高度近视并发性白内障患者睫状肌麻痹前后眼部生物学参数及人工晶状体度数的变化

Changes in ocular biological parameters and intraocular lens power of high myopic cataract patients after cycloplegia

目的观察高度近视并发性白内障(HMC)患者睫状肌麻痹前后眼部生物学参数及人工晶状体(IOL)度数计算的变化,并比较HMC患者与年龄相关性白内障(ARC)患者的区别。方法本研究选取2020年10月至2022年5月在蚌埠医学院第一附属医院行白内障超声乳化吸除联合IOL植入术的轴性HMC患者(A组)85例85眼及ARC患者(B组)48例48眼,应用IOL Master⁃700分别测量睫状肌麻痹前后患者的眼轴长度(AL)、平均角膜曲率(Km)、前房深度(ACD)、晶状体厚度(LT)、白到白距离(WTW)及中央角膜厚度(CCT),并使用SRK/T、Haigis及Barrett Universal II公式计算得出IOL度数。比较两组患者睫状肌麻痹前后眼部各生物学参数及IOL度数的变化。结果A组患者睫状肌麻痹前后AL、Km、WTW及三种公式计算IOL度数差异均无统计学意义(均为P>0.05);A组患者睫状肌麻痹前后ACD、LT、CCT差异均有统计学意义(均为P<0.05)。B组患者睫状肌麻痹前后AL、Km及三种公式计算IOL度数差异均无统计学意义(均为P>0.05);B组患者睫状肌麻痹前后ACD、LT、CCT、WTW差异均有统计学意义(均为P<0.05)。睫状肌麻痹前后两组患者间AL、Km、WTW、ACD、LT、CCT及三种公式计算IOL度数的差值差异均无统计学意义(均为P>0.05)。A组患者SRK/T与Haigis及SRK/T与Barrett Universal II公式之间睫状肌麻痹前后IOL度数变化≥0.5 D的人数差异均有统计学意义(均为P<0.05);而Haigis与Barrett Universal II公式相比,睫状肌麻痹前后IOL度数变化≥0.5 D的人数差异无统计学意义(P>0.05)。B组患者三种公式两两比较结果显示,睫状肌麻痹前后IOL度数变化≥0.5 D的人数差异均无统计学意义(均为P>0.05)。两组患者间睫状肌麻痹前后三种公式计算IOL度数变化≥0.5 D的人数差异均无统计学意义(均为P>0.05)。结论睫状肌麻痹会对白内障患者部分眼部生物学参数测量结果产生影响,并且相对于ARC患者,HMC患者出现大度数差别的概率较大。睫状肌麻痹对Haigis及Barrett Universal II公式更容易产生影响。

Objective To evaluate the effects of cycloplegia on ocular biological parameters and intraocular lens(IOL)power of high myopic cataract(HMC)patients and compare HMC with age⁃related cataract(ARC).Methods Totally 85 axial HMC patients(85 eyes)who underwent the phacoemulsification combined IOL implantation(group A)and 48 ARC patients(48 eyes)(group B)admitted to the First Affiliated Hospital of Bengbu Medical College from October 2020 to May 2022 were included in the study.Their axial length(AL),mean corneal curvature(Km),anterior chamber depth(ACD),lens thickness(LT),white⁃to⁃white(WTW)distance and central corneal thickness(CCT)were measured before and after cycloplegia by IOL Master⁃700,and the IOL power was calculated by SRK/T,Haigis and Barrett Universal II formu⁃las.The changes in ocular biological parameters and IOL power before and after cycloplegia were observed.Results There was no significant difference in AL,Km,WTW distance and IOL power calculated by the three formulas(all P>0.05),but significant differences in ACD,LT and CCT(all P<0.05)before and after cycloplegia in group A.There was no significant difference in AL,Km and IOL power calculated by the three formulas(all P>0.05),but significant differences in ACD,LT,CCT and WTW distance(all P<0.05)before and after cycloplegia in group B.Before and after cycloplegia,there was no significant difference in AL,Km,WTW distance,ACD,LT,CCT and IOL power calculated by the three formulas be⁃tween the two groups(all P>0.05).In group A,there were significant differences in the number of patients with IOL pow⁃er change≥0.5 D before and after cycloplegia calculated by SRK/T and Haigis and that calculated by SRK/T and Barrett U⁃niversal II(both P<0.05);there was no significant difference in the number of patients with IOL power change≥0.5 D before and after cycloplegia calculated by Haigis and Barrett Universal II(P>0.05).Pairwise comparison of the three for⁃mulas in group B showed no significant difference in the number of patients with IOL power change≥0.5 D before and af⁃ter cycloplegia(all P>0.05).There was no significant difference in the number of people with IOL power change≥0.5 D before and after cycloplegia calculated by the three formulas between the two groups(all P>0.05).Conclusion Cyclo⁃plegia may affect certain ocular biological parameters of cataract patients.Compared with the ARC patients,there is a grea⁃ter chance of a significant difference in the IOL power of HMC patients.Cycloplegia is more likely to affect the IOL power obtained by Haigis and Barrett Universal II formulas.