前房深度对人工晶状体位置影响的研究

目的探讨前房深度对人工晶状体位置的影响。方法回顾性研究。收集广州爱尔眼科医院2018年1月至12月行飞秒激光辅助白内障超声乳化人工晶状体植入术119例(134眼)的临床资料。据术前前房深度,本组患者分成3组:浅前房组(A组),48例(55眼),前房深度<2.5 mm;正常前房深度组(B组),50例(52眼),前房深度2.5~3.0 mm;深前房组(C组),23例(27眼),前房深度>3.0 mm。术后随访1个月。分析各组术后前房深度变化、屈光度变化与术前前房深度之间的关系,术前IOL屈光度预留与术前前房深度间的关系。结果术后1周,A组前房深度加深了(1.77±0.62)mm;B组加深了(1.33±0.42)mm;C组加深了(1.34±0.50)mm。术后1周及1个月,A组与B组,A组与C组间前房深度加深程度的差异有统计学意义(均P<0.05),B组与C组比较差异无统计学意义(均P>0.05)。术后屈光度变化A组呈远视漂移,B组及C组呈近视漂移。结论在超声乳化手术中,术前浅前房患者人工晶状体位置的变化最大,随着时间延长,人工晶状体位置后移,表现远视漂移。浅前房时人工晶状体屈光度选择应该在计算结果的基础上增加+0.50D~+0.75 D,正常深度前房及深前房可按常规选择。

Study on the effect of anterior chamber depth on the position of intraocular lens

Objective To investigate the effect of anterior chamber depth(ACD)on intraocular lens(IOL)position.Methods This was a retrospective study.The clinical data of 134 eyes of 119 cases with femtosecond laser-assisted phacoemulsification and IOL implantation from Jan.to Dec.2018 in Guangzhou Aier Eye Hospital were collected.Based on the preoperative ACD,the patients were divided into 3 groups:group A with 55 eyes of 48 cases,shallow anterior chamber group(ACD<2.5 mm);group B with 52 eyes of 50 cases,normal deep anterior chamber group(2.5≤ACD≤3.0 mm);group C with 27 eyes of 23 cases,deep anterior chamber group(ACD>3.0 mm).The follow up time was 1 month after surgery.The relationship between postoperative ACD change,diopter change and preoperative ACD in each group were analyzed,and the relationship between preoperative IOL diopter reserve and preoperative ACD was discussed.Results At 1 week after surgery,the ACD in group A was deepened by(1.77±0.62)mm,which was deepened by(1.33±0.42)mm in group B;which was deepened by(1.34±0.50)mm in group C.At 1 week and 1 month after the surgery,the difference in the degree of ACD deepening between group A and group B,group A and group C was statistically significant(all P<0.05),and the difference between group B and group C was not statistically significant(all P>0.05).After the diopter change,group A showed hyperopia shift,group B and group C showed myopia shift.Conclusion In phacoemulsification surgery for cataract,preoperative shallow anterior chamber patients have the largest change on the position of the intraocular lens.As time goes by,the position of the intraocular lens is shift,the performance of hyperopia shift.In shallow anterior chamber,the choice of intraocular lens diopter should be increased by+0.50D-+0.75 D on the basis of the calculated results.Normal ACD and deep chamber can be selected as usual.