高度近视患者硅油取出联合白内障手术前后眼轴及角膜曲率的临床观察

Clinical observation of the axial length and corneal curvature after silicone oil removal combined with cataract surgery in high myopia patients

目的:探讨高度近视患者行硅油取出联合白内障手术前后眼轴长度(AL)、角膜曲率(K)变化及关系。方法:回顾性研究。纳入2020-08/11南昌大学附属眼科医院收治的硅油眼并发性白内障患者45例48眼,其中高度近视组(屈光度≥-6.00D且AL≥26mm)20例20眼和非高度近视组(屈光度<-6.00D或AL<26mm)25例28眼。比较两组患者硅油取出联合白内障手术前后AL、K值。结果:两组患者手术前后角膜K值比较无差异(均P>0.05)。高度近视组术前AL 28.35±1.68mm与术后2wk28.08±1.53mm有差异(P<0.001),非高度近视组无差异(P>0.05)。高度近视组ΔAL[-0.28(-0.44,-0.08)]与非高度近视组[-0.06(-0.20,0.15)]比较有差异(P=0.001),而两组间ΔK无差异(P>0.05)。两组患者|ΔAL|与|ΔK|、术前K值无相关(均P>0.05);高度近视组|ΔAL|与术前AL呈中度正相关(r=0.702,P=0.001),非高度近视组无相关(P>0.05)。结论:高度近视硅油眼并发性白内障患者行硅油取出联合白内障手术前后K值没有明显变化,但AL可能变短,且AL越长,AL变化可能更大。

AIM:To explore the postoperative axial length(AL)and corneal curvature(K)shift in high myopia silicone oil patients complicated cataract after silicone oil removal combined with cataract surgery as well as the relationship.METHODS:From August 2020 to November 2020 in the Affiliated Eye Hospital of Nanchang University,45 patients(48 eyes)with silicone oil eye complicated cataract were divided into 2 groups:20 eyes of 20 patients(refraction≥-6.00D and AL≥26mm)in high myopia group and 28 eyes of 25 patients(refraction<-6.00D or AL<26mm)in non-high myopia group.Record the general information and IOL-Master measurement data AL and K,statistical analysis was performed.RESULTS:There was no difference in preoperative and postoperative K value of two groups(all P>0.05).The AL of the patients in the high myopia group was 28.35±1.68mm after silicone oil removal combined with cataract surgery,which was shorter than 28.08±1.53mm before the operation(P<0.001),yet not statistically significant in non-high myopia group(P>0.05).The medianΔAL of patients in the high myopia group was[-0.28(-0.44,-0.08)]compared with the non-high myopia group[-0.06(-0.20,0.15)],which was statistically different(P<0.05),but no significant difference in bothΔK(P>0.05).There was no correlation between|ΔAL|and|ΔK|,or and preoperative K values(P>0.05)in two groups.Preoperative AL was moderately positive correlated with|ΔAL|in the high myopia group(r=0.702,P=0.01),but not in the non-high myopia group(P>0.05).CONCLUSION:There was no significant shift in K value of high myopia group with silicone oil eye complicated cataract after the silicone oil removal combined with cataract surgery.The longer preoperative AL in high myopia group,the more likely become shorter after surgery,meanwhile the longer AL,the greater AL shift.