| Purpose:To compare and study the differences and consistency of relevant ocular biological parameters before cataract surgery using different biometric instruments;to observe the changes of ocular biological parameters before and after surgery and analyze the correlation of each parameter;to observe the trend of refractive shift after cataract surgery and explore the correlation between relevant parameters and postoperative refractive shift.Methods:This was a prospective study that included 91 patients(130 eyes)with age-related cataract who underwent cataract ultrasound emulsion aspiration combined with IOL implantation at the Eye Center of the Second Affiliated Hospital of Guangzhou Medical University from September 2022 to January 2023.Three instruments,Pentacam,IOL Master,and Lenstar,were used to measure the relevant ocular biological parameters before cataract surgery,including axial length(AL),anterior chamber depth(ACD),central corneal thickness(CCT),and Lens thickness(LT).The preoperative variability was analyzed by paired t-test and the concordance was analyzed by Bland-Altman analysis;the ACD was measured by Pentacam and the AL and CCT were measured by Lenstar at 1 day,1 week,1 month and 3 months after cataract surgery,and the trends of the relevant parameters were observed in the postoperative period.One-way analysis of variance was used to compare the differences at each time point.;observe the trend of refractive drift at each time point after cataract surgery,and analyze the correlation between preoperative and postoperative related parameters and postoperative refractive shift using Pearson’s method.Results:1.(1)The AL obtained by IOL Master and Lenstar measurements were 24.11±1.85 mm and 24.06±1.75 mm,respectively,and the difference between the AL measured by the two instruments was statistically significant(t=2.697,P<0.05),while Bland-Altman analysis showed good agreement between them.(2)The ACDs obtained from the IOL Master and Lenstar measurements were 3.10±0.51 mm and 3.04 ± 0.46 mm,respectively,and the differences between the ACDs measured by the two instruments were not statistically significant(t=2.016,P>0.05).Bland-Altman analysis showed that the two were in good agreement.(3)The ACD measured by IOL Master and Pentacam were 3.12±0.49 and 3.05±0.44 mm,respectively,and the difference between the ACD measured by the two instruments was statistically significant(t=2.478,P < 0.05).Bland-Altman analysis showed good agreement between the two.(4)The CCTs measured by Lenstar and Pentacam were 540.42 ± 33.08 μ m and 543.43 ± 33.12 μ m,respectively,and the difference between the CCTs measured by the two instruments was statistically significant(t=-3.995,P < 0.05).Bland-Altman analysis showed a good agreement between the two.(5)The ACDs obtained from Lenstar and Pentacam measurements were 2.45 ± 0.40 mm and 2.45 ±0.42 mm,respectively,and the difference between the ACDs measured by the two instruments was not statistically significant(t=-0.442,P>0.05).Bland-Altman analysis showed a good agreement between the two.2.(1)CCT was greater than preoperative CCT at all postoperative time points after cataract surgery,with the thickest CCT on postoperative day 1 and the CCT gradually becoming thinner over time.The difference between preoperative CCT and postoperative CCT at 1 day and 1 week was statistically significant(all P <0.05),and the difference between CCT at 1 month and 3 months postoperatively was not statistically significant(all P>0.05).(2)The ACDs of the preoperative short,medium,and long eye axis groups were 1.96±0.43 mm,2.46±0.38 mm,and 2.66±0.25 mm,respectively,all of which were smaller than the ACDs at each postoperative time point,and the differences were statistically significant(P< 0.05).The ACD at 1 day postoperatively was greater than that at 1 week postoperatively in the short-eye axis group,whereas the ACD at 1 day postoperatively was less than that at 1 week postoperatively in the medium-and long-eye axis groups,with a statistically significant difference(P < 0.05).In the three groups with short,medium,and long eye axes,the differences in ACD between the time points of 1 week,1 month,and 3 months after surgery were not statistically significant(all P > 0.05).(3)The preoperative AL of the short-eye axis group was 20.66 ± 0.86 mm,which was greater than the postoperative AL at each time point,and the difference was not statistically significant(P > 0.05);the preoperative AL of the medium-eye axis group and the long-eye axis group were 23.74±0.88 mm and 27.63±1.30 mm,respectively,and the difference was not statistically significant(P > 0.05)from the postoperative AL at each time point.3.Preoperative ACD was positively correlated with preoperative AL(r=0.4040,P< 0.05);preoperative ACD was negatively correlated with preoperative LT(r=-0.5973,P < 0.05);preoperative AL was negatively correlated with preoperative LT at a low level(r=-0.2161,P<0.05).4.Preoperative ACD was negatively correlated with ACD change(r=-0.6712,P<0.05);preoperative LT was positively correlated with ACD change(r=0.6561,P<0.05);preoperative CCT and AL were not significantly correlated with ACD change(r=-0.1063,r=-0.1066,P>0.05).5.There was an overall myopic shift in the short-axis group,and an overall hyperopic shift in the medium-axis and long-axis groups after cataract surgery.In these three groups,there was no statistically significant change in refraction from1 week to 3 months after surgery(all P>0.05).6.The patients’ refractive changes at 3 months postoperatively were negatively correlated with the changes in ACD at 3 months postoperatively(r=-0.5434,P<0.05),positively correlated with preoperative AL(r=0.3723,P<0.05),positively correlated with preoperative ACD at a low level(r=0.2192,P<0.05),and not significantly correlated with preoperative LT(r=0.1165,P>0.05).Conclusions:1.There was a difference between IOL Master and Lenstar for measuring preoperative AL of cataract and no difference when measuring preoperative ACD;there was a difference between IOL Master and Pentacam for measuring preoperative ACD;there was a significant difference between Lenstar and Pentacam for measuring preoperative CCT and no difference when measuring preoperative ACD.All three instruments showed good agreement in measuring the above ocular biological parameters.2.The CCT was thickest at 1 day after cataract surgery and gradually returned to the preoperative level 1 month after surgery;the ACD deepened after cataract surgery and stabilized at 1 week after surgery,and the IOL position moved forward after surgery in the short-axis group and backward in the medium-axis and long-axis groups.3.The longer the preoperative AL,the deeper the ACD;the thicker the preoperative LT,the shallower the ACD;the longer the preoperative AL,the thinner the LT.4.The shallower the preoperative ACD and the thicker the LT,the greater the postoperative ACD change.5.Patients with short eye axis are prone to myopic shift after cataract surgery,while patients with medium and long eye axes are prone to hyperopic shift.The refractive status stabilizes 1 week after surgery.6.The longer the preoperative AL,the deeper the ACD or the smaller the postoperative ACD change,the more likely the postoperative hyperopic shift will occur. |
PDF Full Text Request