青少年晶状体形态与眼轴长度的关系

Relationship between lens morphology and axial length in adolescents

目的通过分析青少年晶状体形态与眼轴长度的关系,探讨晶状体变化规律。方法选取2020年5~6月于川北医学院附属医院眼科就诊的6~18岁青少年285例(570眼)。通过睫状肌麻痹验光、光学生物测量仪(IOL Master)、眼前节光学相干断层扫描分析仪(CASIA2)分别获得屈光度、眼轴长度、角膜曲率和晶状体参数。按年龄分为3组,分别为6~10岁组、>10~14岁组和>14~18岁组;按等效球镜度分为3组,分别为远视组、正视组和近视组。采用单因素方差分析、Pearson相关性分析、线性回归对不同年龄、屈光组晶状体参数进行比较,并分析与眼轴长度的关系。结果不同年龄组晶状体前表面曲率半径、晶状体屈光度存在统计学差异(P<0.05);不同屈光组晶状体前表面曲率半径、晶状体屈光度、晶状体厚度和晶状体直径存在统计学差异(P<0.05)。不同年龄组和屈光组晶状体前后表面曲率半径、晶状体屈光度、晶状体厚度、晶状体直径与眼轴长度均显著相关(P<0.001)。眼轴每增长1 mm,远视组、正视组和近视组晶状体前表面曲率半径分别增加1.19、1.04、0.58 mm;后表面曲率半径分别增加0.41、0.38、0.30 mm;屈光度分别减少1.68 D、1.44 D、0.98D;厚度分别减少0.076、0.091、0.059 mm;直径分别增加0.30、0.23、0.24 mm。结论青少年不同年龄、屈光状态晶状体参数差异主要是由眼轴长度不同引起的,晶状体形态变化与眼轴增长相适应,但随着眼轴增长晶状体形态变化减小。

Objective To investigate the change rules of lens by analyzing the relationship between lens morphology and axial length in adolescents. Methods A total of 285 adolescents(6~18 years old, 570 eyes) who visited our ophthalmological department from May to June 2020 were enrolled in this study. Diopter, axial length, keratometry and lens parameters were obtained by optometry after cycloplegia, optical biomimetry(IOL Master) and anterior segment optical coherence tomography(CASIA2), respectively. The subjects were divided into 3 age groups(6~10, 11~14 and 15~8 years), and were also assigned into 3 groups in accordance with their equivalent spherical specularity: hyperopia, emmetropia and myopia groups. One-way analysis of variance was adopted to compare lens parameters among different age and refractive groups, and their relationships with axial length were analyzed with Pearson correlation analysis and linear regression analysis. Results In different age groups, statistical differences were observed in the radius of anterior surface curvature and the diopter of lens(P<0.05);And similar results were seen in above 2 parameters and in the thickness and diameter of lens among different refractive groups(P<0.05). The curvature radius of the anterior and posterior surface, diopter, and thickness and diameter of lens were all significantly correlated with the axial length of eye in different age groups and refractive groups(P<0.001). In the hyperopia, emmetropia and myopia groups, with the increase of every 1 mm in ocular axis, the radius of anterior surface curvature was increased by 1.19, 1.04 and 0.58 mm;the radius of posterior surface curvature was increased by 0.41, 0.38 and 0.30 mm, the diopter was decreased by 1.68 D, 1.44 D and 0.98 D;the thickness was reduced by 0.076, 0.091 and 0.059 mm, and the diameter increased by 0.3, 0.23 and 0.24 mm, respectively. Conclusion The disparity of lens parameters among different ages and refractive states in adolescents is mainly caused by the diversity of axial length. The morphological changes of the lens are coordinated with the growth of axial length, but the changes will be decreased with the growth.