影响高度近视合并白内障术后视力恢复的相关因素分析

Analysis on the related factors of postoperative visual recovery in cataract patients concomitant with high myopia

目的:分析影响高度近视合并白内障术后视力恢复的相关因素。方法:选取皖南医学院第二附属医院眼科收治的高度近视合并白内障患者41例(62眼)。所有患者均完善白内障术前检查,并行白内障超声乳化摘除联合人工晶状体植入术,对影响术后视力恢复的相关因素进行分析。结果:患者术后3个月时最佳矫正视力(BCVA)(0.49±0.24)较术前视力(1.37±0.43)改善(P<0.001),低视力组患者的眼轴[(29.61±2.13)mm]长于正常视力组[(28.40±1.84)mm](P<0.05)。术后3个月时BCVA与眼轴(r=-0.297,P<0.05)、后巩膜葡萄肿(r_(s)=-0.465,P<0.001)均呈负相关,与黄斑区视网膜椭圆体带完整性呈正相关(r_(s)=0.452,P<0.001)。多因素Logistic回归分析显示,长眼轴(Or=1.429,95%CI:1.040~1.964)、有后巩膜葡萄肿(Or=5.348,95%CI:1.658~17.254)是低视力的危险因素(均P<0.05)。结论:高度近视合并白内障患者可以通过手术提高视力,术后视力与眼轴长度和后巩膜葡萄肿的严重程度存在相关性。

Objective:To analyze the related factors of postoperative visual recovery in cataract patients combined with high myopia.Methods:The study included 41 cataract patients(62 eyes)combined with high myopia admitted to our department.All patients underwent preoperative examination and phacoemulsification plus intraoculaRlens implantation.Related factors of postoperative visual recovery were analyzed.Results:Compared to preoperative vision(1.37±0.43),best corrected visual acuity(BCVA,0.49±0.24)was significantly improved at 3 months afteRsurgery(P<0.001).The axial length of low vision group(29.61±2.13)mm was significantly longer than that in normal vision group(28.40±1.84)mm(P<0.05).At 3 months after surgery,BCVA was negatively correlated with axial length(r=-0.297,P<0.05),posterior staphyloma(r_(s)=-0.465,P<0.001),and positively with the integrity of ellipsoid zone in maculaRarea(r_(s)=0.452,P<0.001).Multivariate logistic regression analysis showed that axial length(Or=1.429,95%CI:1.040-1.964)and posterior staphyloma(Or=5.348,95%CI:1.658-17.254)were risk factors for low vision(P<0.05).Conclusion:Surgery can improve the vision of cataract patients combined with high myopia.Postoperative vision correlates with axial length and posterioRstaphyloma.