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[50岁以上年龄相关性白内障患者角膜散光的特征及分析]

[Characteristics and analysis of corneal astigmatism in age-related cataract patients over 50 years old].

作者信息

Pang Y L, Yuan L, Cao X G, Hou X R, Bao Y Z

机构信息

Department of Ophthalmology, Peking University People's Hospital, Eye Diseases and Optometry Institute, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, College of Optometry, Peking University Health Science Center, Beijing 100044, China.

出版信息

Zhonghua Yan Ke Za Zhi. 2020 May 11;56(5):349-355. doi: 10.3760/cma.j.cn112142-20190618-00323.

DOI:10.3760/cma.j.cn112142-20190618-00323
PMID:32450667
Abstract

To investigate the relationship between corneal astigmatism and age, axial length (AL) in age-related cataract patients over 50 years old. In this retrospective study, 1 906 eyes of 953 patients with age-related cataract were diagnosed from February 2016 to August 2016 atPeking University People's Hospital, and their demographics, preoperative AL, magnitude and meridian of the corneal astigmatism measured by IOL Master were collected. Restricted cubic splines and Spearman rank correlation coefficients were used to investigate the relationship of the magnitude of cornea astigmatism to age. Chi-square test was used to assess the relationship of the meridian of astigmatism to age, AL and the magnitude of cornea astigmatism. The patients were 410 men and 543 women. The corneal astigmatism was with-the-rule (WTR) in 570 eyes (29.91%), against-the-rule (ATR) in 1 005 eyes (52.73%) and oblique in 331 eyes (17.37%). The mean age was (72±9) years old. The medians (min, max) of AL and corneal astigmatism magnitude were 23.49 mm (19.83 mm to 33.89 mm) and 0.97 D (0.06 D to 4.65 D) in right eyes and 23.41 mm (17.54 mm to 32.09 mm) and 0.92 D (0.11 D to 4.88 D) in left eyes, respectively. The corneal astigmatism was ≥0.75 D in 64.95% (619/953) of the right eyes and 61.59% (587/953) of the left eyes. Among the elderly patients over 65 years old, when the AL was between 22.00-25.99 mm (0.186-0.279), the value of corneal astigmatism was positively correlated with age (all 0.01) in both eyes. The value of ATR corneal astigmatism was positively correlated with age (right eyes, 0.278, 0.01; left eyes, 0.225, 0.01), while the value of WTR corneal astigmatism had no statistically significant correlation with age (right eyes, 0.335; left eyes, 0.633). The prevalence of WTR astigmatism decreased with age from 43.81% (46/105) to 20.73% (51/246) in right eyes and from 40.00% (42/105) to 24.80% (61/246) in left eyes, while the prevalence of ATR astigmatism increased with age from 38.10% (40/105) to 61.38% (151/246) in right eyes and from 33.33% (35/105) to 58.94% (145/246) in left eyes. The prevalence of oblique astigmatism was not significantly changed with age (right eyes, χ(2)=31.986, 0.01; left eyes, χ(2)=27.686, 0.01). There was no statistically significant difference in the distribution of corneal astigmatism meridians between different AL groups (right eyes, 0.497; left eyes, 0.897). With the increase of the magnitude of corneal astigmatism, the prevalence of oblique astigmatism significantly decreased from 25.45% (85/334) to 0 in right eyes and from 29.78% (109/366) to 1.35% (1/74) in left eyes, while the prevalence of ATR astigmatism significantly increased from 39.82% (133/334) to 79.27% (65/82) in right eyes and from 41.80% (153/366) to 59.46% (44/74) in left eyes (right eyes, χ(2)=72.229, 0.01; left eyes, χ(2)=72.166, 0.01). A majority of age-related cataract patients over 50 years old have astigmatism ≥0.75 D before cataract surgery. When the AL is between 22.00 mm and 25.99 mm, the magnitude of corneal astigmatism increases with age among people over 65 years old, especially the magnitude of ATR corneal astigmatism, while the magnitude of WTR corneal astigmatism has no obvious increase with age. The percentage of ATR astigmatism increases while the percentage of WTR astigmatism decreases with age. -.

摘要

为研究50岁以上年龄相关性白内障患者角膜散光与年龄、眼轴长度(AL)之间的关系。在这项回顾性研究中,于2016年2月至2016年8月期间在北京大学人民医院确诊了953例年龄相关性白内障患者的1906只眼,并收集了他们的人口统计学资料、术前眼轴长度、使用IOL Master测量的角膜散光度数和子午线方向。采用受限立方样条和Spearman等级相关系数来研究角膜散光度数与年龄的关系。使用卡方检验来评估散光子午线方向与年龄、眼轴长度及角膜散光度数的关系。患者中男性410例,女性543例。角膜散光顺规(WTR)的有570只眼(29.91%),逆规(ATR)的有1005只眼(52.73%),斜轴的有331只眼(17.37%)。平均年龄为(72±9)岁。右眼眼轴长度和角膜散光度数的中位数(最小值,最大值)分别为23.49mm(19.83mm至33.89mm)和0.97D(0.06D至4.65D),左眼分别为23.41mm(17.54mm至32.09mm)和0.92D(0.11D至4.88D)。右眼64.95%(619/953)和左眼61.59%(587/953)的角膜散光≥0.75D。在65岁以上的老年患者中,当眼轴长度在22.00 - 25.99mm(0.186 - 0.279)时,双眼角膜散光度数均与年龄呈正相关(均P<0.01)。ATR角膜散光度数与年龄呈正相关(右眼,r = 0.278,P<0.01;左眼,r = 0.225,P<0.01),而WTR角膜散光度数与年龄无统计学显著相关性(右眼,r = 0.335;左眼,r = 0.633)。顺规散光的患病率随年龄增长而降低,右眼从43.81%(46/105)降至20.73%(51/246),左眼从40.00%(42/105)降至24.80%(61/246);而逆规散光的患病率随年龄增长而升高,右眼从3

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