河南地区白内障患者角膜前后表面散光情况的调查与分析

Investigation and Analysis of Corneal Astigmatism in Cataract Patients in Henan Province

目的调查河南地区接受超声乳化白内障吸除手术患者术前角膜散光情况分布和特征。方法回顾性收集2018年5月至2019年5月在郑州大学第一附属医院接受超声乳化白内障吸除手术的523例(673眼)患者的临床资料。采用Pentacam眼前节分析仪测量角膜前后表面的散光度数、散光轴位,并对以上参数进行描述性及相关性分析。结果角膜前表面散光(ACA)中位度数为0.8(0.5,1.3)D,顺规散光占49.5%,逆规散光占29.3%。角膜后表面散光(PCA)中位度数为0.3(0.2,0.4)D,顺规散光占9.2%,逆规散光占76.1%。年龄与ACA类型显著相关(r=0.176,P<0.01),随年龄增加,ACA有从顺规散光向逆规散光转变趋势。随年龄增加,PCA逆规散光比例有下降趋势。ACA度数与PCA度数呈正相关(r=0.301,P<0.01),ACA轴位与PCA轴位呈正相关(r=0.165,P<0.01)。结论建议在白内障患者术前充分检查其角膜前后表面散光情况,相当一部分患者的角膜散光应手术矫正。

Objective To investigate the distribution and characteristics of corneal astigmatism before phacoemulsification in Henan province.Methods The clinical data of 523 patients(673 eyes)who underwent phacoemulsification in the First Affiliated Hospital of Zhengzhou University from May 2018 to May 2019 were retrospectively collected.The astigmatism degree and the axis of anterior and posterior corneal surface were measured by Pentacam.Descriptive and correlation analysis was performed on the parameters above.Results The median degree of anterior corneal astigmatism(ACA)was 0.8(0.5,1.3)D.The with-the-rule(WTR)astigmatism accounted for 49.5%,and against-the-rule(ATR)astigmatism accounted for 29.3%.The median degree of posterior corneal astigmatism(PCA)was 0.3(0.2,0.4)D,with WTR astigmatism accounting for 9.2%,and ATR astigmatism accounting for 76.1%.Age was significantly related to ACA type(r=0.176,P<0.01).With the increase of age,ACA had a tendency to change from WTR to ATR astigmatism,and proportion of ATR PCA had a downward trend.ACA degree was positively correlated with PCA degree(r=0.301,P<0.01).ACA axis position was positively correlated with PCA axis position(r=0.165,P<0.01).Conclusion It is recommended to check the astigmatism of corneal before cataract surgery.Corneal astigmatism in a significant number of patients should be corrected surgically.