不可忽视的高度近视白内障术后屈光误差与屈光漂移

摘要

The prevalence of high myopia in Asian areas is much higher than that in the rest of the world, with high myopic cataract accounting for growing proportion of cataract surgery in China.One noteworthy phenomenon is that the refractive error in high myopic eyes after cataract surgery is significantly larger than eyes with normal axial length, frequently accompanied by obvious refractive shift, which results in impaired precision of the surgery.The article analyzes this problem and finds that improper measurement methods as well as intraocular lens (IOL) power calculation formulas selection, inadequate constant optimization, neglection of fixation stability and changes in effective IOL position are all important causes of this phenomenon.Based on these findings, corresponding precautions are raised to achieve better outcomes of high myopic cataractous patients.%高度近视在亚洲的患病率远高于世界其他地区,同时高度近视白内障在我国的手术比例亦逐年增加.一个值得关注的现象,是高度近视白内障术后的屈光误差明显大于正常眼轴眼,且往往伴随显著的屈光漂移,最终影响手术治疗的准确性.本文针对该现象进行剖析,发现测量方法和人工晶状体公式选择不当、常数优化不到位、固视稳定性的忽视及有效人工晶状体位置的变化可能是造成这一现象的重要原因.根据这些原因,提出相应的防范措施,以期在高度近视白内障获得更优的治疗效果.