超长眼轴白内障手术前后眼生物测量参数变化及相互关系
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摘要
目的:研究超长眼轴白内障患者超声乳化手术前后眼生物测量参数变化及其相互关系。方法:收集2013-09/2015-03在首都医科大学宣武医院眼科确诊为白内障,且行白内障超声乳化联合人工晶状体植入术患者44例61眼,其中超长眼轴组20例29眼,正常眼轴对照组24例32眼。术前应用光学相干生物测量仪(IOL Master)测量眼生物参数,术后3mo应用IOL Master及超声生物显微镜(UBM)测量眼生物参数,应用SPSS17. 0统计软件进行统计学描述并分析其变化及相互关系。结果:超长眼轴组术后前房深度与年龄、术前眼轴长度、术前角膜曲率无相关性(P>0. 05)。术后前房深度与术前前房深度呈正相关(r=0. 402,P=0. 031)。超长眼轴组术后3mo相比术前,眼轴长度显著缩短,角膜曲率增加,前房深度较术前显著增加(P<0. 05)。正常眼轴对照组术后前房深度与年龄、术前眼轴长度、术前前房深度无相关性(P>0. 05),术后前房深度与术前角膜曲率呈正相关(r=0. 538,P=0. 001)。正常眼轴对照组术后3mo较术前,眼轴长度显著缩短,前房深度显著增加(P<0. 05),角膜曲率无改变(P>0. 05)。手术前后,超长眼轴组相比正常眼轴对照组角膜曲率变化更大(P<0. 05);眼轴长度变化百分率、前房深度变化百分率,两组差异无统计学意义(P>0. 05)。结论:超长眼轴白内障患者术后眼轴长度缩短,角膜曲率增加,在计算人工晶状体度数时应增加一定度数,以便获得更佳的术后视力。超长眼轴白内障患者的术后前房深度预测具有复杂性与个体差异的不可预知性,需要进一步研究。
AIM: To study the variation of ocular biometric parameters and their relationship before and after phacoemulsification in cataract patients with over-long axial length.METHODS: A total of 44 cases( 61 eyes) were collected from September 2013 to March 2015 in Xuanwu Hospital which had underwent phacoemulsification and intraocular lens( IOL)implantation. The study contained 29 eyes of 20 patients with over-long axial length and 32 eyes of 24 patients with normal axial length. Before cataract surgery, the optical biometric measurements had been measured by IOL Master. And 3 mo after surgery,the ocular biometric parameters had been recorded by IOL Master and ultrasound biomicroscopy( UBM). The changes and correlation of biometric parameters was performed using the SPSS software( version 17.0).RESULTS: Pearson correlation analysis showed there was no correlation between postoperative anterior chamber depth and age,preoperative axial length, or preoperative corneal curvature in over-long axial length group( P > 0. 05). There was a positive correlation between the postoperative anterior chamber depth and the preoperative anterior chamber depth( r = 0.402,P = 0. 031).Compared with the preoperative biometric parameters in over-long axial length group, axial length shortened, corneal curvature increased,anterior chamber depth deepened after surgery,and the difference was statistically significant( P < 0. 05). However,in the normal axial control group there was no correlation between the postoperative anterior chamber depth and age,preoperative axial length,or preoperative anterior chamber depth( P > 0. 05).There was a positive correlation between the postoperative anterior chamber depth and the preoperative corneal curvature( r = 0.538,P = 0. 001). And in normal axial control group,the axial length was significantly shorter than that before surgery( P< 0. 05). The anterior chamber depth was significantly increased compared with the preoperative( P< 0. 05), and the corneal curvature was unchanged( P > 0. 05). The percent change of corneal curvature was statistically significant between two groups( P < 0. 05),and the percent change of corneal curvature in over-long axial length group was bigger than normal axial length group. There was no significant difference in the percent change of axial length and anterior chamber depth( P> 0.05).CONCLUSION: In cataract patients with over-long axial length,postoperative axial length shortened, and postoperative corneal curvature increased. A certain number of degrees should be added when calculating the degree of intraocular lens in order to obtain better postoperative visual acuity. The prediction of postoperative anterior chamber depth in cataract patients with over-long axial length has complexity and unpredictability of individual differences,and requires further research.
AIM: To study the variation of ocular biometric parameters and their relationship before and after phacoemulsification in cataract patients with over-long axial length.METHODS: A total of 44 cases( 61 eyes) were collected from September 2013 to March 2015 in Xuanwu Hospital which had underwent phacoemulsification and intraocular lens( IOL)implantation. The study contained 29 eyes of 20 patients with over-long axial length and 32 eyes of 24 patients with normal axial length. Before cataract surgery, the optical biometric measurements had been measured by IOL Master. And 3 mo after surgery,the ocular biometric parameters had been recorded by IOL Master and ultrasound biomicroscopy( UBM). The changes and correlation of biometric parameters was performed using the SPSS software( version 17.0).RESULTS: Pearson correlation analysis showed there was no correlation between postoperative anterior chamber depth and age,preoperative axial length, or preoperative corneal curvature in over-long axial length group( P > 0. 05). There was a positive correlation between the postoperative anterior chamber depth and the preoperative anterior chamber depth( r = 0.402,P = 0. 031).Compared with the preoperative biometric parameters in over-long axial length group, axial length shortened, corneal curvature increased,anterior chamber depth deepened after surgery,and the difference was statistically significant( P < 0. 05). However,in the normal axial control group there was no correlation between the postoperative anterior chamber depth and age,preoperative axial length,or preoperative anterior chamber depth( P > 0. 05).There was a positive correlation between the postoperative anterior chamber depth and the preoperative corneal curvature( r = 0.538,P = 0. 001). And in normal axial control group,the axial length was significantly shorter than that before surgery( P< 0. 05). The anterior chamber depth was significantly increased compared with the preoperative( P< 0. 05), and the corneal curvature was unchanged( P > 0. 05). The percent change of corneal curvature was statistically significant between two groups( P < 0. 05),and the percent change of corneal curvature in over-long axial length group was bigger than normal axial length group. There was no significant difference in the percent change of axial length and anterior chamber depth( P> 0.05).CONCLUSION: In cataract patients with over-long axial length,postoperative axial length shortened, and postoperative corneal curvature increased. A certain number of degrees should be added when calculating the degree of intraocular lens in order to obtain better postoperative visual acuity. The prediction of postoperative anterior chamber depth in cataract patients with over-long axial length has complexity and unpredictability of individual differences,and requires further research.
引文
1 Epitropoulos A.Axial length measurement acquisition rates of two optical biometers in cataractous eyes.Clin Ophthalmol 2014;8:1369-1376
2方薇,张健,刘大川,等.长眼轴老年白内障患者人工晶状体预测公式的应用分析.国际眼科杂志2017;17(7):1249-1253
3郑虔,赵镇南,廉恒丽,等.轴性高度近视眼超声乳化白内障吸除联合人工晶状体植入术后屈光度数误差分析.中华眼科杂志2015;51(4):276-281
4 Xu L,Li J,Cui T,et al.Refractive error in urban and rural adult Chinese in Beijing.Ophthalmology 2005;112(10):1676-1683
5 Yang K,Liang YB,Gao LQ,et al.Refractive errors in a rural Chinese adult population the Handan eye study.Ophthalmology 2009;116(11):2119-2127
6赵海亮,张健,张海霞,等.超长眼轴白内障患者手术前后眼生物测量参数变化.中华眼外伤职业眼病杂志2015;37(2):95-98
7郁琪华,邬一楠,沈降.白内障手术前后眼轴和屈光状态的变化.眼科2016;25(2):90-93
8 Bilak S,Simsek A,Capkin M,et al.Biometric and intraocular pressure change after cataract surgery.Optom Vis Sci 2015;92(4):464-470
9 Irak-Dersu I,Nilson C,Zabriskie N,et al.Intraocular pressure change after temporal clear corneal phacoemulsification in normal eyes.Acta Ophthalmol 2010;88(1):131
10张舒,袁鹂,李苏梅.白内障超声乳化术中前房深浅对角膜曲率的影响.临床眼科杂志2006;14(5):418-420
11唐健青,刘锦魁.超声乳化联合人工晶状体植入术对前房深度及房角宽度的影响.国际眼科杂志2017;17(1):134-136
12 Kozue K,Genichiro T,Koichi K,et al.Measurement of early changes in anterior chamber morphology after cataract extraction measured by anterior segment optical coherence tomography.Graefes Arch Clin Exper Ophthalmol 2015;253(10):1751-1756
13俞嘉怡.应用超声生物显微镜观察白内障超声乳化人工晶状体植入术后前房容积的改变.中国实用眼科杂志2011;29(6):555-561
14张帅,张一凡,李穗苓,等.白内障患者应用Pentacam和UBM测量前房直径、前房深度的研究.中华眼外伤职业眼病杂志2010;32(7):489-495
2方薇,张健,刘大川,等.长眼轴老年白内障患者人工晶状体预测公式的应用分析.国际眼科杂志2017;17(7):1249-1253
3郑虔,赵镇南,廉恒丽,等.轴性高度近视眼超声乳化白内障吸除联合人工晶状体植入术后屈光度数误差分析.中华眼科杂志2015;51(4):276-281
4 Xu L,Li J,Cui T,et al.Refractive error in urban and rural adult Chinese in Beijing.Ophthalmology 2005;112(10):1676-1683
5 Yang K,Liang YB,Gao LQ,et al.Refractive errors in a rural Chinese adult population the Handan eye study.Ophthalmology 2009;116(11):2119-2127
6赵海亮,张健,张海霞,等.超长眼轴白内障患者手术前后眼生物测量参数变化.中华眼外伤职业眼病杂志2015;37(2):95-98
7郁琪华,邬一楠,沈降.白内障手术前后眼轴和屈光状态的变化.眼科2016;25(2):90-93
8 Bilak S,Simsek A,Capkin M,et al.Biometric and intraocular pressure change after cataract surgery.Optom Vis Sci 2015;92(4):464-470
9 Irak-Dersu I,Nilson C,Zabriskie N,et al.Intraocular pressure change after temporal clear corneal phacoemulsification in normal eyes.Acta Ophthalmol 2010;88(1):131
10张舒,袁鹂,李苏梅.白内障超声乳化术中前房深浅对角膜曲率的影响.临床眼科杂志2006;14(5):418-420
11唐健青,刘锦魁.超声乳化联合人工晶状体植入术对前房深度及房角宽度的影响.国际眼科杂志2017;17(1):134-136
12 Kozue K,Genichiro T,Koichi K,et al.Measurement of early changes in anterior chamber morphology after cataract extraction measured by anterior segment optical coherence tomography.Graefes Arch Clin Exper Ophthalmol 2015;253(10):1751-1756
13俞嘉怡.应用超声生物显微镜观察白内障超声乳化人工晶状体植入术后前房容积的改变.中国实用眼科杂志2011;29(6):555-561
14张帅,张一凡,李穗苓,等.白内障患者应用Pentacam和UBM测量前房直径、前房深度的研究.中华眼外伤职业眼病杂志2010;32(7):489-495