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[婴儿白内障手术后眼轴长度、角膜屈光力及屈光状态的动态变化]

[Dynamic changes of axial length, corneal refractive power, and refractive state after cataract surgery in infants].

作者信息

Wang J J, Wang D D, Kou J J, Zhao Y E

机构信息

Eye Hospital of Wenzhou Medical University, Hangzhou Branch, Hangzhou 310020, China.

出版信息

Zhonghua Yan Ke Za Zhi. 2021 Jan 11;57(1):34-40. doi: 10.3760/cma.j.cn112142-20200114-00024.

Abstract

To investigate the changes of axial length, corneal refractive power, and refractive state in infants with congenital cataract surgery. Retrospective cohort study. Medical records of 103 patients who underwent congenital cataract surgery in the Eye Hospital of Wenzhou Medical University Hangzhou Branch from January 1, 2015 to December 31, 2018 were reviewed. There were 61 boys and 42 girls in the study. The mean age at the surgery of 103 congenital cataract patients was (3.95±1.94) months. In patients receiving bilateral cataract surgery, only the left eye was selected for analysis. The patients were followed up for at least 1 year. The patients were divided into the groups of <4 months old and 4-12 months old according to the age at cataract surgery. The change in the axial length, corneal refractive power, and refractive state of each patient at 1 year after surgery was analyzed. Independent sample -test, one way variance analysis and simple linear regression were used for statistical analysis. There were 71 cases of bilateral cataract, including 33 in the group of <4 months old and 38 in the group of 4-12 months old, and 32 cases of unilateral cataract, including 17 in the group of <4 months old and 15 in the group of 4-12 months old. The change in the axial length of bilateral cataract children in the <4-month-old group was (2.46±1.33) mm at 1 year after surgery, which was greater than (1.52± 1.00) mm in the group of 4-12 months old (=3.21; <0.01). In the same surgery age group, there was no significant difference in the change of axial length among bilateral cataract eyes, unilateral cataract eyes and the contralateral eyes at 1 year after surgery (both >0.05). One year after surgery, the axial length of the eyes in patients with bilateral cataract, the affected eyes and the fellow eyes in patients with unilateral cataract all was highly correlated with the logarithm of the actual age (=0.68, 0.52, 0.73; all <0.01). The corneal refractive power showed a decreased trend with the increase of age. The change in the corneal refractive power of the bilateral cataract children in the <4-month-old group at 1 year after surgery was (1.43±2.87) D, and in the group of 4-12 months old was (0.68±2.10) D, but the difference was not statistically significant (>0.05). The chang in spherical equivalent of bilateral cataract children was (2.02±2.60) D in the <4-month-old group, greater than that in the group of 4-12 months old [(0.69±1.89) D; =2.15; <0.05]. The change of spherical equivalent one year after surgery in 4-12 months group, unilateral cataract eyes was significantly greater than that of bilateral cataract eyes [(2.05±0.95) D (0.69±1.89) D; =2.49; <0.05]. The spherical equivalent of both bilateral and unilateral cataract children was highly correlated with the actual age (=-0.51, -0.54; both <0.01). The axial length is increased, the corneal refractive power is decreased, and the spherical equivalent is decreased at 1 year after surgery for congenital cataract in infants. The younger the age at cataract surgery, the greater the change in the axial length, myopia drift, and corneal refractive power. .

摘要

探讨先天性白内障手术患儿眼轴长度、角膜屈光力及屈光状态的变化。回顾性队列研究。回顾性分析2015年1月1日至2018年12月31日在温州医科大学附属眼视光医院杭州院区接受先天性白内障手术的103例患者的病历资料。研究对象中男61例,女42例。103例先天性白内障患者手术时的平均年龄为(3.95±1.94)个月。接受双眼白内障手术的患者,仅选取左眼进行分析。对患者进行至少1年的随访。根据白内障手术时的年龄将患者分为<4个月组和4 - 12个月组。分析每组患者术后1年时眼轴长度、角膜屈光力及屈光状态的变化。采用独立样本t检验、单因素方差分析和简单线性回归进行统计学分析。双眼白内障71例,其中<4个月组33例,4 - 12个月组38例;单眼白内障32例,其中<4个月组17例,4 - 12个月组15例。<4个月组双眼白内障患儿术后1年眼轴长度变化为(2.46±1.33)mm,大于4 - 12个月组的(1.52±1.00)mm(t = 3.21,P<0.01)。在同一年龄手术组中,术后1年双眼白内障眼、单眼白内障眼及对侧眼的眼轴长度变化差异无统计学意义(均P>0.05)。术后1年,双眼白内障患者的患眼、单眼白内障患者的患眼及健眼的眼轴长度均与实际年龄的对数呈高度相关(r = 0.68、0.52、0.73,均P<0.01)。角膜屈光力随年龄增长呈下降趋势。<4个月组双眼白内障患儿术后1年角膜屈光力变化为(1.43±2.87)D,4 - 12个月组为(0.68±

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