高度病理性屈光参差自身双眼屈光要素差异性对比分析

The differences between eyesrefractiveelements in the high anisometropia

目的分析高度屈光参差同例双眼的屈光要素构成差异,了解影响屈光状况及高度屈光参差的形成机理.方法自动验光仪散瞳前后客观验光,结合插片法确定屈光状况.129例等效球镜≥3D的近视性高度屈光参差患者,依据屈光状况,同例双眼分别列为高屈光眼组与低屈光眼组.角膜地形图检查角膜屈光力,A型超声仪检查前房深度、晶状体厚度及眼轴长度.各屈光要素相关数据进行配对t检验;与眼球近视度相关性进行多元线性回归分析.随机对部分屈光参差患者的直系亲属,确定屈光状态,检查屈光要素,探索屈光参差的遗传性规律.结果高、低屈光组双眼角膜屈光力差异率25.58%;前房深度差异率31.01%;晶状体厚度差异率20.19%;眼轴长度差异率占比86.05%;角膜屈光力、眼轴长度t检验均有显著性差异(P<0.05;P<0.01);前房深度t检验无显著性差异(P>0.05).相关性分析:眼球近视度与角膜屈光力、晶状体厚度及眼轴长度呈正相关,与前房深度呈负相关.遗传性相对存在,明显相关性占比19.36%(6:31).结论角膜屈光力及眼轴长度是影响眼球屈光力的主要因素;前房深度及晶状体在眼纵轴线上的位置差异可导致特异性屈光不正.遗传依从性、双眼发育进度不等量,可能是高度病理性屈光参差发生的重要因素.

Objective Analyze binocular refractive elements composition differences in high myopia anisometropia cases,to understand the influence of refractive state and high anisometropia formation mechanism.Methods The two eyes of 129 patients with high myopic anisometropic(≥3D)were divided into two groups according to the refractive status.Related refractive elements were paired with T test.The correlation between refractive factors and ocular myopia were analyzed with multivariate linear regression.Results The difference of corneal refractive power was in rate of 25.58%,the anterior chamber depth accounted for 31.01%,lens thickness differences accounted for 20.19%,axial length differences accounted for 86.05%in two groups.Conieal refractive power,axial lengthitest.There were significant differences with t-test both in Corneal refractive power and axial length(P<0.05;P<0.01),no significant difference in the anterior chamber depth(P>0.05).Correlation analysis:the corneal refractive power,lens thickness and axial length were positively correlated with the degree of myopia,and the anterior chamber depth was negatively correlated.Conclusion The main factors of the eye refractive power are the corneal refractive power,axial length.Anterior chamber depth and lens in the axial line position differences can lead to the specific refractive errors.Genetic adherence and different amount of development progress may he an important factor in the highly pathological anisometropia appearance.