高度近视白内障患者超声乳化术后视力恢复情况的影响因素

Influencing Factors of Recovery of Visual Acuity in Patients with HighMyopia Cataract after Ultrasonic Emulsification

目的探讨高度近视白内障患者超声乳化(UE)术后视力恢复情况的影响因素。方法回顾性分析2018年6月至2020年6月在淅川县人民医院行UE后出现视力损伤的60例高度近视白内障患者临床资料,设为异常组;另收集同期在淅川县人民医院行UE后视力恢复正常的60例高度近视白内障患者临床资料,设为正常组。查阅资料并收集病例资料相关内容,经单因素与多因素分析高度近视白内障患者UE术后视力恢复情况的影响因素。结果异常组眼轴长度(AL)值、角膜散光度、伴有黄斑病变占比高于正常组(P<0.05);组间其他基线资料相比,差异无统计学意义(P>0.05)。经单因素分析后,建立多元logistic回归模型行多因素分析,结果显示,AL值较高、角膜散光度较高及伴有黄斑病变均是高度近视白内障患者UE术后视力恢复较差的影响因素(OR>1,P<0.05)。结论 AL值较高、角膜散光度较高及伴有黄斑病变的高度近视白内障患者行UE后视力恢复较差,临床工作者在术前可采取有效的干预措施(如严格把控手术指征、药物、手术干预等)来进行干预,以此促进高度近视白内障患者行UE后的视力康复。

Objective To investigate the influencing factors of visual acuity recovery in patients with high myopia cataract after ultrasonic emulsification(UE).Methods The clinical data of 60 patients with high myopia and cataract who developed visual impairment after receiving UE in Xichuan County People’s Hospital from June 2018 to June 2020 were retrospectively analyzed,and those were seted as the abnormal group.In addition,the clinical data of 60 patients with high myopia cataract who had normal vision after UE in Xichuan County People’s Hospital were collected,and those were seted as the normal group.The data were consulted and the relevant content of medical data were collected,univariate analysis and multivariate analysis were used to analyze the influencing factors of visual acuity recovery in patients with high myopia cataract after UE.Results The axial length(AL)value,corneal astigmatism and the proportion of macular lesions in the abnormal group were higher than those in the normal group(P<0.05).There were no statistical significant differences in other baseline data between the two groups(P>0.05).After univariate analysis,logistic regression model was established and multivariate analysis was performed,and the results showed that higher AL value,higher corneal astigmatism and macular lesions were the influencing factors of poor recovery of visual acuity in patients with high myopia cataract after UE(OR>1,P<0.05).Conclusion The recovery of visual acuity after UE in high myopia cataract patients with high AL value,high corneal astigmatism and macular lesions is poor.Clinical workers can take effective intervention measures for intervention(such as strict control of surgical indications,drugs,surgical intervention,etc.)before surgery,so as to promote the recovery of vision of high myopia cataract patients after UE.