Li H E, Wang Y, Chen M S, Li X T, Xu Y X, Tang Q Y, Zhou Y W, Wu Z M, Sima J, Wu L, Zeng Q S, Cao X R, Gao Y, Dang X H, Qiu Z F, Li L, Li Z Q, Shan M H, Zupi Liya, Xu H F, Li H X
Wuhan Aier Eye Hospital, Aier School of Ophthalmology, Central South University, Wuhan 430061, China.
Chongqing Aier Eye Hospital, Aier School of Ophthalmology, Central South University, Chongqing 400020, China.
Zhonghua Yan Ke Za Zhi. 2021 Jan 11;57(1):56-62. doi: 10.3760/cma.j.cn112142-20200107-00010.
To analyze the distribution characteristics of the anterior corneal astigmatism in 140 000 cataract patients from 18 hospitals in China. Retrospective study. A total of 143 889 patients (143 889 right eyes) over the age of 40 years with age-related catarac were admitted to 18 Aier eye hospitals in China from July 2015 to October 2018. The average values of the three measurements of the magnitude of anterior corneal astigmatism, the meridian of corneal astigmatism, anterior chamber depth, corneal refractive power, and axial length measured by IOLMaster 500 were obtained. The data acquisition method of each sub-center was to collect and analyze the electronic case data in accordance with the inclusion and exclusion criteria, and to provide them for the sponsor Wuhan Aier Eye Hospital. Non-normal distribution data are presented as (, ). Mann-Whitney test, Kruskal-Wallis test, Chi-square test were used to analyze the distribution differences of the magnitude of corneal astigmatism and the meridian of corneal astigmatism in gender, age, anterior chamber depth, corneal refractive power and axial length. Among the 143 889 patients, 84 319 were females and 59 570 were males, the median age was 72 (65, 78) years old, the median corneal astigmatism was 0.84 (0.51, 1.33) D; the corneal astigmatism was ≥0.75 D in 80 895 patients (56.22%) and was ≥1.00 D in 57 304 patients (39.83%). The median corneal astigmatism was 0.87 (0.53, 1.37) D in women and 0.82 (0.50, 1.29) D in men; with statistical difference (=-14.891; <0.05). The proportion of with-the-rule (WTR) astigmatism was 33.26% (28 046/84 319) for women and 34.26% (20 408/59 570) for men; The proportion of against-the-rule (ATR) astigmatism was 49.08% (41 385/84 319) for women and 46.91% (27 945/59 570) for men, with statistical difference (χ²=70.913; <0.05). With the increase of age, the magnitude of corneal astigmatism first decreased from 0.94 (0.57, 1.48) D to 0.75 (0.46, 1.18) D, and then increased to 1.19 (0.74, 1.79) D, with statistical difference (=1 263.438; <0.05), and the change was at 61 to 70 years old. With the increase of age, the proportion of WTR astigmatism decreased from 77.50% (396/511) to 12.50% (3/24), the proportion of ATR astigmatism increased from 11.15% (57/511) to 79.07% (34/43), and the proportion of oblique astigmatism changed little from 17.02% (16/94) to 19.92% (245/1 230), the distribution difference was significant (χ²=10 174.496; <0.05). As the anterior chamber became shallow, the magnitude of corneal astigmatism significantly increased from 0.82 (0.51, 1.31) D to 1.05 (0.61, 1.56) D, and the proportion of ATR astigmatism increased from 47.32% (60 207/127 227) to 51.69% (184/356) (=409.961, χ²=120.995, both <0.05). With the corneal refractive power rising, the magnitude of corneal astigmatism increased from 0.80 (0.49, 1.33) D to 0.95 (0.58, 1.53) D, the proportion of ATR astigmatism decreased from 52.84% (4 963/9 392) to 39.97% (9 023/22 577); the difference was significant (=808.562, χ²=752.147, both <0.05). When the axial length was>25.00 mm, the magnitude of corneal astigmatism was highest [1.04 (0.62, 1.65) D], and the proportion of ATR astigmatism was also highest [49.00% (10 964/22 376)]; the difference was significant (=2 071.198, χ²=131.130, all <0.05). The meridian of corneal astigmatism in middle-aged and elderly cataract patients is mainly ATR astigmatism. With the increasing of age, the magnitude of corneal astigmatism decreases first and then increases. The turning point from the proportion of WTR astigmatism to the proportion of ATR astigmatism is 65 years old. The shallower the anterior chamber is, the more the magnitude of corneal astigmatism and the proportion of ATR astigmatism increase. When the axial length is>25.00 mm, both the magnitude of corneal astigmatism and the proportion of ATR astigmatism reach the peak. .
分析我国18家医院140000例白内障患者角膜前表面散光的分布特征。回顾性研究。2015年7月至2018年10月,我国18家爱尔眼科医院共收治143889例40岁以上的年龄相关性白内障患者(143889只右眼)。获取IOLMaster 500测量的角膜前表面散光度数、角膜散光子午线、前房深度、角膜屈光力和眼轴长度这三项测量值的平均值。各分中心的数据采集方法是按照纳入和排除标准收集并分析电子病例数据,然后提供给申办方武汉爱尔眼科医院。非正态分布数据以(,)表示。采用Mann-Whitney检验、Kruskal-Wallis检验、卡方检验分析角膜散光度数和角膜散光子午线在性别、年龄、前房深度、角膜屈光力和眼轴长度方面的分布差异。143889例患者中,女性84319例,男性59570例,年龄中位数为72(65,78)岁,角膜散光中位数为0.84(0.51,1.33)D;80895例患者(56.22%)角膜散光≥0.75 D,57304例患者(39.83%)角膜散光≥1.00 D。女性角膜散光中位数为0.87(0.53,1.37)D,男性为0.82(0.50,1.29)D;差异有统计学意义(=-14.891;<0.05)。女性顺规散光比例为33.26%(28046/84319),男性为34.26%(20408/59570);女性逆规散光比例为49.08%(41385/84319),男性为46.91%(27945/59570),差异有统计学意义(χ²=70.913;<0.05)。随着年龄增加,角膜散光度数先从0.94(0.57,1.48)D降至0.75(0.46,1.18)D,然后升至1.19(0.74,1.79)D,差异有统计学意义(=1263.438;<0.05),变化转折点在61至70岁。随着年龄增加,顺规散光比例从77.50%(396/511)降至12.50%(3/24),逆规散光比例从11.15%(57/511)升至79.07%(34/43),斜向散光比例从17.02%(16/94)至19.92%(245/1230)变化不大,分布差异有统计学意义(χ²=10174.496;<0.05)。随着前房变浅,角膜散光度数从0.82(0.51,1.31)D显著增至1.05(0.61,1.56)D,逆规散光比例从47.32%(60207/127227)增至5l.69%(184/356)(=409.961,χ²=120.995,均<0.05)。随着角膜屈光力升高,角膜散光度数从0.80(0.49,1.