闭角型青光眼伴白内障患者术前角膜球面像差分析  

Analysis of the corneal spherical aberration in patients with primary angle-closure glaucoma with cataract

作　　者：朱晓弘[1] 刘文洁[2] 赵军梅[1] Zhu Xiaohong;Liu Wenjie;Zhao Junmei(Department of Glaucoma,Shanxi Eye Hospital,Taiyuan 030002,China;Department of Cataract,Shanxi Eye Hospital,Taiyuan 030002,China)

机构地区：[1]山西省眼科医院青光眼科,太原030002 [2]山西省眼科医院白内障科,太原030002

出　　处：《中华眼外伤职业眼病杂志》2019年第11期813-817,共5页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的分析原发性闭角型青光眼伴白内障患者术前角膜球面像差的分布情况及其相关因素。方法回顾性系列病例研究。收集该院2018年11月至2019年3月原发性闭角型青光眼伴白内障120例(154只眼)的临床资料。以Pentacam HR眼前段分析仪进行测量和分析。结果患者年龄范围33~85岁,平均为(68.00±9.95)岁。角膜球面像差平均值为(0.35±0.16)μm,波动范围为-0.35~0.76μm。角膜球面像差与年龄呈正相关(r=0.287,P=0.000)、与角膜平均屈光力呈正相关(r=0.170,P=0.035),与角膜后表面平均屈光力呈负相关(r=-0.164,P=0.042),与角膜直径、角膜厚度、角膜体积、眼轴不具有相关性(r=-0.034、-0.149、-0.126、-0.123,P=0.681,0.066,0.119,0.134)。以残余球差(0.1±0.05)μm为目标,不同类型非球面人工晶状体(0、-0.20μm、-0.27μm)可矫正90只眼,占58.4%。结论原发性闭角型青光眼伴白内障患者术前平均角膜球差较既往报道值(+0.27μm)稍大,且波动范围大。青光眼患者术前应根据个性化的球差值以及综合评估患者瞳孔、视野、视神经损伤情况选择适合的人工晶状体。Objective To analyze the distribution and related factors of the spherical aberration in patients with primary angle-closure glaucoma and cataract.Methods Retrospective series of case study.The data of 154 eyes of 120 patients of primary angle-closure glaucoma with cataract from Nov.2018 to Mar.2019 in this hospital were analyzed.Pentacam HR anterior segment analyzer(Oculus,Germany)was used to measure and analyse datas.Results The average age of patients was(68.00±9.95)years,ranged from 33 to 85 years.The average spherical aberration was(0.35±0.16)μm,ranged from-0.35μm to 0.76μm.A positive correlation was found between spherical aberration and age(r=0.287,P=0.000),spherical aberration and mean corneal refractive power(r=0.170,P=0.035).A negative correlation was found between spherical aberration and corneal refractive power of posterior surface(r=-0.164,P=0.042).There were no correlation between spherical aberration and corneal diameter,corneal thickness,corneal volume and axis length(r=-0.034,-0.149,-0.126,-0.123,P=0.681,0.066,0.119,0.134).With residual spherical aberration(0.1±0.05)μm as the target,90 eyes(58.4%)were corrected by different aspheric IOLs(0,-0.20μm,-0.27μm).Conclusion Corneal spherical aberration in patients with primary angle-closure glaucoma and cataract is larger than that reported in other populations(+0.27μm),and with larger fluctuation range.A suitable IOL should be selected according to the preoperative comprehensive evaluation of personalized spherical aberrations,pupil,visual field and the injury of the optic nerve.

关 键 词：青光眼 白内障 像差 球面 角膜 晶状体 人工 非球面 

分 类 号：R47[医药卫生—护理学]