年龄相关性白内障患者眼轴长度与角膜曲率、角膜散光、前房深度和眼压的关系

目的 探讨年龄相关性白内障患者眼轴长度与角膜曲率、角膜散光、前房深度和眼压的关系.方法 本次研究对象为在武汉大学中南医院行白内障手术的年龄相关性白内障患者368例(368眼).患者的眼轴长度、角膜曲率、角膜散光和前房深度均应用IOL-Master(德国蔡司公司)进行测量,眼压采用iCare眼压计测量.使用随机抽样法从不同眼轴长度患者中随机抽出80例(80眼),分别为短眼轴组、中眼轴组和长眼轴组.各组间比较采用单因素方差分析.眼轴长度和角膜曲率、角膜散光、前房深度及眼压的关系采用Spearman相关分析.结果 眼轴长度与角膜曲率(r=-0.424,P＜0.001)、眼轴长度与角膜散光(r=0.138,P=0.008)、眼轴长度与前房深度(r=0.561,P＜0.001)均相关.其中,眼轴长度与角膜曲率呈负相关,与角膜散光和前房深度呈正相关,但与角膜散光相关性较弱,而与角膜曲率和前房深度中度相关.眼轴长度与眼压无相关性(r =0.064,P=0.326).中眼轴组和长眼轴组角膜曲率与短眼轴组比较,差异均有统计学意义(均为P＜0.001);而中眼轴组与长眼轴组差异无统计学意义(P =0.438).中眼轴组与短眼轴组的角膜散光差异无统计学意义(P=0.333),同样中眼轴组与长眼轴组的角膜散光差异亦无统计学意义(P =0.718),但是短眼轴组与长眼轴组的角膜散光差异有统计学意义(P =0.042).短眼轴组的前房深度与中眼轴组(P=0.001)和长眼轴组(P＜0.001)比较差异均有统计学意义,中眼轴组与长眼轴组的前房深度差异亦有统计学意义(P ＜0.001).3组眼压两两比较差异均无统计学意义(均为P＞0.05).结论 角膜曲率与眼轴长度呈负相关;角膜散光与眼轴长度相关性弱,只有眼轴长度明显增长,才有可能表现出角膜散光度数增加;前房深度与眼轴长度中等相关,并随眼轴增长而加深;眼轴长度与眼压无相关性.

Effects of axial length on corneal curvature,corneal astigmatism,anterior chamber depth and intraocular pressure in age-related cataract

Objective To investigate the influence of different axial lengths (AL) on corneal curvature (CC),corneal astigmatism (CA),anterior chamber depth (ACD) and intraocular pressure (IOP) in age-related cataract.Methods Ocular data of 368 patients 368 eyes from Zhongnan Hospital of Wuhan University undergoing cataract surgery were retrospectively reviewed.AL,corneal curvature,corneal astigmatism and anterior chamber depth were measured using IOL-Master (Zeiss,German),and the intraocular pressure was measured using an iCare tonometer.Together 80 patients (80 eyes) selected from these patients with different AL using random number table were randomly divided into three groups,including short,moderate and long AL group.Spearman's rank test was used to assess the correlation between AL and ocular biological parameters.Each parameter was compared by one-way analysis of variance among the three groups,respectively.Results Spearman's rank test presented that AL was related with CC (r =-0.424,P ＜ 0.001),CA (r =0.138,P =0.008) and ACD (r =0.561,P ＜0.001),but there was no correlation of AL with IOP (r =0.064,P =0.326).The AL was negatively correlated with CC,positively correlated with CA and ACD,but there was weak correlation between AL and CA,as well as moderate correlation of AL with CC and ACD.The CC of the moderate and long AL group was significantly different from that of the short AL group (all P ＜ 0.001),but there was no significant difference between moderate and long AL group (P =0.438).Moreover,difference in CA was not statistical significant between short and moderate AL group (P =0.333) as well as between moderate and long AL group (P =0.718),but its difference approached statistical significance between short and long AL group (P =0.042).Pairwise comparison of ACD among the three groups had significant difference (all P≤0.001),but difference in IOP was not statistically significant with palrwise comparison (all P ＞ 0.05).Conclusion CC is negatively related to AL,and CA is weakly correlated to AL;meanwhile,it is possible to show that the degree of CA increases as AL gets longer.There is a moderate correlation between ACD and AL,while there is no relationship between AL and IOP.