高度近视白内障患者行超声乳化技术联合人工晶体植入术后眼轴变化及视觉质量分析

目的探讨高度近视白内障患者行超声乳化技术(PHACO)联合人工晶体(IOL)植入术后眼轴变化及视觉质量。方法前瞻性选取2017年10月至2019年5月北京市平谷区医院收治的高度近视白内障患者83例为研究对象。根据随机数字表法分为研究组42例(54眼)与对照组41例(51眼),研究组采取PHACO-IOL术治疗,对照组采取白内障囊外摘除联合IOL植入术治疗。观察2组患者视力恢复情况,术前、术后1周、术后3个月及术后1年眼轴长度,术前及术后2周视力质量。结果研究组术后视力在0.5~0.6及1.0~1.5所占人数比为50.00%、11.11%,显著高于对照组的23.52%、0,而在<0.1、0.1~0.4所占人数比为16.6%、22.2%,明显低于对照组的37.25%、39.21%,差异均有统计学意义(P<0.05)。研究组与对照组术前、术后1周、3月及术后1年眼轴长度变化比较差异无统计学意义(P>0.05)。术后2周,2组患者夜间视物、看电视、阅读书写及精细操作评分均较术前升高,且研究组术后上述评分(2.83±1.25)、(3.05±1.18)、(2.83±1.05)、(2.97±1.20)分]均显著高于对照组(1.76±0.74)、(2.11±0.86)、(1.83±0.56)、(1.92±1.02)分],差异均有统计学意义(P<0.05)。结论对高度近视白内障患者行PHACO联合IOL术能促进患者术后视力恢复,改善视觉质量,且不增长眼轴长度,是较为理想的治疗手段。

Axial changes and visual quality of patients with high myopia and cataract after phacoemulsification combined with intraocular lens implantation

Objective To investigate the axial changes and the visual quality of patients with high myopia and cataract after phacoemulsification(PHACO)combined with intraocular lens(IOL)implantation.Methods A total of 83 patients with high myopia and cataract who were admitted to Beijing Pinggu District Hospital from October 2017 to May 2019 were prospectively selected and randomly divided into study group(42 cases,54 eyes)and control group(41 cases,51 eyes).The study group was treated with PHACO-IOL,and the control group was treated with extracapsular cataract extraction combined with IOL implantation.Visual recovery,axial length before operation,1 week after operation,3 months after operation,and 1 year after operation and visual quality at 3 days before operation and 2 weeks after operation of the two groups of patients were observed.Results The percentage of patients at recovery detection of postoperative visual acuity in terms of 0.5-0.6,1.0-1.5 in the study group were 50.00%,11.11%,much higher than those of the control group 23.52%,0,while in terms of<0.1,0.1-0.4 were 16.6%and 22.2%,much lower than those of the control group 37.25%,39.21%,the differences were statistically significant(P<0.05).There was no significant difference in the ocular axial length between the study group and the control group before operation,1 week after operation,3 months after operation,and 1 year after operation(P>0.05).Two weeks after the operation,night vision,TV,reading and writing,and fine workmanship scores of the two groups were significantly increased,and the scores above of study group(2.83±1.25),(3.05±1.18),(2.83±1.05),(2.97±1.20)scores]were higher than those in the control group(1.76±0.74),(2.11±0.86),(1.83±0.56),(1.92±1.02)scores],the differences were statistically significant(P<0.05).Conclusion PHACO combined with IOL surgery for patients with high myopia and cataract can promote postoperative vision recovery and improve visual quality without increasing the ocular axial length,which is an ideal treatment.