原发性急性闭角型青光眼合并白内障超乳术后的屈光误差及其相关影响因素  

Analysis of the refraction error and the influencing factors after phacoemulsification in acute primary angle-closure glaucoma with cataract

作　　者：邓水凤 庞柏林 廖锐[1] 文勇强 张碧玉[1] 周秀婵[1] Shui-Feng Deng;Bo-Lin Pang;Rui Liao;Yong-Qiang Wen;Bi-Yu Zhang;Xiu-Chan Zhou(Department of Ophthalmology,The Third Hospital of Huizhou,Huizhou 516000,Guangdong Province,China)

机构地区：[1]中国广东省惠州市第三人民医院眼科,516000

出　　处：《国际眼科杂志》2018年第8期1488-1491,共4页International Eye Science

摘　　要：目的:对比原发性急性闭角型青光眼(acute primary angel-closure glaucoma,APACG)合并白内障患者及单纯白内障患者行PHACO+IOL术后3mo的屈光误差(refraction error,RE),并分析影响两组术后屈光误差相关的眼球生物学参数(眼轴、角膜曲率、前房深度)。方法:前瞻性、非随机性病例对照研究。APACG合并白内障组为试验组,单纯白内障组为对照组,每组各30例30眼,测量眼压、眼轴长度、角膜曲率、前房深度,利用SRK-Ⅱ公式计算预留屈光度。以术后3mo的主觉验光结果作为术后屈光度,减去术前预留屈光度,即为屈光误差(RE,<-0.50D或>+0.50D;-0.50～+0.50D不认为存在屈光误差)。采用独立样本t检验比较两组间屈光误差的差别及比较两组间的相关参数如眼轴、角膜曲率、前房深度的差异,采用配对样本t检验分别比较两组术前术后相关参数如眼轴、角膜曲率、前房深度的差异。结果:白内障组术后的平均屈光误差为-0.46±0.46D,其中近视性屈光误差共24例(80%),远视性屈光误差共6例(20%);APACG组术后的平均屈光误差为+0.56±0.79D,其中近视性屈光误差共9例(30%),远视性屈光误差共21例(70%),两组术后屈光误差的差异具有统计学意义(P<0.05)。两组内的术前术后生物参数比较:白内障组术前眼轴长度23.55±0.47mm,术后23.56±0.48mm,眼轴长度变化差异无统计学意义(P>0.05);APACG组术后的眼轴长度21.52±0.54mm,较术前的眼轴长度(21.71±0.46mm)变短,差异有统计学意义(P<0.05)。白内障组术后前房深度4.09±0.38mm,较术前前房深度(2.71±0.24mm)明显增加,差异有统计学意义(P<0.05);APACG组术后的前房深度3.55±0.35mm,较术前前房深度(1.90±0.23mm)明显增加,差异有统计学意义(P<0.05)。白内障组术前平均角膜曲率43.93±0.95D,术后43.92±0.95D,平均角膜曲率变化差异无统计学意义(P>0.05);APACG组术前平均角膜曲率44.71±0.84D,术后44.70±0.9D,平均角膜曲率变化差�AIM： To compare the refraction error（ RE） 3 mo after phacoemulsification combined with intraocular lens implantation（ PHACO＋IOL） between patients with acute primary angle-closure glaucoma（ APACG） with cataract（ APACG group） and patients with simple cataract（ cataract group）,and the biological parameters of the eye（ axial length,corneal curvature,anterior chamber depth） associated with the postoperative RE in the APACG and cataract groups.METHODS： This was a prospective,non-randomized,case-control study. Each group had 30 cases（ 30 eyes）.Intraocular pressure,axial length,corneal curvature,and anterior chamber depth were measured. The reserved refractive power was calculated using the SRK-II formula.Three months postoperatively, subjective RE was calculated as the postoperative refractive power which subtracted the preoperative reserved diopter（ RE was considered as -0. 50 D or ＋0. 50 D;-0. 50 D to ＋0. 50 D not considered as RE）. An independent sample t-test was used to compare the difference in RE between the two groups and to compare the differences among relevant parameters such as axial length,corneal curvature,and anterior chamber depth. Paired t-test was used to compare preoperative and postoperative parameters such as axial length, corneal curvature, and difference in anterior chamber depth.RESULTS： Mean RE in the cataract group was-0. 46 D±0. 46 D,with 24 cases of myopic RE（ 80%） and 6 cases of hyperopic RE（ 20%）. Mean RE in the APACG group was＋0. 56 D±0. 79 D,with 9 cases of myopic RE（ 30%） and 21 cases of hyperopic RE（ 70%）. The difference in RE between the two groups was statistically significant（ P〈0. 05）. On comparison of pre-and postoperative biological parameters of the two groups,in the cataract group,there was a non-significant difference in pre-and postoperative axial length（ 23. 55±0. 47 mm versus 23. 56±0. 48 mm,respectively; P〉0. 05）. In the APACG group,pre-and postoperative axial length was 21. 71±0. 46 mm and 21. 5

关 键 词：原发性闭角型青光眼 屈光误差 白内障超声乳化吸除 

分 类 号：R779.6[医药卫生—眼科]