目的：探索Kappa角对高度近视并发白内障患者区域折射多焦点人工晶状体(MIOL)植入术后视觉质量与立体视锐度改变的影响。

方法：回顾性分析我院2024年1月至2025年1月期间Kappa角正常的高度近视并发白内障患者资料，根据患者术前测量的Kappa角中位数0.182 mm将患者分为两组：A组(0结果：共纳入Kappa角正常的高度近视并发白内障患者100例100眼，其中A组52例52眼，男34例，女18例，平均年龄52.35±3.16岁； B组48例48眼，男31例，女17例，平均年龄52.79±3.54岁。两组术后3 mo的9% 对比度视力(CVA)、20% CVA、100% CVA、调制传递函数截止频率(MTF cut off)、斯特列尔比(SR)均较同组术前升高，客观散射指数(OSI)降低(均P<0.05)。而两组比较术后各时间段BCDVA、BCIVA、BCNVA、9%、20%、100% CVA与OSI、MTF cut off、SR以及全眼高阶像差、全眼球差无差异(均P>0.05)，A组术后7 d、1 、3 mo的实际残留散光度均低于B组(均P<0.001)，近立体视锐度<60″的眼数占比高于B组，近立体视锐度400″-3 000″的眼数占比低于B组(均P<0.05)。同时，B组视觉不良症状发生率高于A组(P<0.05)。

结论：Kappa角对Kappa角正常的高度近视并发白内障患者行区域折射MIOL植入术后的视力及客观视觉质量无显著影响，但Kappa角较大的患者术后实际残留散光更高、近立体视锐度更差，且视觉相关不良症状发生率更高。

METHODS:A retrospective analysis was conducted on data from patients with normal Kappa angle and high myopia complicated by cataract treated at the hospital from January 2024 to January 2025. Patients were divided into two groups based on the median preoperative Kappa angle(0.182 mm): Group A(0RESULTS: A total of 100 patients(100 eyes)with normal Kappa angle and high myopia complicated by cataract were included. Patients were divided into Group A(52 patients, 52 eyes; 34 males, 18 females; mean age 52.35±3.16 y)and Group B(48 patients, 48 eyes; 31 males, 17 females; mean age 52.79±3.54 y). At 3 mo postoperatively, both groups showed increases in 9% contrast visual acuity(CVA), 20% CVA, 100% CVA, modulation transfer function cut off(MTF cut off), and strehl ratio(SR)compared with their respective preoperative values, while objective scatter index(OSI)decreased(all P<0.05). However, there were no differences between the two groups in BCDVA, BCIVA, BCNVA, 9%, 20%, and 100% CVA, OSI, MTF cut off, SR, total ocular higher-order aberrations, or total ocular spherical aberration at any postoperative time point(all P>0.05). The actual residual astigmatism in Group A was lower than that in Group B at 7 d, 1 and 3 mo postoperatively(all P<0.001). The proportion of eyes with near stereoscopic acuity <60″ was higher in Group A than in Group B, while the proportion of eyes with near stereoscopic acuity between 400″ and 3000″ was lower in Group A than in Group B(both P<0.05). Meanwhile, the incidence of visual disturbances in Group B was higher than that in Group A(P<0.05).

CONCLUSION: The Kappa angle has no significant effect on visual acuity or objective visual quality in patients with normal Kappa angle and high myopia complicated by cataract after regional refractive MIOL implantation. However, patients with a larger Kappa angle exhibit higher postoperative residual astigmatism, worse near stereoscopic acuity, and a higher incidence of vision-related adverse symptoms.