IOLMaster测量高度近视并发性白内障患者手术前后眼轴长度变化

Axial length changes measured by IOLMaster after surgery in cataract secondary to high myopia

目的比较IOLMaster测量高度近视并发性白内障患者手术前后眼轴长度变化,为临床评价白内障术后高度近视患者眼轴长度提供理论依据。方法前瞻性队列研究(注册号:Chi CTR-IPC-15005890)。收集2014年2月至2014年9月在西安市第四医院眼科白内障病区住院病手术治疗的高度近视并发性白内障患者29例(38只眼)。术前所有患者均应用IOLMaster测量眼轴,眼轴长度大于27.00 mm且组合信号信噪比大于32。术后3个月以上,患者复查时再次应用IOLMaster测量眼轴,并记录术后组合信号信噪比。术前术后眼轴长度、信噪比进行配对t检验,同时对术前术后眼轴长度进行直线相关分析。结果本研究最终完成术前术后眼轴长度变化比较患者23例(29只眼),排除共6例(9只眼)。患者术前眼轴平均值为(31.19±2.27)mm,术后眼轴平均值为(31.03±2.25)mm,术前术后眼轴测量值差异有统计学意义(t=15.19,P<0.01)。术后眼轴均较术前缩短,平均减少0.16 mm。患者术前组合信号平均信噪比为102.5±50.1,术后为272.5±134.5,术前术后信噪比差异有统计学意义(t=-5.96,P<0.01)。本研究中,术前眼轴=1.009×术后眼轴-0.130。结论在眼轴长度大于27.00 mm的高度近视并发性白内障患者,IOLMaster测量术后眼轴眼轴较术前眼轴缩短,两者呈线性相关。有必要对高度近视并发白内障患者IOLMaster术后眼轴长度测量值进行校正。

Objective To investigate the axial length（ AL） changes before and after surgeries for secondary cataract in high myopic patients.Methods This study was a perspective cohort trial（No：Chi CRT-IPC-15005890）.From February 2014 to September 2014,38 eyes of 29 patients with secondary cataract due to high myopia were recruited in Xi’an No.4 hospital.AL were measured with IOLMaster before surgery.AL was over 27.00 mm and combined signal-noise ratio（ SNR） was higher than 32 in all patients.AL and combined SNR were measured again more than 3 months later.These results were compared to pre-operative levels and linear regression of AL between pre- and post-operation was analyzed.Results Totally 29 eyes of 23 patients were studied.Nine eyes of 6 patients were excluded.Pre-and postoperative AL were 31.19 ± 2.27 mm and 31.03 ± 2.25 mm,respectively（ t = 15.19,P 〈 0.01）.Postoperative AL was significantly shorter.Average AL change was 0.16 mm.Pre- and postoperative combined SNR were 102.5 ± 50.1 and 272.5 ± 134.5,respectively（t=- 5.96,P 〈 0.01）.Linear regression analysis showed that preoperative AL=1.009×postoperative AL- 0.130.Conclusion In secondary cataract due to high myopia,if AL was over 27.00 mm before surgery,postoperative AL will become significantly shorter,and is linearly correlated to preoperative measurements.It is necessary to correct the postoperative AL of high myopia cataract measured by IOLMaster.