屈光参差眼的屈光结构分析

摘要

Objective To clarify the optical etiology of anisometropia by analyzing the difference in the optical components between the two eyes in anisometropia. Methods Ninety-one anisometropes with a spherical equivalent difference of ＞2.00 D were studied. Two groups were created based on the type of anisometropia: a hyperopic anisometropia group and a myopic anisometropia group. All eyes were examined for refraction and corneal curvature (CC) with a Topcon KR.8800 autor refractor (Japan). Anterior chamber depth (ACD), lens thickness (LT), vitreous chamber length (VCL) and axial length (AL) were measured by A-scan ultrasound (French Quantel 0459). Self-control analysis, multiple linear regression and partial correlation analysis were used to describe the optical differences in anisometropia. Results Only vitreous chamber length and axial length differed between the two eyes in anisometropia (tVCD=9.506, 3.654, P＜0.01; tAL=12.334, 3.447,P＜0.01). Multiple linear regression analysis found that corneal curvature and anterior chamber depth were not correlated with age (tcc=0.0491, P＞0.05; tACD=0.449, P＞0.05). The keratometry and anterior chamber depth of myopic anisometropia were greater than that of hyperopic (tK=4.600, P＜0.01; tACD=2.894, P＜0.01), while there was no difference in the thickness of the lens between the two groups (t=0.936, P＞0.05). The keratometry and anterior chamber depth of the two groups were not correlated with axial length (rCC=-0.177, -0.110, P＞0.05; rACD=-0.080, -0.041, P＞0.05), while lens thickness was correlated with axial length for the two groups (r=0.358, 0.296, P＜0.01). Vitreous chamber length was correlated with both refraction and axial length (r=0.975, 0.979, P＜0.01). Conclusion A change in vitreous chamber length is an underlying cause of anisometropia.%目的 探讨屈光参差眼屈光要素的差异程度对屈光参差的形成作用.方法 收集双眼等效球镜度数差＞2.00 D的屈光参差患者91例,按屈光参差类型分为远视性屈光参差和近视性屈光参差2组.用日本Topcon KR.8800自动验光仪测量双眼屈光度数和角膜曲率(CC).用法国Quantel 0459 A型超声生物测量仪测量双眼前房深度(ACD)、晶状体厚度(LT)、玻璃体腔长度(VCL)及眼轴长度(AL),将患者的双眼进行自身对照观察,所测数据采用配对t检验进行统计学分析.屈光参差眼各屈光要素与年龄及分组的关系采用多元线性回归进行分析,屈光参差眼的屈光要素与眼轴的关系采用偏相关的方法进行分析.结果 屈光参差者双眼之间只有玻璃体腔长度和眼轴长度存在差异(tVCL=9.506、3.654,P均＜0.01;tAL=12.334、3.447,P均＜0.01).多元线性回归分析发现:屈光参差者双眼的角膜曲率、前房深度都与年龄无关;近视性屈光参差眼的角膜曲率、前房深度都大于远视性屈光参差眼(tK=4.600,P＜0.01;tACD=2.894,P＜0.01),而晶状体厚度没有差异;2组屈光参差者双眼的角膜曲率、前房深度都与眼轴长度无关,而晶状体厚度与眼轴相关(r=0.358、0.296,P＜0.01).玻璃体腔的长度与眼屈光状态和眼轴都相关(r=0.975、0.979,P＜0.01).结论 玻璃体腔长度的变化是屈光参差发生的内在根本原因.