高度近视白内障患者角膜后散光的特征

Wen-jie Liu, Jie-wei Liu, Jing-jing Wang, Qi Wang
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摘要

目的:探讨高度近视白内障患者角膜后散光(PA)的特点。方法:本系列病例研究选取山西省眼科医院2018年1 - 6月收治的215例患者215只眼,分为高度近视组(94例,94只眼)和对照组(121例,121只眼)。采用旋转Scheimplfulg相机(Pentacam HR)测量PA、角膜总散光(TA)和模拟角膜散光(KA)。采用矢量法和算术分析法计算了KA法测温产生的误差。结果:高度近视组平均近视度数为-0.33±0.20 D,超过0.5 D的占30.8%;最陡子午线垂直排列的占79.6%。高度近视组与对照组的平均屈光度为-0.31±0.18 d,差异无统计学意义(t=0.589, P=0.557)。高度近视组KA与TA的矢量误差为(0.12±0.21)D@4°。PA与KA、PA与Km (KA)、PA与Km (PA)呈显著相关(r=0.340, P=0.001;r = 0.285, P = 0.006;r = 0.333, P = 0.001)。对于KA>0.5 D的患者,ta和KA的幅度差异随着pa幅度的增加而显著增加(r=0.235, P=0.004)。结论:高度近视组与对照组之间PA无显著性差异。在高度近视组中,忽略PA可能导致对ta的不正确估计。环形人工晶状体植入术患者应考虑个体化PA。关键词:角膜后散光;高度近视;白内障
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Characteristics of Posterior Corneal Astigmatism in Cataract Patients with High Myopia
Objective: To evaluate the characteristics of posterior corneal astigmatism (PA) in cataract patients with high myopia. Methods: In this series of case study, 215 eyes of 215 patients from Shanxi Eye Hospital were recruited from January to June 2018 and divided into a high myopia group (94 patients, 94 eyes) and a control group (121 patients, 121 eyes). PA, total corneal astigmatism (TA) and simulated keratometric astigmatism (KA) were measured by arotating Scheimplfulg camera (Pentacam HR). The error produced by TA using KA was calculated with vector and arithmetical analysis. Data were analyzed by t test and correlation analysis Results: In the high myopia group, the mean magnitude of the pa was -0.33±0.20 D, and exceeded 0.5 D in 30.8%. The steepest meridian was vertically aligned in 79.6% of the cases. In the control group, the mean magnitude of the PA was -0.31±0.18 D. There was no significant difference in PA between the high myopia group and the control group (t=0.589, P=0.557). In the high myopia group, the vector error between KA and TA was (0.12±0.21) D@4°. There was a correlation between the magnitude of PA and KA, PA and Km (KA), and PA and Km (PA) (r=0.340, P=0.001; r=0.285, P=0.006; r=0.333, P=0.001). For KA>0.5 D patients, the difference in magnitude between ta and Ka significantly increased with an increase in the magnitude of pa (r=0.235, P=0.004). Conclusion: There was no significant difference in PA between the high myopia group and the control group. In the high myopia group, neglecting PA may lead to an incorrect estimate of ta. Personalized PA should be considered in patients with Toric intraocular lens implants. Key words: posterior corneal astigmatism; high myopia; cataract
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