摘要
目的 观察高度近视并发白内障患者术后角膜曲率变化情况及视力影响因素。方法 回顾分析2016年1月-2022年1月在我院治疗的43例高度近视并发白内障患者的临床资料,比较手术前后视力、角膜曲率变化情况;术后早期依据矫正视力,将患者分为视力良好患者(矫正视力≥0.3)和低视力患者(矫正视力<0.3),采用单因素和多因素Logistic回归分析高度近视白内障术后早期视力恢复的影响因素。结果 患者术后视力高于术前(P<0.05);手术前后患者前表面中心、鼻上、鼻下、颞上、颞下和后表面中心、鼻下、颞上、颞下方角膜曲率比较,差异无统计学意义(P>0.05),术后患者后表面鼻上方角膜曲率大于术前(P<0.05);低视力患者年龄、术前视力等级、近视时间、眼轴长度、角膜散光度、玻璃体后脱离、后巩膜葡萄肿、合并黄斑病比例与视力良好患者比较,差异有统计学意义(P<0.05);二者角膜屈光度、性别比较,差异无统计学意义(P>0.05);多因素非条件Logistic回归分析显示,术前视力低等级、眼轴长度、角膜散光度、合并后巩膜葡萄肿、合并黄斑病是影响高度近视并发白内障患者术后视力的独立危险因素(P<0.05)。结论 高度近视并发白内障患者行超声乳化术治疗可提高患者视力,改善鼻上方角膜曲率。而术前视力等级、眼轴长度、角膜散光度、合并后巩膜葡萄肿、合并黄斑病是影响患者术后视力的危险因素,临床术前应进行眼底、角膜曲率相关检查,以确保手术效果。
Objective To observe the changes of corneal curvature and visual acuity in patients with high myopia complicated with cataract.Methods The clinical data of 43 patients with high myopia complicated with cataract treated in our hospital from January 2016 to January 2022 were retrospectively analyzed. The changes of visual acuity and corneal curvature before and after operation were compared. According to the corrected visual acuity, the patients were divided into good vision group(corrected visual acuity ≥0.3) and low vision group(corrected visual acuity <0.3).Univariate and multivariate Logistic regression were used to analyze the influencing factors of early visual acuity recovery after cataract surgery for high myopia.Results The postoperative visual acuity was higher than that before operation(P<0.05), there was no significant difference in corneal curvature among anterior surface center, superior nasal, inferior nasal, superior temporal, inferior temporal and posterior surface center, inferior nasal,superior temporal and inferior temporal before and after operation(P>0.05). The postoperative corneal curvature above the nasal surface was greater than that before surgery(P<0.05). There were significant differences in age, preoperative visual acuity, myopia time, axial length, corneal astigmatism,posterior vitreous detachment, posterior scleral staphyloma and macular disease between the patient with low vision and the good vision( P<0.05), and there was no significant difference in corneal diopter and gender between them(P>0.05). Multivariate unconditional Logistic regression analysis showed that low preoperative visual acuity, axial length, corneal astigmatism, posterior scleral staphyloma and macular disease were independent risk factors for postoperative visual acuity in patients with high myopia complicated with cataract(P <0.05).Conclusion Phacoemulsification can improve the visual acuity and corneal curvature above the nose in patients with high myopia complicated with cataract. Preoperative visual acuity, axial length,corneal astigmatism, posterior scleral staphyloma, and macular disease are risk factors affecting postoperative visual acuity. Fundus and corneal curvature should be examined before surgery to ensure surgical results.
作者
魏星
WEI Xing(Department of Ophthalmology,Dafeng People's Hospital,Yancheng 224100,Jiangsu,China)
出处
《医学信息》
2023年第2期120-123,共4页
Journal of Medical Information
关键词
高度近视
白内障
视力
超声乳化术
角膜曲率
High myopia
Cataract
Vision
Ultrasonic emulsification
Corneal curvature
