不同眼轴长度对超声乳化手术效果的影响

Effect of different axial length on phacoemulsification operation

目的评估不同眼轴长度对超声乳化人工晶状体植入术效果的影响。方法回顾性病例对照研究。分析舟山市普陀区人民医院2020年6月至2022年6月就诊的白内障100例(111眼)的临床资料,根据术前眼轴长度分为短眼轴组13例(15眼,眼轴<22 mm)、正常眼轴组74例(80眼,眼轴22~26 mm)和长眼轴组13例(16眼,眼轴>26 mm),3组均进行超声乳化人工晶状体植入术。比较不同眼轴长度者手术效果、术后并发症及眼部生物参数,并采用Spearman相关性分析眼轴长度与术后眼部生物参数的相关性。结果3组术后前房深度均提高(P<0.05),最佳矫正视力较术前改善(P<0.05);角膜曲率、眼压、角膜内皮细胞密度均降低(P<0.05);短眼轴组、正常眼轴组、长眼轴组并发症总发生率分别为93.33%(14/15)、3.75%(3/80)、18.75%(3/16),短眼轴组并发症角膜上皮破损、虹膜撕裂/晶状体损伤、角膜水肿发生率高于正常眼轴组和长眼轴组(χ^(2)=22.01,P<0.001;χ^(2)=33.36,P<0.001;χ^(2)=20.23,P<0.001);术前眼轴长度与术后最佳矫正视力、晶状体屈光度呈负相关(r=-0.22,P=0.021;r=-0.89,P<0.001),与前房深度、角膜内皮细胞密度呈正相关(r=0.60,P<0.001;r=0.19,P=0.042)。结论不同眼轴长度与超声乳化术后白内障患者晶状体屈光度、最佳矫正视力、前房深度、角膜内皮细胞密度之间存在联系,眼轴长度与术后最佳矫正视力、晶状体屈光度呈负相关,与前房深度及角膜内皮细胞密度呈正相关,眼轴长度<22 mm的患者术后并发症发生的可能性大于眼轴长度≥22 mm者。

Objective To evaluate the effect of different axial length on the curative efficacy of phacoemulsification and intraocular lens implantation.Methods This was a retrospective case-control study.The clinical data of 111 eyes of 100 cataract patients from Jun.2020 to Jun.2022 in Putuo District People′s Hospital of Zhoushan City were analyzed.Based on the preoperative axial length,they were divided into 3 groups with 13 cases in the short axial group(15 eyes,axis<22 mm),74 cases in the normal axial group(80 eyes,axis 22-26 mm)and 13 cases in the long axial group(16 eyes,axis>26 mm).All groups underwent phacoemulsification and intraocular lens implantation.The operative effect,postoperative complications and ocular biological parameters of patients with different axial length were compared,and the correlation between ocular axial length and ocular biological parameters were analyzed by Spearman correlation analysis.Results The anterior chamber depth was increased in all 3 groups(all P<0.05).The best corrected visual acuity after surgery improved,the corneal curvature,intraocular pressure and corneal endothelial cell density were all decreased(all P<0.05).The incidence of complications in short axis group,the normal axis group and the long axis group were 93.33%(14/15),3.75%(3/80)and 18.75%(3/16),respectively.The complication rate of corneal epithelial abrasion,iris tear/lens injury and corneal edema in the short axis group were higher than that of the normal axis group and that of the long axis group(χ^(2)=22.01,P<0.001;χ^(2)=33.36,P<0.001;χ^(2)=20.23,P<0.001).Preoperative axial length was negatively correlated with the best corrected visual acuity and lens diopter after surgery(r=-0.22,P=0.021;r=-0.89,P<0.001),was positively correlated with anterior chamber depth and corneal endothelial cell density(r=0.60,P<0.001;r=0.19,P=0.042).Conclusion There are correlations between different axial length and lens diopter,best corrected visual acuity,anterior chamber depth and corneal endothelial cell density in cataract patients after phacoemulsification.Axial length of eye is negatively correlated with best corrected visual acuity and lens diopter,while positively correlated with anterior chamber depth and corneal endothelial cell density.The likelihood of postoperative complications of patients is greater with axial length<22 mm than with axial length≥22 mm.