扫频OCTCASIA2测量白内障患者术前晶状体与术后人工晶状体偏心和倾斜的相关性

目的：应用眼前节扫频OCT CASIA2研究白内障患者术前晶状体和术后人工晶状体（IOL）偏心和 倾斜的相关性。方法：自身对照研究。纳入2020年3月至7月于川北医学院附属医院接受白内障手 术的患者109例（157眼），其中右眼80眼，左眼77眼，年龄为48~88（69.8±9.1）岁。应用CASIA2 于白内障手术前、术后1周测量散瞳前、后晶状体和IOL的偏心和倾斜，3次测量并取其矢量平均 值。采用Pearson相关分析术后IOL与术前晶状体相同指标间的相关性。结果：在散瞳前，白内障 患者右眼术后IOL偏心量与术前晶状体无相关性，术后IOL偏心轴向、倾斜度及倾斜轴向与术前 晶状体的相同指标均分别呈正相关（r=0.48, P<0.001; r=0.53, P<0.001; r=0.36, P=0.002）；左眼术后 IOL偏心量与术前晶状体同样无相关性，术后IOL倾斜度与术前晶状体的倾斜度呈中等强度相关 性（r=0.44, P＜0.001），术后IOL偏心轴向、倾斜轴向与术前晶状体的相同指标分别呈较强相关性 （r=0.62, P<0.001; r=0.91, P<0.001）。散瞳后测量，右眼术后IOL偏心量与术前晶状体呈弱相关性 （r=0.26, P=0.024），右眼术后IOL偏心轴向、倾斜度和倾斜轴向与术前晶状体的相同指标均分别成正 相关性（r=0.34, P=0.004; r=0.56, P<0.001; r=0.36, P=0.002）；左眼术后IOL偏心量与术前晶状体无相 关性，左眼术后IOL与术前晶状体的偏心轴向、倾斜度及倾斜轴向均分别呈较强的正相关性（r=0.64, P=0.010; r=0.55, P<0.001; r=0.93, P<0.001）。结论：除偏心量外，CASIA2测量白内障患者术后IOL 和术前晶状体的偏心轴向、倾斜度和倾斜轴向均分别呈正相关，且倾斜轴向的相关性最高。临床可 参考白内障术前晶状体的偏心和倾斜，为患者选择更合适的IOL。

Correlation of Decentration and Tilt between Crystalline Lens and Intraocular Lens Measured by Swept-Source Ocular Coherence Tomography CASIA2

Objective: To measure the correlation of decentration and tilt between crystalline lens and intraocular lens (IOL) in cataract patients with anterior segment swept-source ocular coherence tomography (SS-OCT)CASIA2. Methods: A self-control design was carried out in this study. One hundred and fifty-seven eyes of 109 cataract patients who underwent cataract surgery in Affiliated Hospital of North Sichuan Medical College from March to July in 2020 were included. The age ranged from 48 to 88 years (69.8±9.1). CASIA2 was used to measure the decentration and tilt of crystalline lens for three consecutive times under non-mydriatic and mydriatic conditions respectively, and to measure the decentration and tilt of IOL for three times one week after cataract surgery; vector averages of the three measures were calculated. Pearson correlation analysis was used to detect the correlation between preoperative crystalline lens and postoperative IOL. Results: There was no correlation in the decentration between IOL and crystalline lens in the right eyes under non-mydriatic condition, while there was a positive correlation in the axis of decentration, tilt and the axis of tilt (r=0.48, P<0.001; r=0.53, P<0.001; r=0.36, P=0.002). In the left eyes, there was no correlation in the decentration between IOL and crystalline lens, while moderate correlation in tilt (r=0.44, P<0.001) and robust correlation in the axis of decentration and tilt (r=0.62, P<0.001; r=0.91, P<0.001) were found. After mydriasis, there was a poor correlation in decentration (r=0.26, P=0.024), and positive correlation in the axis of decentration, tilt and the axis of tilt (r=0.34, P=0.004; r=0.56, P<0.001; r=0.36, P=0.002). There was no correlation in decentration between IOL and crystalline lens in the left eyes, while there was a strongly positive correlation in the axis of decentration, tilt and the axis of tilt (r=0.64, P=0.010; r=0.55, P<0.001; r=0.93, P<0.001). Conclusions: Except for decentration, there was a positive correlation in the axis of decentration, tilt and the axis of tilt between IOL and crystalline lens in cataract patients measured by CASIA2. The most robust correlation was found in the axis of tilt. A more appropriate IOL could be selected for patients by referring to the decentration and tilt of crystalline lens before cataract surgery