高度近视合并白内障患者术前术后角膜散光与视力恢复的关系

doi:10.3969/j.issn.1006-6233.2021.03.015

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摘要目的探究高度近视合并白内障患者术前术后角膜散光情况,并分析其与患者术后视力恢复的关系。方法回顾性分析2017年12月至2020年7月于本院行超声乳化手术的白内障患者90例(共90只眼),根据是否合并高度近视分为非高近组(非高度近视患者)44例(44只眼),高近组(高度近视患者)46例(46只眼),所有患者均于术前、术后一周测量角膜各方位角膜曲率、前后表面角膜散光情况及视力情况。结果与术前比较,高近组患者术后后表面鼻上方角膜曲率及前、后表面角膜散光水平显著增加(P<0.05),且前、后表面散光类型差异显著(P<0.05);非高近组与高近组患者术后一周最佳矫正视力均有所好转,且与高近组比较,非高近组患者术后最佳矫正视力较优(P<0.05)。结论高度近视合并白内障患者比非高度近视合并白内障患者术后视力差、术后后表面鼻上角膜曲率大,因此对于此类患者手术中更应注意在做角膜侧切口时小心操作并熟练控制超声能量,以减少角膜后表面损伤影响手术效果。

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	黄德晗
	唐双军
	李孝慈
	葛瑞菲

关键词 ：高度近视合并白内障, 术前术后角膜散光, 视力恢复

Abstract：Objective: To investigate the corneal astigmatism in patients with high myopia and cataract before and after operation,and to analyze the relationship between corneal astigmatism and postoperative visual acuity recovery. Methods: A total of 90 cataract patients (90 eyes) who underwent phacoemulsification in our hospital from December 2017 to July 2020 were retrospectively analyzed. According to whether they had complicated high myopia,they were divided into non high myopia group (44 cases,44 eyes) and high myopia group (46 cases,46 eyes). The corneal curvature in all directions,corneal curvature,corneal astigmatism on anterior and posterior surfaces and visual acuity were measured before and one week after operation. Results: Compared with before operation,the surface curvature above the nose and the level of astigmatism on the anterior and posterior surfaces of the high myopia group were significantly increased (P<0.05),and the type of astigmatism on the anterior and posterior surfaces was significantly different (P<0.05). The corrected visual acuity was improved in both groups one week after operation,compared with those in the high myopia group; the postoperative corrected visual acuity of the non-high myopia group was better (P<0.05). Conclusion: The postoperative visual acuity of the high myopia with cataract patients is worse than that of the non-high myopia with cataract patients,and the postoperative posterior supranasal corneal curvature is larger. Therefore,to reduce the damage of corneal posterior surface,more attention should be paid to the careful operation of such patients and skillfully control the ultrasonic energy when making the corneal lateral incision.

Key words： High myopia with cataract Preoperative and postoperative corneal astigmatism Visual acuity recovery

基金资助:安徽省自然科学基金项目,(编号:1808085MH305)

引用本文:

黄德晗, 唐双军, 李孝慈, 葛瑞菲. 高度近视合并白内障患者术前术后角膜散光与视力恢复的关系[J]. 河北医学, 2021, 27(3): 425-429.
HUANG Dehan, TANG Shuangjun, LI Xiaoci, et al. An Investigation of the Relationship Between Preoperative and Postoperative Corneal Astigmatism and Visual Acuity Recovery in Patients with High Myopia and Cataract. HeBei Med, 2021, 27(3): 425-429.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2021.03.015 或 http://www.hbyxzzs.cn/CN/Y2021/V27/I3/425

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