| Part one Comparison of the Lenstar LS 900 with A-scan for intraocular lens power calculation in Super high myopia cataract patientsObjective:To compare the difference between Lenstar LS900 and A-scan in the calculation of intraocular lens in patients with super high myopia.Methods:This was a retrospective study.Thirty five patients,fifty one eyes with super high myopia and cataract who came to the clinic between Jan.to Sept.2015 were included.The cataract operation was performed by the same doctor.Complete LS900 Lenstar and A-scan data were available.The detection rates of the two instruments were compared.The targeted diopters based on the actual implanted IOL and corneal curvature and A constant given by the two system were calculated using SRK-T and compared with the patient's actual refractive degree three months after the surgery.Results:The detection rate of LS900 and A-scan was 76.47%(39/51)and100%(51/51),respectively.The averaged axial length measured by A-scan and Lenstar LS900 in 39 eyes were(28.78 ± 1.70)mm and(29.11 ± 1.57)mm,respectively.The difference was statistically significant(P<0.05).The targeted refractive diopter calculated according to Lenstar LS900,A-scan and the actual refractive diopter were(-3.69± 0.80),(-3.51± 1.02)and(-3.61 ± 0.84)D,respectively,with no statistical significance within the group(P>0.05).The difference between the Lenstar LS900 calculated and A-scan calculated and the actual refractive diopter were(-0.08 + 0.29)D and(0.10 + 0.89)D,respectively.Although the differences was not statistically significant,Lenstar LS900 showed less variability and better stability.Conclusions: For the calculation of intraocular lens power in super high myopia cataract patients,A-scan showed an absolute advantage in the detection rate over Lenstar LS900,however,the latter appeared to be more accurate and reliable for the calculation of the targeted refraction.Part two Super high myopia with cataract visual quality assessment of patients after phacoemulsificationObjective: To evaluate the visual quality after phacoemulsification in patients with super high myopia with cataract.Methods:53 patients,81 eyes were completed cataract sugery by the same expert doctor from our hospital on 2015,The average age of patients was(62.01 ±6.73)years old.Preoperative refraction is(-17.92 ±6.70)D.According to the axis length,the patients were divided into three parts:<29mm,29~31mm and >31mm.Lenstar LS 900 combined with A-scan did preoperative axial length examination,Automatic optometry instrument checked patients with preoperative refraction and checked patients best corrected visual acuity,Two eye Refraction more than 2.5D is anisometropia,the postopertive bect corrected visual acuity was checked in one week,one month,three month after surgery,respectively,we checked the standard near vision,OCT and Mara(4-2 strategy)after three month of surgery.Results :The patient is given priority to with nuclear cataract,III,IV and V class nuclear patients accounts for 90.12%(72 eyes),8.64%(7 eyes),1.24%(1 eye).Preoperative refractive degree(-17.92± 6.70)D,eye axis length of(29.96 ± 2.06)mm,31 eyes' AL is <29mm,The preoperative and postoperative one week,one month,three month BCVA is(0.20 ±0.17)?(0.67 ± 0.26)?(0.66±0.23)?(0.65 ± 0.21),The near visual acuity is(0.31± 0.11),the normal degree of the Mara's Average Thresh and Fixation Stability accouts for 83.33% and 50.00% in three months after the operation.20 eyes' AL is 29~31mm,The preoperative and postoperative one week,one month,three month BCVA is(0.15±0.13)?(0.62±0.32)?(0.63±0.33)?(0.60±0.32),The near visual acuity is(0.28±0.13)and the normal degree of the Mara's Average Thresh and Fixation Stability accouts for 47.56% and 47.56% in three months after the operation.30 eyes' AL is >31mm,The preoperative and postoperative one week,one month,three month BCVA is(0.09±0.09)?(0.54±0.27)?(0.54±0.27)?(0.52±0.25),The near visual acuity is(0.27±0.15 and the normal degree of the Mara's Average Thresh and Fixation Stability accouts for 40.00%% and 55.00% in three months after the operation.17 patients is preoperative anisometropia,including 13 patients double eyes and 4 patients single eye,postoperative anisometropia is completely eliminated.Conclusions: Patients with super high myopia with cataract,the best corrected visual acuity,retinal function and near vision will decrease with the increase of the axial length.The operation is not only to solve the problem of cataract,but also to solve the problem of refraction of patients.Therefore,super high myopia combined with cataract patients with phacoemulsification can greatly improved visual quality of patients,and these patients sooner rather than intervention to obtain more satisfactory visual quality. |
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