眼科

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白内障手术前后眼轴和屈光状态的变化

郁琪华  邬一楠  沈降   

  1. 315040 浙江省宁波市眼科医院
  • 收稿日期:2015-06-12 出版日期:2016-03-25 发布日期:2016-03-24
  • 通讯作者: 郁琪华,Email: yqh791130@163.com

The changes in axial length and refraction before and after cataract surgery

YU Qi-hua, WU Yi-nan, SHEN Jiang   

  1. Ningbo Eye Hospital, Ningbo  Zhejiang 315040, China
  • Received:2015-06-12 Online:2016-03-25 Published:2016-03-24
  • Contact: YU Qi-hua, Email: yqh791130@163.com

摘要:

 目的 比较白内障手术前后眼轴及屈光状态的变化,以期指导术后配镜时间选择及术后屈光度的预留。设计 前瞻性病例系列。研究对象 白内障超声乳化摘除联合人工晶状体植入术患者30例(37眼)。方法 根据术前眼轴长度将患者分为两组,超长眼轴组15例(17眼),眼轴长度29.71~32.89 mm,普通眼轴组15例(20眼),眼轴长度22.16~25.54 mm。应用相干光生物测量仪(IOL Master)测量术前,术后1天、1周、1个月、3个月的眼轴长度,并在术后1周、1个月、3个月同时进行验光,比较各个时间眼轴长度及屈光度的变化。采用随机区组设计的方差分析进行统计学分析。主要指标 眼轴长度,屈光度。结果 超长眼轴组患者术后3个月眼轴(30.60±0.88)mm,较术前(31.07±1.02)mm短(P=0.000)。普通眼轴组患者术后3个月眼轴(23.37±0.75)mm,较术前(23.51±0.78)mm短(P=0.000)。超长眼轴组患者术后1个月眼轴(30.61±0.90)mm与术后3个月眼轴(30.60±0.88)mm比较差异无统计学意义(P=0.683);普通眼轴组患者眼轴在术后1周(23.38±0.79)mm、术后1个月(23.38±0.78)mm、术后3个月(23.37±0.75)mm间比较无统计学意义(P=0.750)。超长眼轴组患者术后1天等效球镜度数(-3.78±0.68)D,较术后1个月(-3.01±0.55)D高(P=0.000),术后1个月与3个月(-3.03±0.54)D比较差异无统计学意义(P=0.563)。普通眼轴组患者术后1天等效球镜(-0.53±0.10)D,较1周(-0.40±0.07)D高(P=0.013),术后1周、术后1个月(-0.42±0.11)D、术后3个月(-0.41±0.08)D比较差异无统计学意义(P=0.502)。结论 白内障超声乳化摘除联合人工晶状体植入术后眼轴不同程度缩短,超高度近视眼尤其明显。超高度近视眼的眼轴和屈光状态术后1个月达到稳定,而普通眼的眼轴和屈光状态术后1周即可达到稳定。(眼科,2016,25: 90-93)

关键词: 白内障/外科学, 眼轴长度, 屈光状态, IOL Master

Abstract:

 Objective To compare axial length and refraction before and after cataract surgery. To guide on the spectacle prescription time and reserved refractive outcome after surgery. Design Prospective case series. Participants 30 patients (37 eyes) underwent phacoemulsification cataract extraction with IOL implantation. Methods All the patients were separated into two groups. Group of over-long axial length included 15 patients(17 eyes) with axial length 29.71~32.89 mm and group of normal axial length included 15 patients(20 eyes) with axial length 22.16~25.54 mm. The axial length was measured by IOLMaster preoperatively and postoperatively at 1 day, 1 week, 1 month, 3 months. Refraction was also measured at 1 week, 1 month and 3 months after surgery. All the data were analyzed in the randomized block design with the SPSS 17.0 statistical software package. Main Outcome Measures Axial length and refraction. Results The axial length in group of over-long axial length was (31.07±1.02)mm preoperatively and was(30.60±0.88)mm 3 months postoperatively, and the difference was statistically significant. The axial length in group of normal axial length was(23.51±0.78)mm preoperatively and (23.37±0.75)mm 3 months postoperatively, and the difference was also statistically significant. The refraction in group  of over-long axial length was (-3.78±0.68)D 1 day postoperatively and was (-3.01±0.55)D 1 month postoperatively, and the difference was statistically significant. The refraction in group of normal axial length was (-0.53±0.10)D 1 day postoperatively and was (-0.40±0.07) D 1 week postoperatively, and the difference was also statistically significant. The difference in axial length has no statistical significance between 1 month (30.61±0.90 mm) and 3 months(30.60±0.88 mm) postoperatively in group of over-long axial length, and among 1 week(23.38±0.79 mm), 1 month(23.38±0.78 mm) and 3 months(23.37±0.75 mm) postoperatively in group of normal axial length. The difference in refraction has no statistical significance between 1 month and 3 months(-3.03±0.54)D postoperatively in group of over-long axial length, and between 1 week, 1 month(-0.42±0.11)D and 3 months(-0.41±0.08)D postoperatively in group of normal axial length. Conclusion The axial length shortened after phacoemulsification cataract extraction with IOL implantation, especially in over-long axial length eyes. The axial length and refraction both stabilized in 1 month in group of over-long axial length, while in 1 week in group of normal axial length. (Ophthalmol CHN,2016,25: 90-93)

Key words:  cataract/surgery, axial length, refracion; IOL Master