摘要
目的探讨白内障术后人工晶状体(intraocular lens,IOL)位置的影响因素,分析不同眼轴长度(axial length,AL)下眼部生物参数对IOL居中性的影响。方法前瞻性选择2024年2-7月在四川大学华西医院眼科行白内障超声乳化+IOL植入的患者。根据AL的不同分为非高度近视组(22.0 mm≤AL<26.0 mm)和高度近视组(AL≥26.0 mm),探讨白内障术后IOL位置的影响因素。结果本研究共连续纳入患者240例(240只眼),非高度近视组及高度近视组各120例(120只眼)。非高度近视组和高度近视组术前晶状体倾斜度和偏心量分别为(4.41±1.07)°、(0.13±0.09)mm和(3.57±1.81)°、(0.20±0.10)mm。多重线性回归分析结果显示,非高度近视组中,术前晶状体倾斜度(P<0.001)是术后IOL倾斜度的影响因素,晶状体厚度(P=0.027)和术前晶状体偏心量(P<0.001)是术后IOL偏心量的影响因素。高度近视组中,晶状体厚度(P=0.023)和术前晶状体倾斜度(P<0.001)是术后IOL倾斜度的影响因素,前房深度(P=0.030)、晶状体厚度(P=0.013)和术前晶状体偏心量(P<0.001)是术后IOL偏心量的影响因素。结论眼科医生可在术前依据患者的近视程度(重点识别高度近视)及其具体眼部生物参数,更准确地预测术后IOL位置,进而优化手术方案,改善术后效果。
Objective To explore the influencing factors of intraocular lens(IOL)position after cataract surgery and analyze the effect of ocular biological parameters on IOL centering under different axial length(AL).Methods Patients who underwent cataract phacoemulsification and IOL implantation at West China Hospital of Sichuan University between February and July 2024 were prospectively selected.According to the different AL values,the patients were divided into non-high myopia group(22.0 mm≤AL<26.0 mm)and high myopia group(AL≥26.0 mm)to explore the influencing factors of IOL position after cataract surgery.Results This study included a total of 240 patients(240 eyes),with 120 cases(120 eyes)in both the non-high myopia group and the high myopia group.The preoperative lens tilt and decentration of the non-high myopia group and high myopia group were(4.41±1.07)°,(0.13±0.09)mm and(3.57±1.81)°,(0.20±0.10)mm,respectively.The results of multiple linear regression analysis showed that in the non-high myopia group,preoperative lens tilt(P<0.001)was the influencing factor of postoperative IOL tilt,while lens thickness(P=0.027)and preoperative lens decentration(P<0.001)were the influencing factors of postoperative IOL decentration.In the high myopia group,lens thickness(P=0.023)and preoperative lens tilt(P<0.001)were the influencing factors of postoperative IOL tilt,while anterior chamber depth(P=0.030),lens thickness(P=0.013),and preoperative lens decentration(P<0.001)were the influencing factors of postoperative IOL decentration.Conclusion Ophthalmologists can accurately predict the postoperative IOL position based on the patient’s degree of myopia(with a focus on identifying high myopia)and specific ocular biological parameters before surgery,thereby optimizing surgical plans and improving postoperative outcomes.
作者
徐逢
穆建成
杨宁
郭婉月
孙楚桓
彭柏森
范玮
XU Feng;MU Jiancheng;YANG Ning;GUO Wanyue;SUN Chuhuan;PENG Bosen;FAN Wei(Department of Ophthalmology,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,P.R.China)
出处
《华西医学》
2025年第6期937-943,共7页
West China Medical Journal
基金
四川大学华西医院学科卓越发展1·3·5工程项目(2019-058)。
关键词
人工晶状体
眼轴长度
倾斜
偏心
高度近视
Intraocular lens
axial length
tilt
decentration
high myopia
作者简介
通信作者:范玮,Email:fanwei55@wchscu.edu.cn。
