Tan Yehui, Liu Liangping, Li Jianbing, Qin Yingyan, Sun Ao, Wu Mingxing
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
Ann Transl Med. 2021 Apr;9(8):618. doi: 10.21037/atm-20-6757.
High myopia and cataracts are major causes of blindness in East and Southeast Asia. Corneal astigmatism is a major contributor to uncorrected poor vision after cataract surgery in patients with high myopia. The purpose of the present study was to evaluate the demographic characteristics and distribution of preoperative corneal astigmatism in Chinese cataract surgery candidates with high myopia.
Swept-source optical coherence tomography-based optical biometry was performed preoperatively in consecutive cataract surgery candidates who were classified by axial length (AL) into a high myopia group (defined as AL ≥26.0 mm) and a control group (normal ALs). The demographics, ALs, and keratometry values were recorded.
Among 15,063 cataract surgery candidates (15,063 eyes), 1,921 patients (12.8%, 1,921 eyes) in the high myopia group and 11,880 patients (11,880 eyes) in the control group were enrolled. In the high myopia group, the mean age was 59.8±12.6 (standard deviation) years, which was younger than that in the control group (69.1±11.0 years, P<0.001). In the high myopia group, the mean corneal astigmatism was 1.20±0.83 dioptre (D), which was greater than that in the control group (0.93±0.69 D, P<0.001). In the high myopia group, 82.2% had corneal astigmatism ≥0.50 D, 51.4% ≥1.00 D, 27.4% ≥1.50 D and 14.4% ≥2.00 D, all of which were higher than the respective proportions in the control group (P<0.001 for all). In the high myopia group, 66.8% had moderate to high corneal astigmatism, and 42.8% had "with-the-rule" astigmatism, and both of these proportions were higher than the respective proportions in the control group (P<0.001 for both). In the high myopia group, corneal astigmatism tended to increase with increasing age (r =0.134, P<0.001) after the age of 50, which was consistent with the tendency in the control group.
A significant burden of preoperative corneal astigmatism was observed in Chinese cataract surgery candidates with high myopia. Moderate to high corneal astigmatism was more common in highly myopic eyes than in normal AL eyes.
高度近视和白内障是东亚和东南亚地区失明的主要原因。角膜散光在高度近视患者白内障手术后导致未矫正视力不佳方面起主要作用。本研究的目的是评估中国高度近视白内障手术候选患者术前角膜散光的人口统计学特征和分布情况。
对连续的白内障手术候选患者术前进行基于扫频源光学相干断层扫描的光学生物测量，这些患者按眼轴长度（AL）分为高度近视组（定义为AL≥26.0mm）和对照组（正常AL）。记录人口统计学数据、AL和角膜曲率计测量值。
在15063名白内障手术候选患者（15063只眼）中，纳入高度近视组1921例患者（12.8%，1921只眼）和对照组11880例患者（11880只眼）。高度近视组的平均年龄为59.8±12.6（标准差）岁，低于对照组（69.1±11.0岁，P<0.001）。高度近视组的平均角膜散光为1.20±0.83屈光度（D），高于对照组（0.93±0.69D，P<0.001）。高度近视组中，82.2%的患者角膜散光≥0.50D，51.4%≥1.00D，27.4%≥1.50D，14.4%≥2.00D，所有这些比例均高于对照组中的相应比例（均P<0.001）。高度近视组中，66.8%的患者有中度至高度角膜散光，42.8%的患者有顺规散光，这两个比例均高于对照组中的相应比例（均P<0.001）。在高度近视组中，50岁以后角膜散光倾向于随年龄增长而增加（r =0.134，P<0.001），这与对照组的趋势一致。
在中国高度近视白内障手术候选患者中观察到显著的术前角膜散光负担。高度近视眼中中度至高度角膜散光比正常眼轴长度的眼睛更常见。
