合并病理性近视的圆锥角膜患者的白内障手术治疗

Objective: To evaluate the safety, efficacy of cataract surgery, and the predictability of intraocular lens (IOL) power calculation in eyes with mild to moderate keratoconus and high myopia. METHODS: 5 eyes with mild to moderate keratoconus and high myopia underwent phacoemulsification with IOL implantation. Pre- and postoperative evaluation included best corrected visual acuity (BCVA), corneal topography, corneal endothelial cell density, slit-lamp examination, and fundoscopy. The IOL power was calculated by using topographic keratometry in SRK/T fomula. Predictability was measured as aquired spherical equivalent (SE) versus desired refraction (DR) and as the percentage of eyes within ±1.0 D, ± 2.0 D, and ± 3.0 D of defocus equivalent (DE). RESULTS: The mean axial lenth was 31.18 ± 3.08 mm; mean follow-up time was 12.2 ± 5.0 months. All eyes got improved BCVA postoperatively. At the last follow-up, postoperative mean SE was–1.16 ± 0.68 D, while DR was –3.48 ± 1.98 D; the difference between SE and DR was statistically significant (P = 0.036); 3 eyes (60%) were within ±3 D of DE, 1 eye (20%) was within ±2 D, and no eyes were within ±1D. Pre- and postoperative mean keratometric cylinder was – 4.25 ± 1.01 D and –3.58 ± 1.69 D respectively, the difference was not statistically significant (P = 0.346). Corneal endothelial cell loss was 5.3% during follow-up. CONCLUSIONS: Cataract surgery is safe and effective in eyes with mild to moderate keratoconus and high myopia, while the predictability of IOL power calculation needs improvement.