摘要
目的研究超高度近视眼白内障行超声乳化吸除并人工晶状体（IOL）植入术后晶状体前囊膜直径、面积及IOL偏心量、倾斜角的改变。方法选择超高度近视白内障患者62例（90眼,眼轴〉27mm）为超高度近视组,正常眼轴白内障患者55例（90眼,22mm≤眼轴≤24mm）为正常眼轴组,均行超声乳化并人工晶状体植入术,于术后1~3、3~6和6~12个月时（每个阶段均30眼）散瞳后拍摄眼前节彩照,使用Pentacam三维眼前节成像系统采集Scheimpflug图像,通过Image J图像分析软件测量各前囊口直径、面积及IOL的偏心量、倾斜角和术后房水深度（PAD）。比较两组患者各时间段前囊口形态和IOL稳定性。结果 （1）与正常眼轴组比较,超高度近视组患者术后1~3个月PAD加深,IOL倾斜角加大（t=3.544、2.380,P〈0.01或0.05）;术后3~6个月PAD加深、IOL倾斜角加大,晶状体前囊口面积缩小、平均直径缩短（t=3.390、2.107、-2.186、-2.009,P〈0.01或0.05）;术后6~12个月PAD变浅,但差异无统计学意义（P〉0.05）,而超高度近视组患者前囊口面积进一步缩小、水平径及平均直径缩短,IOL倾斜角变化减小（t=-2.652、-2.989、-2.628、0.463,P〈0.01或0.05）。（2）术后组内不同时间段比较,正常眼轴组前囊口形态及IOL稳定性改变的差异均无统计学意义（均P〉0.05）;超高度近视组患者术后6~12个月时的IOL倾斜角较术后1~3及3~6个月明显增加（均P〈0.01）。结论超高度近视合并白内障患者术后前囊口更容易发生收缩,且水平方向收缩程度更加明显,容易引起IOL倾斜角及PAD的改变。
Objective To study the diameter and size of anterior capsular opening, the tilt and decentration of intraocular lenses （IOL） as well, in super high myopic patients who underwent uneventful phacoemulsificationand foldable IOL implantation. Methods The study group was consisted of 62 cases of super high myopic eyes with cataract （90 eyes, axis〉27mm）, while the control group was consisted of 55 cases of normal axial length （90 eyes, 22ram ~〈 axis ~〈 24ram）. Data of 30 eyes from each group was collected at 1-3month, 3-6month, 6-12month follow-up after operation, including dilated anterior segment photography, Scheimplug image by Pentacam. The diameter and size of anterior capsular opening, tilt and decentration of IOL and postoperative aqueous depth （PAD） was analyzed by Image J analysis software. Comparied the diameter and size of anterior opening, tilt and decentration of IOL and PAD between two groups at each follow-up. Results （1）Compared with patient of normal axial length,patients with super high myopia had deeper PAD and larger tilt （t=3.544,2.380, P〈0.01or 0.05） at postoperative 1-3 months, with statistically significant differences between two groups. Also, super high myopic patients had deeper PAD and larger tilt,smaller areaand shorter average diameter （t=3.390,2.107, -2.186, -2.009, P〈 0.01 or 0.05） of anterior capsular opening at postoperative 3-6 months, with statistically significant differences between two groups. Patients with super high myopia had lower PAD at 6-12 months, without statistically significant differences, but the area, horizontal diameter, average diameter and IOL tilt （t=-2.652,-2.989, -2.628, 0.463, P〈0.05 or 0.01） were further decreased, with statistically significant differences. （2）Comparison between different postoperative time periods in the same group. There were no statistical differences of normal axial length groups in postoperative 1-3 months, 3-6 months and 6-12 months in the changes ofanterior capsular opening and stability of intraocular lens. The changes of IOL tilt were of statistical difference in postoperative 6-12 super-high myopia group, compared with the 1-3 months（P〈0.01） and 3-6 months（P〈0.01）.Conclusion The super high myopic eyes with cataracts were more prone to have anterior capsular contraction, especially at horizontal direction, which could induce IOL tilt and PAD change after phacoemulsification.
出处
《浙江医学》
CAS
2016年第17期1397-1400,共4页
Zhejiang Medical Journal
关键词
高度近视
白内障超声乳化吸除术
人工晶状体
晶体囊
High myopic Cataract phacoemulsification Intraocular lens Lens capsule crystalline
