Analysis Of Relevant Factors Of Postoperative Refractive Drift In Patients With High Myopia Complicated By Cataracts

Purpose:Compare patients with short axis cataract and normal axis cataract,analyze the differences in the probability and degree of refractive drift after phacoemulsification and intraocular lens implantation in patients with high myopia complicated cataract,and analyze the relevant influencing factors of refractive drift,providing a certain theoretical basis for finding effective solutions.method:A total of 78 cataract patients(80 eyes)who underwent Phaco+IOL at the Affiliated Ophthalmology Hospital of Nanchang University from June 2022 to March 2023 were selected and divided into long axis group,normal axis group,and short axis group based on axial length.The IOL Master was used to measure preoperative AL,corneal curvature(K1,K2 mean values,i.e.Km values),and anterior chamber depth(ACD),The corneal topography instrument measures the white to white distance(WTW)of the corneal limbus,estimates postoperative refractive error,and follows up to record the actual refractive error measured by the patient’ s subjective refraction one month after surgery.The difference between this and the preoperative estimated refractive error is Refractive Error(RE),and the absolute value of the difference is Absolute Value Of Refractive Error(ARE).A positive RE indicates hyperopia drift,If RE is negative,it means myopia drift.Considering the influence of measurement errors,this study adopts ARE>0.5D as the effective refractive drift value,analyzes the differences between the three groups of ARE,and conducts correlation analysis between AL,ACD,WTW,Km values and postoperative ARE in different AL patients for one month.result:The probability of postoperative refractive drift in three groups of patients is ranked from high to low: long eye axis group,short eye axis group,and normal eye axis group(p=0.008<0.05).The postoperative ARE values of patients in the long axis group were higher than those in the short axis group and normal axis group(p=0.006<0.05).The ARE of patients in the long axis group and normal axis group at 1 month after surgery was positively correlated with preoperative AL,ACD,and WTW(rs=0.748,0.534,0.684,all P<0.05);(rs=0.377,0.556,0.753,all P<0.05).The ARE of patients in the short eye axis group at one month after surgery was negatively correlated with preoperative AL and ACD(rs=-0.746,-0.497,all P<0.05),and positively correlated with WTW(rs=0.444,P<0.05).There was no correlation between the ARE and preoperative Km values at 1 month after surgery in the long axis group,normal axis group,and short axis group(rs=-0.124,rs=-0.099,rs=0.095,all P>0.05).Conclusion:The likelihood of postoperative refractive drift in patients with high myopia complicated with cataract is higher than that in patients with normal and short axis cataracts.Most cases are hyperopia drift,and the degree of refractive drift is also greater,which significantly affects the postoperative visual quality recovery.AL,ACD,and WTW are important influencing factors for postoperative refractive drift in cataract patients.In clinical work,for patients with high myopia and complicated cataract with a long eye axis,the preoperative reserved myopia diopter can be appropriately increased to reduce the impact of postoperative hyperopia drift.