患者前房深度(ACD)、晶状体厚度、玻璃体腔深度(VCD)、CA及AL/角膜曲率半径及VCD/AL的平均值分别为3.45±0.40、4.41±0.47、21.34±2.60 mm，1.18±0.78 D，3.79±0.38及0.73±0.03，以上参数均大于对照组(均P<0.01)。在高度近视眼组中，有350眼(50.4%)CA ≥1.00 D，192眼(27.6%)CA ≥1.50 D及94眼(13.5%)CA ≥2.00 D，这些比例均高于对照组(32.8%，15.1%和6.6%； 均P<0.001)。高度近视眼组患者中有87眼(12.5%)合并扁平角膜，424眼(61.0%)合并中度散光，40眼(5.8%)合并高度散光，这些比例均高于对照组(6.0%，46.9%和2.9%； 均P<0.001)。高度近视眼组患者中ACD和ACD/AL均与AL呈负相关关系(r=-0.162、-0.661，均P<0.001)，但对照组患者ACD和ACD/AL均与AL呈正相关关系(r=0.338、0.105，均P<0.01)。高度近视眼组患者当患者年龄≥50岁时，CA随年龄增加而增大(r=0.197，P<0.001)，这一趋势与对照组一致。

结论：高度近视眼患者白内障术前规范的眼生物参数数据有助于眼科医生精准计算人工晶状体(IOL)度数及选择合适的IOL类型。大多数高度近视眼患者在白内障手术过程中需要同时矫正CA。

METHODS:A prospective cross-sectional study was conducted, and 695 cataract patients(695 eyes)with high myopia \〖defined as an axial length(AL)≥26.00 mm\〗 scheduled to undergo cataract surgery at our hospital from January 2022 to December 2024 were consecutively enrolled, another 695 cataract patients(695 eyes)with normal ALs(22.00 mm ≤AL≤25.00 mm)who underwent cataract surgery at our hospital during the same period were included in the control group. For patients with both eyes eligible, the right eye was used for analysis. Before cataract surgery, IOL Master 700 was used to measure the ocular biometric parameters of both eyes for each patient in the two groups. The medical records and ocular biometric data in the two groups were recorded and collected.

RESULTS:There were no statistically significant differences between the two groups in genger, age, corneal diameter, and central corneal thickness(all P>0.05). In the high myopia group, the mean AL was 29.20±2.61 mm, and 252 eyes(34.1%)had AL ≥30.00 mm(extremely high myopia). The mean anterior chamber depth(ACD), lens thickness, vitreous chamber depth(VCD), CA, AL/corneal radius of curvature and VCD/AL in the high myopia group were 3.45±0.40, 4.41±0.47, 21.34±2.60 mm, 1.18±0.78 D, 3.79±0.38, and 0.73±0.03, respectively, which were all greater than those in the control group(all P<0.01). In the high myopia group, 350 eyes(50.4%)had CA ≥1.00 D, 192 eyes(27.6%)had CA ≥1.50 D, and 94 eyes(13.5%)had CA ≥2.00 D, which were all higher than those in the control group(32.8%, 15.1%, and 6.6%, respectively; all P<0.001). In the high myopia group, 87 eyes(12.5%)had flat corneas, 424 eyes(61.0%)had moderate CA, and 40 eyes(5.8%)had high CA. These proportions were all higher than those in the control group(6.0%, 46.9%, and 2.9%, respectively; all P<0.001). In the high myopia group, ACD and ACD/AL were negatively correlated with AL(r=-0.162 and -0.661, respectively; all P<0.001), while both ACD and ACD/AL in the control group were positively correlated with AL(r=0.338 and 0.105, respectively; both P<0.01). In the high myopia group, CA increased with age when the patient's age was ≥50 years(r=0.197, P<0.001), which was consistent with the control group.

CONCLUSION: The standardized ocular biometric data of cataract patients with high myopia before cataract surgery are helpful for ophthalmologists to accurately calculate the intraocular lens(IOLs)power and select the appropriate IOL type. The majority of high myopia patients need simultaneous correction of CA during cataract surgery.