儿童人工晶体植入后近视漂移的临床探讨

Myopia shift after implantation of intraocular lens(IOL)in children

目的 探讨儿童白内障摘除人工晶体植入后近视漂移及人工晶体屈光度的选择。方法 对 44例 5 5眼行白内障摘出加人工晶体植入的儿童进行回顾性分析 ,按手术时的年龄分为两组 :A组 2～ 8岁 2 1例 2 8眼 ,B组 9～ 14岁 2 3例 2 7眼。应用A超测量眼轴 ,曲率计测量角膜曲率 ,由SRK-Ⅱ公式计算IOL的屈光度 ,并根据患儿年龄植入等于或小于计算度数的IOL。随访 3～ 3 8mo屈光状态 ,分析IOL植入术后屈光状态及眼轴长度的变化。结果 A组平均屈光度的变化为 -1 43±1 3 9D ,眼轴长度的平均变化为 1 71± 0 73mm ,B组平均屈光度的变化为 -0 73± 0 76D ,眼轴长度的平均变化为 0 41± 0 3 0mm。其中A组屈光状态及眼轴长度的变化均具有统计学意义 ,P <0 0 5 ;B组屈光状态及眼轴长度的变化不具有统计学意义 ,P >0 1。A、B两组眼轴长度及屈光度变化相比均有显著差异。结论 儿童人工晶体眼仍存在视觉发育的近视化趋向。

Objective To investigate the myopia shift in children after implantation of IOL and the selection of the power of IOL.Methods 44 cases(55 eyes)of cataract children after cataract extraction and implantation of IOL were followed up from 3～38 months.These patients were divided into 2 groups according to their ages when they accepted operation,group A:28 eyes of 21 cases(2～8 years old);and B:27 eyes of 23 cases(9～14 years old).The IOL power were decided by SRK-II.The refractive condition and the axial length were measured and analyzed after operation.Results The mean diopter difference before and after operation in group A was -1.43±1.39D,and mean axial length difference 1.71±0.73mm;the difference in B were -0.73±0.76D and 0.41±0.30mm,respectively.There was statistical significance in diopter and axial length changes in group A(P<0.05),but no in B(P>1).Conclusions The ocular growth of children after implantation of IOL still has a trend to myopia.The choice of IOL power should be a little under-correction.