先天性白内障患者的眼生物测量数据分析

Analysis of ocular biometry in patients with congenital cataract in Northern China

目的了解先天性白内障患者的眼生物测量数据特征。设计回顾性病例系列。研究对象北京同仁医院2010-2018年小于18岁的先天性白内障患者117例。方法回顾患者的病历资料。所有患者均接受了A超、角膜曲率计检查或IOL-Master 500检查。分析不同年龄(1~24个月组、25~72个月组及73~216个月组)、性别、单双眼先天性白内障患者以及单眼先天性白内障患者的白内障眼和对侧眼的眼生物测量数据差异。主要指标眼轴长度、角膜曲率和角膜散光(K1-K2)。结果117例先天性白内障患者平均眼轴长度、角膜曲率和角膜散光分别为(21.92±1.76)mm、(43.78±1.81)D和(2.03±1.10)D。1~24个月组、25~72个月组及73~216个月组先天性白内障患者的眼轴长度分别为(20.59±1.31)mm、(22.00±1.70)mm和(22.60±1.65)mm(F=11.99,P<0.001)。不同年龄组患者的角膜曲率和角膜散光均无显著差异(F=0.330,P=0.720和F=0.625,P=0.537)。不同性别患者的眼轴长度和角膜曲率均无差异(t=-1.862,P=0.065和t=1.709,P=0.090)。单眼和双眼患者的眼轴长度和角膜曲率均无差异(t=1.272,P=0.206和t=-0.145,P=0.885)。单眼患者的白内障眼和对侧眼的眼轴长度和角膜曲率也无差异(t=-0.624,P=0.536和t=-0.201,P=0.842),但白内障眼的角膜散光更大(2.05±1.00D、1.38±0.83D,P<0.001)。结论先天性白内障可能阻碍了角膜散光的生理性降低。先天性白内障患者2岁前眼轴长度增长较快,2岁后眼轴长度增长缓慢,这为先天性白内障患者人工晶状体植入合适时机的选择提供了参考。(眼科,2021,30:36-41)

Objective To investigate the biometry data of eyes with congenital cataract(CC)in North China.Design Retrospective case series.Participants 117 CC patients under 18 years old in Beijing Tongren Hospital from 2010 to 2018.Methods The medical records of CC patients were reviewed.All patients underwent A-scan,keratometry examination or IOL-Master 500 examination.CC patients were grouped according to their age(1~24 months,25~72 months,and 73~216 months),gender(male or female)and whether both eyes were affected(monocular or binocular),and the ocular biometrics between different groups were compared.For patients with monocular CC,the differences between cataract eyes and contralateral eyes were also analyzed.Main Outcome Measures axial length,keratometry and corneal astigmatism.Results The average axial length,keratometry and corneal astigmatism of 117 CC patients were 21.92±1.76 mm,43.78±1.81 D,and 2.03±1.10 D respectively.The axial length of CC patients in 1~24 months group,25~72 months group and 73~216 months group were 20.59±1.31 mm,22.00±1.70 mm and 22.60±1.65 mm respectively(F=11.99,P<0.001).There was no significant difference in keratometry and corneal astigmatism among different age groups(F=0.330,P=0.720 and F=0.625,P=0.537).There was no significant difference in axial length and keratometry between different gender groups(t=-1.862,P=0.065 and t=1.709,P=0.090).There was no difference in axial length and keratometry between monocular and binocular CC patients(t=1.272,P=0.206 and t=-0.145,P=0.885).There was no significant difference in axial length and keratometry between cataract eyes and contralateral eyes in monocular CC patients(t=-0.624,P=0.536 and t=-0.201,P=0.842),but the corneal astigmatism of cataract eyes was larger(2.05±1.00 D vs 1.38±0.83 D,P<0.001).Conclusion CC may defer the physiological decrease of corneal astigmatism.The axial length of CC patients increased rapidly before 2 years old,and slowly after 2 years old,which provided a reference for the selection of appropriate time for intraocular lens implantation in CC patients.(Ophthalmol CHN,2021,30:36-41)