白内障超声乳化术源性散光影响因素分析  

The influencing factors of surgically induced astigmatism in phacoemulsification

作　　者：黄瑶瑶 胡宝琪 王欣 龙潭[2,3,4] 马挺[2,3,4] 王睿 HUANG Yaoyao;HU Baoqi;WANG Xin;LONG Tan;MA Ting;WANG Rui(College of Life Sciences,Northwest University,Xi’an 710069;The First Affiliated Hospital of Northwest University,Xi’an 710002;Xi’an No.1 Hospital,Xi’an 710002;Shaanxi Institute of Ophthalmology,Xi’an 710002;Department of Ophthalmology,The First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061,China)

机构地区：[1]西北大学生命科学学院,陕西西安710069 [2]西北大学附属第一医院,陕西西安710002 [3]西安市第一医院,陕西西安710002 [4]陕西省眼科研究所,陕西西安710002 [5]西安交通大学第一附属医院眼科,陕西西安710061

出　　处：《西安交通大学学报（医学版）》2023年第2期263-270,共8页Journal of Xi’an Jiaotong University（Medical Sciences）

基　　金：国家自然科学基金资助项目(No.81902014)。

摘　　要：目的观察白内障超声乳化术源性散光(surgically induced astigmatism,SIA)的影响因素。方法对2021年12月-2022年3月的69例具有角膜规则散光的白内障患者进行白内障超声乳化手术,术后观测以角膜顶点为中心3 mm、5 mm、7 mm直径范围内的角膜前表面、后表面以及角膜前表面的模拟角膜屈率(Sim K)的SIA,使用矢量分析计算XSIA、YSIA和SIA均值(|SIA|),并对SIA与年龄、眼轴长度(axial length,AL)、前房深度(anterior chamber depth,ACD)、角膜直径(white-to-white,WTW)、中央角膜厚度(central corneal thickness,CCT)使用Pearson相关性分析,使用多元线性回归进行SIA影响因素的分析。结果69例患者的平均年龄为(63.25±14.74)岁,其中男性28例(40.58%)。分析发现,Sim K的|SIA|与WTW呈负相关(r=-0.265,P=0.028);3 mm、5 mm、7 mm前表面|SIA|与WTW呈负相关(r=-0.320,P=0.007;r=-0.337,P=0.005;r=-0.287,P=0.017);3 mm、5 mm、7 mm后表面|SIA|与AL呈负相关(r=-0.390,P=0.001;r=-0.352,P=0.003;r=-0.317,P=0.008)。多元回归分析结果显示,WTW与Sim K、3 mm、5 mm、7 mm前表面及3 mm后表面的|SIA|呈负相关(B=-0.261,P=0.047;B=-0.387,P=0.016;B=-0.323,P=0.009;B=-0.297,P=0.041;B=-0.085,P=0.049),而与3 mm前表面XSIA、5 mm、7 mm前表面YSIA呈正相关(B=0.347,P=0.040;B=0.318,P=0.034;B=0.403,P=0.010);AL与3 mm、5 mm后表面的|SIA|呈负相关(B=-0.023,P=0.021;B=-0.034,P=0.030)。结论在进行白内障超声乳化手术时,应考虑患者的眼部生物参数,如眼轴长度、角膜直径等对SIA的影响。Objective To investigate the influencing factors of surgically induced astigmatism(SIA)in phacoemulsification.Methods Cataract phacoemulsification was performed in 69 patients with regular corneal astigmatism from December 2021 to March 2022.SIA of the anterior corneal surface,posterior corneal surface and simulated keratometry(Sim K)in the diameter range of 3 mm,5 mm and 7 mm centered at the apex of the cornea was observed.Pearson correlation analysis was used to analyze SIA with age,axial length(AL),anterior chamber depth(ACD),white-to-white(WTW),and central corneal thickness(CCT).Multiple linear regression was used to analyze the influencing factors of SIA.Results The mean age of the 69 patients was(63.25±14.74)years old,and 28(40.58%)were male.The analysis found that the|SIA|of Sim K wasnegatively correlated with WTW(r=-0.265,P=0.028),the|SIA|of 3 mm,5 mm,7 mm anterior surface was negatively correlated with WTW(r=-0.320,P=0.007;r=-0.337,P=0.005;r=-0.287,P=0.017),and the|SIA|of 3 mm,5 mm,7 mm posterior surface was negatively correlatedwith AL(r=-0.390,P=0.001;r=-0.352,P=0.003;r=-0.317,P=0.008).Multiple regression analysis showed that WTW was negatively correlated with|SIA|of SimK,3 mm,5 mm,7 mm anteriorsurface and 3 mm posterior surface(B=-0.261,P=0.047;B=-0.387,P=0.016;B=-0.323,P=0.009;B=-0.297,P=0.041;B=-0.085,P=0.049).WTW was positively correlated with XSIA of 3 mm anterior surface,YSIA of 5 mm,and 7 mm anterior surface(B=0.347,P=0.040;B=0.318,P=0.034;B=0.403,P=0.010).AL was negatively correlated with|SIA|on the posterior surface of 3 mm and 5 mm(B=-0.023,P=0.021;B=-0.034,P=0.030).Conclusion During cataract surgery,the effect of ocular biological parameters such as axial length and corneal diameter on SIA should be considered.

关 键 词：白内障超声乳化 术源性散光 角膜后表面 眼轴长度 角膜直径 

分 类 号：R778.1[医药卫生—眼科]