Changes in refractive status in high-myopic patients with rhegmatogenous retinal detachment after vitrectomy combined with cataract surgery / 眼科新进展

ABSTRACT

Objective To evaluate the changes in refractive state in high-myopic patients with rhegmatogenous retinal detachment after vitrectomy combined with cataract surgery.Methods Clinical data of 30 patients of rhegmatogenous retinal detachment in the Affiliated Hospital of Qingdao University from January 2016 to March 2017 was retrospectively analyzed,and these patients were randomly dividedly into two groupshigh myopia (15 patients of 15 eyes) and non high myopia group (15 patients of 15 eyes),in which patients firstly underwent vitrectomy combined with phacoemulsification and silicone oil tamponade,followed by intraocular lens (IOL) implantation after the removal of silicone oil 3 months later.The two groups were continuously followedup for 6 months after IOL implantation.Before vitrectomy,the axial length,corneal curvature were measured for calculating the predictive spherical equivalent (SE).Then axial length and corneal curvature at 1 month,3,6 months after IOL implantation were measured for calculating the actual SE.The best corrected visual acuity (BCVA) was recorded before and after operation and the LogMAR was calculated in each groups.The SE,axial length,corneal curvature before vitrectomy and 1 month,3,6 months after IOL implantation were respectively compared in each group.The relationship between the refractive prediction errors and the preoperative axial length in the high myopia group was evaluated.Results The LogMAR visual acuity was improved in both groups,and the difference between before and after treatment was statistically significant (both P ＜0.05).The SE at 1 month,3,6 months after surgery showed significantly myopic shift in the high myopic eyes,and the myopic shift gradually increased with time,with statistically significant at each time point (all P ＜ 0.05),but there was no significant difference in myopic shift between before and after surgery as well as among each time point after surgery in the non-high myopic eyes (P ＞ 0.05).Axial length and corneal curvature at 1 month,3,6 month after surgery in the high myopia group were significantly increased (all P ＜ 0.05),whereas those in the non high myopia group did not change significantly (all P ＞ 0.05).By simple linear regression analysis,the refractive prediction errors had a negative correlation with the preoperative axial length in the high myopia group (R2 =0.580,P =0.001).Conclusion The LogMAR visual acuity after vitrectomy combined with cataract surgery is improved in patients with rhegmatogenous retinal detachment.Postoperative axial length growth and corneal curvature increase are presented in patients with high myopia,and the longer the preoperative axial length is,the more myopic shift the eye shows.