应用Pentacam三维眼前节分析诊断系统对白内障超声乳化术后眼前节变化与屈光飘移的相关性分析

目的　使用Ｐｅｎｔａｃａｍ三维眼前节分析诊断系统记录白内障超声乳化术后患者前房容积（ａｎｔｅｒｉｏｒｃｈａｍｂｅｒｖｏｌｕｍｅ，ＡＣＶ）、前房深度（ａｎｔｅｒｉｏｒｃｈａｍｂｅｒｄｅｐｔｈ，ＡＣＤ）及人工晶状体位置，探讨它们的变化和屈光漂移的关系。方法　在术前，术后第１天、１周、２周、１个月，使用Ｐｅｎｔａｃａｍ系统测量４０例（４０眼）白内障患者的ＡＣＶ、ＡＣＤ等，同时使用自动验光仪记录它们的角膜地形图及屈光状态。使用非参数检验方法，对收集的数据进行统计分析。结果　验光显示患者白内障术后２周屈光度为（－１．１３±１．００）Ｄ、术后１个月为（－１．３４±１．２０）Ｄ、术后３个月为（－１．２３±１．１０）Ｄ，近视度均比术后第１天显著增加（均为Ｐ＜０．０５）。Ｐｅｎｔａｃａｍ系统检查显示，白内障术后２周患者ＡＣＤ为（３．１２±０．２３）ｍｍ、ＡＣＶ为（１３１．００±４５．５７）ｍｍ３，术后１个月ＡＣＤ为（２．３７±０．２２）ｍｍ、ＡＣＶ为（１２９．００±４１．３３）ｍｍ３，术后３个月ＡＣＤ为（２．７０±０．３３）ｍｍ、ＡＣＶ为（１３１．００±４３．２７）ｍｍ３，均比术后第１天显著减少（均为Ｐ＜０．０５）。患者术后屈光度变化和ＡＣＤ变化呈正相关（ｒ１周＝０．７６，ｒ２周＝０．７８，ｒ１个月＝０．７９，ｒ３个月＝０．７５，均为Ｐ＜０．０５）。但是，患者术后屈光度变化、ＡＣＤ变化和术前ＡＣＤ的相关性均无统计学意义（（ｒ＝－０．４２、－０．５６，均为Ｐ＞０．０５）。结论白内障手术患者，术后存在屈光飘移的可能，影响术后视功能。人工晶状体植入术后早期的屈光飘移与ＡＣＤ的变化密切相关。

Correlation analysis between anterior segment changes and refractive shift after cataract phacoemulsification by Pentacam system

Objective To measure the anterior chamber volume ( ACV) , anterior chamber depth ( ACD) and position of intraocular lens in the cataract patients after phacoemulsification by Pentacam system . and analyze the correlation between anterior segment changes and refractive shift. Methods ACV. ACD. and Km ( corneal curvature ) were measured in 40 cataract patients (40 eyes) before phacoemulsification and I day , I week , 2 weeks . I month . 3 months after phacoemulsification by Pentacam system. The corneal topography and refraction were recorded by automatic optometry instrument. The data were statistically analyzed by non-parametric test. Results After medical optometry,it was showed that the average refraction was ( - 1. 13 + 1. 00 ) D at 2 weeks after surgery, ( - 1. 34 + 1. 20)D at I month after surgery and ( - 1. 23 + 1. IO)D at 3 months after surgery. There were statistically significant differences between them and the first day after surgery in the average refraction ( all P < 0. 05 ) . Pentacam system showed that the average ACD was (3. 12 + 0. 23 ) mm, the average ACV was ( 131. 00 + 45. 57) mmJ at 2 weeks after surgery , (2. 37 + 0. 22) mm , ( 129 +41. 33 ) mm3 at I month after surgery , and (2. 70 +0. 33 ) mm . ( 131. 00 + 43. 27 ) mm3 at 3 month after surgery. There was statistically significant difference between them and the first day after surgery in the ACD and ACV ( all P <0. 05 ) . The positive correlation was found between the changes of refractive power and changes of ACD ( ri week = 0. 76 , r2 weeks = 0. 78 , ri month = 0. 79 , r3 mo iths = 0. 75 , all P < 0. 05 ) , but there was no statistically significant difference in the correlation between the changes of refractive power , changes of ACD after surgery and ACD before surgery ( r = - 0. 42 , - 0. 56 . all P > 0. 05 ) . Conclusion The phenomenon of refractive drift may exists in the cataract patients after intraocular lens implantation ,will affects the visual function.which is closely related with the changes of ACD.