超高度近视眼屈光力及眼轴影响因素分析

目的 研究超高度近视患者屈光力及眼轴影响因素,并分析超高度近视患者易发青光眼的危险因素.方法 选取216例(354眼)受试者按照屈光力不同分成3组AA组260眼(＞-9.00～12.00 D)、B组75眼(＞-12.00～15.00 D)、C组19眼(＞-15.00D),对其屈光力、眼轴长度(axial length,AL)、前房深度(anterior chamber depth,ACD)、前房角(anterior chamber angle,ACA)、中央角膜厚度(central corneal thickness,CCT)、眼压(intraocular pressure,IOP)等相关眼部参数进行测量,分析各参数之间的相互关系.结果 超高度近视眼等效球镜度数(spherical equivalent,SE)与AL、角膜最大屈光力(K2)、年龄之间呈负相关(均为P＜0.05),与ACD及ACA之间呈正相关(均为P＜0.05).AL与Goldmann眼压值(Goldmann-correlated IOP value,IOPg)、角膜代偿的眼压值(corneal compensated intraoeular pressure,IOPcc)和年龄之间呈正相关关系(均为P＜0.001),而与角膜最小屈光力(K1)、K2之间呈显著负相关关系(均为P＜0.001).IOPcc与K1、K2呈显著负相关关系(均为P＜0.001)；IOPg与GCT和AL呈显著正相关关系(均为P＜0.001),而与K1、K2呈负相关关系(均为P＜0.05).ACD与ACA、IOPg之间,ACA与IOPg、IOPcc之间均呈正相关关系(均为P ＜0.05).B组的SE与IOPcc呈显著负相关关系(P＜0.01).影响超高度近视眼屈光力的主要因素为SE、AL、K2及ACD,而影响AL的主要因素为K1、K2、IOPg及年龄.结论 AL延长是超高度近视眼发展的重要影响因素,AL越长近视越严重,而IOP可以通过影响AL而影响超高度近视眼的屈光力,从而加快超高度近视的发展.

Affecting factors of diopter and axis of super-high myopia

Objective To study the factors affecting diopter and axis of super-high myopia,and investigate the risk factors of glaucoma in super-high myopia.Methods A total of 216 cases (354 eyes) were chosen,based on the diopter,all patients were divided into group A(from -9.00 D to -12.00 D,260 eyes),group B(from -12.25 D to -15.00 D,75 eyes)and group C(less than -15.00 D,19 eyes).The diopter,axial length (AL),anterior chamber depth (ACD),anterior chamber angle (ACA),central corneal thickness (CCT),intraocular pressure (IOP) were measured.The linear correlation among these factors was analyzed.Results The spherical equivalent (SE) of super-high myopia was negative correlated with AL,maximum of corneal diopter (K2) and age(both P<0.05),while positive correlated with ACD and ACA(both P<0.05).AL was positive correlated with Goldmann-correlated IOP (IOPg),corneal compensated IOP (IOPcc) and age(both P<0.01),while negative correlated with minimum of corneal diopter (K1) and K2(both P<0.001).IOPcc was negative correlated with K1 and K2(both P<0.001).IOPg was positive correlated with CCT and AL(both P<0.001),while positive correlated with K1 and K2(both P<0.05).ACD was positive correlated with ACA and IOPg(both P<0.05).ACA was positive correlated with IOPg and IOPcc (both P<0.05).SE was negative correlated with IOPcc in group B(P<0.01).The significant factors affecting diopter of super-high myopia were SE,AL,K2 and ACD.The significant factors affecting axis of super-high myopia were K1,K2,IOPg and age.Conclusion The growth of AL is the most important factor for development of super-high myopia.The more long the AL,the more severe the myopia.IOP affect diopter of super-high myopia by affecting AL and speed up the development of super-high myopia.