Changes In Refractive Status In High-myopia Patients With Rhegmatogenous Retinal Detachment After Vitrectomy Combined With Cataract Surgery

Objective To evaluate the changes of refractive state in patients with rhegmatogenous retinal detachment in high myopia 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 divided into two groups:high myopia(15patients of 15 eyes)and non high myopia group(15patients 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 3months later.The two groups were continuously followed up for 6months 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 Log MAR was calculated in each groups.The SE,axial length,corneal curvature before vitrectomy and 1month,3,6months 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 1.The Log MAR visual acuity was improved in both groups and the difference between before and after treatment was statistically significant(both P<0.05).2.The SE at 1 month,3,6months 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).The refraction between the two groups at different time points was statistically significant(all P <0.05).3.Axial length and corneal curvature at 1 month,3,6 month after surgery in the high4.myopia group were significantly increased(all P<0.05),where as those in the non-high myopia group did not change significantly(all P>0.05).The axial length between the two groups at different time points was statistically significant(all P <0.05),the corneal curvature between the two groups at different time points was not statistically significant(all P>0.05).4.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),The regression equation was Y=2.125-0.111X(R2 =0.580),axial length increased to 1mm,myopia shift 0.111 D.Conclusions 1.The Log MAR visual acuity after vitrectomy combined with cataract surgery is improved in patients with rhegmatogenous retinal detachment.2.Postoperative axial length growth and corneal curvature increase are presented in patients with high myopia.3.The longer the preoperative axial length is,the more myopic shift the eyes shows.4.Vitrectomy combined with cataract surgery has been widely applied to the treatment of rhegmatogenous retinal detachment.With the improvement of the success rate of retinal reattachment,postoperative visual function recovery should received more and more attention.