散瞳对白内障合并高度近视患者眼球生物学测量和IOL度数计算的影响

Effect of pupil dilation on ocular biometry measurement and IOL power calculation in cataract patients with high myopia

目的:研究散瞳对白内障合并高度近视患者眼球生物学测量和人工晶状体(IOL)度数计算结果的影响及与正常眼轴白内障患者的区别。方法:采用IOL Master测量白内障合并高度近视患者22例34眼(A组)和正常眼轴白内障患者23例39眼(B组)散瞳前后眼轴(AL)、角膜曲率(K,包括K1和K2)、前房深度(ACD),并用SRK-T、Haigis公式计算IOL度数。结果:散瞳后A组ACD(3.84±0.58mm)较散瞳前(3.61±0.35mm)增加(P<0.01),B组ACD(3.30±0.70mm)也较散瞳前(3.13±0.63mm)增加(P<0.01),两组散瞳前后ACD差值无差异(P>0.05)。两组散瞳后AL、K测量值与散瞳前相比均未见明显差异(P>0.05)。散瞳前后两组采用SRK-T、Haigis公式计算IOL度数均无明显差异(P>0.05),但散瞳前后计算的IOL度数差异≥1D占比A组分别为15%、27%,B组分别为3%、5%。结论:散瞳引起白内障合并高度近视患者前房深度明显增加,与对正常眼轴白内障患者的影响相比无区别。散瞳对角膜曲率和眼轴测量没有影响。散瞳不影响用SRK-T、Haigis两种公式计算白内障合并高度近视患者IOL度数的计算结果,但相对正常眼轴患者出现大度数差别的几率较大,故建议在未散瞳状态下进行测量和计算以尽量减少误差。

AIM:To evaluate the effect of pupil dilation on ocular biometry and IOL power in cataract patients with high myopia,and the difference between cataract patients with high myopia and cataract patients with normal axial length(AL).METHODS:Measurements of AL,corneal curvature(K including K1 and K2),anterior chamber depth(ACD)were performed using IOLmaster in 22 cataract patients with high myopia(34 eyes)(group A)and 23 cataract patients with normal AL(39 eyes)(group B)before and after pupil dilation.SRK-T and Haigis were used to caculate pre-and post-cycloplegic IOL power.RESULTS:ACD after dilation(3.84±0.58mm)significantly increased comparing with ACD before dilation(3.61±0.35mm)in group A(P<0.01).ACD after dilation(3.30±0.70mm)also significantly increased comparing with ACD before dilation(3.13±0.63mm)in group B(P<0.01).But the difference of pre-and post-cycloplegic ACD between the two groups was not statistically significant(P>0.05).Pre-and post-cycloplegic AL and K(including K1 and K2)were not significantly different in two groups(P>0.05).The differences between pre-and post-cycloplegic IOL power were not statistically significant using the SRK-T and Haigis formula(P>0.05),but the IOL power changed by over 1D after pupil dilation using the SRK-T and Haigis formula respectively in 15%and 27%of eyes in group A,in 3%and 5%in group B.CONCLUSION:ACD increases after pupil dilation in cataract patients with high myopia,which is not different from cataract patients with normal AL.Pupil dilation does not affect AL,K and the IOL power(using SRK-T and Haigis)in cataract patients with high myopia.But the IOL power may change greater than in cataract patients with normal AL,so we suggest IOL power should be measured and calculated without mydriasis.