| Objective: Explore the related factors affecting visual recovery after phacoemulsification for high myopia and cataract.Methods: Selected from August 2019 to December 2021 in the Affiliated Hospital of Yan’an University and treated with phacoemulsification and one-stage intraocular lens implantation in patients with high myopia complicated by cataract in 70 cases(101 eyes),including 22 males(32 eyes)and 48 females(69 eyes),preoperative and postoperative related indicators were measured in all patients.Preoperative indicators: uncorrected visual acuity(UCVA)and best corrected visual acuity(BCVA)(Log MAR),corneal astigmatism,corneal diopter,intraocular pressure and corneal endothelial count,lens nucleus hardness was graded by slit lamp microscope,A-ultrasound was used to measure the axial length and anterior chamber depth,B-ultrasound and OCT were used to observed the vitreous body and fundus situation.Postoperative indicators: The UCVA and BCVA(Log MAR)were measured on the first day,on the seventh day and on the third month after operation.The occurrence of intraoperative and postoperative complications of the patients was observed.According to BCVA(Log MAR)at 3 months after operation,they were divided into BCVA≤0.5 and BCVA>0.5 groups..Univariate analysis was performed on the factors that may affect the visual acuity of the two groups,and multivariate Logistic regression analysis was performed on the statistically significant indicators.Results:(1)Comparison of UCVA and BCVA before and after operation: BCVA≤0.5 and BCVA>0.5 groups,UCVA and BCVA were significantly improved on the first day,on the seventh day and on the third month after operation,and the difference was statistically significant.(2)The relationship between axial length,corneal astigmatism and BCVA on the third month after operation: 1)Pearson correlation was used to analyze the relationship between axial length and astigmatism,it was found that there was a positive correlation between axial length and astigmatism(r=0.619,P<0.001).2)Sperman rank correlation analysis was used to analyze the relationship between axial length and BCVA(Log MAR)on the third month after operation,it was found that there was a positive relationship between axial length and BCVA on the third month after operation(rs=0.623,P<0.001).3)Sperman rank correlation was used to analyze the relationship between corneal astigmatism and BCVA on the third month after operation,it was found that there was a positive correlation between corneal astigmatism and BCVA(Log MAR)on the third month after operation(rs=0.615,P<0.001).(3)Univariate analysis of influencing BCVA on the third month after operation:BCVA≤0.5 group and BCVA>0.5 group had significant differences in corneal astigmatism,corneal refraction,axial length,posterior scleral staphyloma,macular disease and posterior vitreous detachment(P<0.05).There was no significant difference in age,disease duration,gender,preoperative intraocular pressure,preoperative UCVA,preoperative BCVA,anterior chamber depth,corneal endothelial count and nuclear grade between the two groups(P>0.05).(4)Multivariate Logistic regression analysis of BCVA on the third month after operation:axial length OR=3.60,95%CI:1.22～10.61;corneal astigmatism OR=3.28,95%CI:1.14～9.44;macular diseases OR=7.47,95%CI:1.85～30.21;posterior scleral staphyloma OR=2.83,95%CI:1.03 ～ 7.79.Axial length,corneal astigmatism,macular diseases and posterior scleral staphyloma were found to be independent influencing factors of BCVA on the third month after operation.Corneal refraction and posterior vitreous detachment were not independent factors affecting postoperative BCVA.(5)Complications: 1 eye(0.99%)had posterior capsule rupture during operation;12 eyes(11.88%) had corneal edema on the first day after operation;anterior chamber occurred inflammatory reaction occurred in 7 eyes(6.93%)on the first day after operation;11 eyes(10.89) had increased intraocular pressure on the first day after surgery;1 eye(0.99%)developed macular edema on the first month after operation;retinal detachment occurred in 1 eye(0.99%)on the first month after operation;CCS occurred in 1 eye(0.99%)on the third month after operation.Conclusions:(1)The uncorrected visual acuity and best-corrected visual acuity of high myopia cataract patients after surgery were improved compared with those before surgery.(2)The factors affecting the recovery of BCVA in patients with high myopia cataract on the third month after surgery are: axial length,corneal astigmatism,macular disease and posterior scleral staphyloma.The macular disease had the greatest impact on BCVA on the third month after surgery,followed by axial length,corneal astigmatism,and posterior scleral staphyloma.Axial length and corneal astigmatism were positively correlated with BCVA(Log MAR)on the third month after surgery,and those with macular disease and posterior scleral staphyloma had poor visual acuity. |
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