高度近视合并白内障术后屈光状态的临床观察

Evaluation of diopter after cataract surgery in high myopia combined cataract

目的:探讨双眼高度近视并发白内障患者白内障术后屈光状态对视力的影响。方法:选择我院行双眼白内障超声乳化摘除联合人工晶状体植入术的双眼高度近视合并白内障患者60例120眼,按术后屈光度分为-1.0^-2.0D(A组)、-2.25^-3.0D(B组)、-3.25^-4.0D(C组)三组,观察患者术后3mo的裸眼远视力、最佳矫正远视力、裸眼近视力及日常视觉活动量表调查,以评估术后患者视力状况。结果:术后3mo,三组裸眼远视力差异有统计学意义,A组优于B组,B组优于C组;最佳矫正远视力三组间无差别;三组裸眼近视力比较有统计学差异,最好为C组,次之为B组,最差为A组。三组患者对手术效果满意度无组间差异,而三组术后戴镜情况组间差异有统计学意义。结论:双眼高度近视合并白内障患者施行白内障手术,应结合患者的不同需求预留术后屈光度。对于术前无戴镜习惯,且无近距离工作要求者,可预留较少的近视度数;而能接受术后配戴中低度数的远视力矫正镜,且有近距离工作要求者,可预留较高的近视度数。

To observe the diopter after cataract surgery for vision gain in high myopia and its effect on visual outcomes.METHODS： Sixty （ 120 eyes ） high myopia combined with cataract cases received phacoemulsification and intraocular lens implantation in our hospital were retrospective studied. The patients were divided into three groups based on postoperative diopter： -1. 0 ~ -2. 0D （group A）, -2. 25^-3. 0D （group B） and -3. 25 ^-4. 0D （ group C ） . The uncorrected distance visual acuity （ UCDVA） , best corrected distant visual acuity （ BCDVA） , uncorrected near visual acuity （ UCNVA ） and questionnaire of Activities of Daily Vision Scale （ ADVS ） were collected to assess the vision gain at 3mo after cataract surgery.RESULTS： At 3mo after surgery, UCDVA of group A was better than that of group B, and UCDVA of group B was better than that of group C. There were no differences in BCDVA among groups. There were significant differences between the three groups＆#39; UCNVA, it was best for the group C, followed by the group B, group A was the worst. For questionnaire, no difference was observed in patients＇ satisfactory for surgical results, but a significant difference was detected in postoperative glasses wearing frequency between groups.CONCLUSlON： For cataract surgery in high myopia combined cataract, postoperative diopter should be calculated based on patients＇ daily requirements. For patients had not used to wearing glasses and near distant working condition, it＇ appropriated to reserve a minor degree of myopia. Conversely, for patients require near distant working and received wearing moderate and low hyperopia mirror, higher degree of myopia can be reserved.