年龄相关性白内障合并浅前房患者白内障术后屈光状态研究

Analysis of refractive status after cataract surgery in age-related cataract patients with shallow anterior chamber

目的 研究年龄相关性白内障合并浅前房患者白内障术后屈光状态特点及白内障术前前房深度与术后屈光状态的相关性.方法 前瞻性对照研究.2010年10月至2012年1月于北京大学人民医院就诊的年龄相关性白内障患者共68例（90只眼）,根据Pentacam眼前节分析系统测量的前房深度将入选病例分为对照组28例（34只眼）,浅前房组40例（56只眼）.应用IOL Master测量眼轴长度和角膜曲率,应用SRK-T公式计算IOL度数.白内障术后1个月及3个月复测屈光度数、前房深度并行眼部全面检查.采用SPSS13.0软件建立数据库,两组比较采用独立样本t检验,采用二元相关与回归进行相关性分析.结果 术后1个月对照组及浅前房组屈光度数误差分别为（-0.39 ±0.62）D及（＋0.73±0.26）D,两组之间差异有统计学意义（=3.67,P=0.00）.术后3个月对照组及浅前房组屈光度数误差分别为（-0.37±0.62）D及（＋0.79±0.28）D,两组之间差异有统计学意义（P=0.00,t=3.33）.浅前房组中,前房深度越浅,术后屈光度数误差越大（r1个月=-0.57,r3个H=-0.61,P=0.00）.结论 年龄相关性白内障合并浅前房患者术后存在远视漂移,且术前前房越浅,远视漂移程度越大.

Objective To evaluate the characteristics of postoperative refractive status in agerelated cataract patients with shallow anterior chamber and the correlation between pre-operative anterior chamber depth and postoperativerefractive status. Methods Prospective case-control study. Sixty-eight cases（90 eyes） with age-related cataract were recruited from October 2010 to January 2012 in People＇s Hospital Peking University including 28 cases（34 eyes） in control group and 40 cases （56 eyes） in shallow anterior chamber group according to anterior chamber depth （ACD） measured by Pentaeam system. Axial length and keratometer were measured by IOL Master and intraoc.ular lens power was calculated using SRK/ T formula. Postoperative refraction, ACD and comprehensive eye examination were performed at 1 month and 3 months after cataract surgery. Using SPSSI3.0 software to establish a database, the two groups were compared with independent samples t-test and correlation analysis were performed with binary logical regression. Results The postoperative refractive deviation atl month were （ -0. 39 ± 0. 62 ）D in control group and （ ＋ 0. 73 ± 0. 26 ）D in shallow anterior chamber group respectively which present statistical significance between the two groups （ P = 0. 00, t = 3.67 ） ; the postoperative refractive deviation in 3 month was（ -0.37 ±0.62）D in control group and （ ＋0.79 ±0.28）D in shallow anterior chamber group seperatively which present statistical significance between the two groups （ P = 0. 00, t = 3.33 ）. In shallow anterior chamber group, with the shallowerof ACD, the greater of refractive deviation （P = 0. 00, r 1 month = - 0. 57, r 3months = - 0. 61 ）. Conclusion Hyperopic shift existed in age-related cataract patients with shallow anterior chamber and the shallower of ACD was, the greater of hyperopic shift happened.