[Correlation between corneal refractive power and anterior chamber morphology in age-related cataract patients with shallow anterior chambers].

Objective: To investigate the relationship between corneal refractive power and anterior chamber parameters in age-related cataract patients with normal axial lengths and shallow anterior chambers. Methods: Retrospective case series study. Clinical data of 627 age-related cataract patients (627 eyes) with axial lengths between 22 mm and 24 mm and anterior chamber depths less than 2.20 mm treated in the Department of Ophthalmology of Peking University International Hospital from June 2018 to October 2021 were selected. There were 215 male patients and 412 female patients, with an average age of (75±10) years. According to the average corneal refractive power, eyes were divided into groups of keratometry (K)<42 diopters (D) (50 eyes), 42 D ≤K<45 D (398 eyes) and K ≥45 D (179 eyes). Axial length, anterior chamber depth, corneal diameter, anterior chamber volume and anterior chamber angle of 3 groups were recorded, and Spearman correlation analysis was used to analyze the correlation between parameters. The differences of parameters among different groups were compared by one-way analysis of variance or Kruskal-Wallis test, and multiple or pairwise comparisons using LSD-t test or Mann-Whitney U test. Results: There was a negative correlation between axial length and corneal refractive power in 627 eyes (r=-0.62, P<0.001). Corneal refractive power was positively correlated with anterior chamber depth (r=0.26, P=0.006), while in the K≥45 D group, corneal refractive power was also positively correlated with anterior chamber depth (r=0.23, P=0.025). Anterior chamber depth [M (Q1,Q3)] was 1.77 (1.64, 1.90) mm in the K<42 D group, 1.85 (1.70, 2.14) mm in the 42 D≤K<45 D group and 2.02 (1.81, 2.18) mm in the K≥45 D group. Multiple comparisons showed that there were significant differences in anterior chamber depth between the K<42 D group and the K≥45 D group, between the 42 D≤K<45 D group and the K≥45 D group (U=14 372.00, 18 226.00; both P<0.05). There was a negative correlation between corneal refractive power and corneal diameter in 627 eyes (r=-0.52,P<0.001), while in the 42 D≤K<45 D group and the K≥45 D group, corneal refractive power were also negatively correlated with corneal diameter (r=-0.20, -0.28; both P<0.05). Corneal diameter was (11.77±0.43) mm in the K<42 D group, (11.24±0.35) mm in the 42 D≤K<45 D group and (10.90±0.33) mm in the K≥45 D group, while there were significant differences in multiple comparisons (t=1.92, 2.96, 2.01; all P<0.05). There was no correlation between corneal refractive power and anterior chamber volume, or between corneal refractive power and anterior chamber angle in 627 eyes (all P>0.05). There was no significant difference both in anterior chamber volume and in anterior chamber angle among 3 groups (all P>0.05). Conclusion: For age-related cataract patients with normal axial lengths and shallow anterior chambers, the anterior chamber depth increase and the corneal diameter decrease with the increase of corneal refractive power, but there is no significant change in anterior chamber volume and anterior chamber angle.目的： 研究正常眼轴长度的年龄相关性白内障合并浅前房患者角膜屈光力与前房形态参数的相关性。 方法： 回顾性病例系列研究。选取2018年6月至2021年10月就诊于北京大学国际医院眼科的22 mm≤眼轴长度<24 mm、前房深度≤2.20 mm的年龄相关性白内障627例（627只眼）患者资料。其中男性215例，女性412例，年龄（75±10）岁。根据平均角膜屈光力（K值）将患者分为K<42 D组（50只眼），42 D≤K<45 D组（398只眼）和K≥45 D组（179只眼）。记录3个组患者的眼轴长度、前房深度、角膜直径、前房容积及前房角，并采用Spearman相关分析法分析各参数间相关性。不同组间眼部参数比较采用单因素方差分析或Kruskal-Wallis检验，多重或两两比较采用LSD-t检验或Mann-Whitney U检验。 结果： 627只眼的眼轴长度与角膜屈光力呈负相关（r=-0.62，P<0.001）。角膜屈光力与前房深度呈正相关（r=0.26，P=0.006），其中K≥45 D组角膜屈光力与前房深度呈正相关（r=0.23，P=0.025）。前房深度K<42 D组［M（Q1，Q3）］为1.77（1.64，1.90）mm，42 D≤K<45 D组为1.85（1.70，2.14）mm，K≥45 D组为2.02（1.81，2.18）mm，多组比较后两两比较显示K<42 D组与K≥45 D组、42 D≤K<45 D组与K≥45 D组间差异有统计学意义（U=14 372.00、18 226.00；均P<0.05）。627只眼角膜屈光力与角膜直径呈负相关（r=-0.52，P<0.001），其中42 D≤K<45 D组及K≥45 D组角膜屈光力与角膜直径均呈负相关（r=-0.20、-0.28；均P<0.05）。角膜直径K<42 D组为（11.77±0.43）mm，42 D≤K<45 D组为（11.24±0.35）mm，K≥45 D组为（10.90±0.33）mm，多组比较后两两比较差异均有统计学意义（t=1.92、2.96、2.01；均P<0.05）。627只眼角膜屈光力与前房容积及前房角均无相关性（均P>0.05）。前房容积、前房角3组间比较，差异均无统计学意义（均P>0.05）。 结论： 对于正常眼轴长度合并浅前房的年龄相关性白内障患者，前房深度随角膜屈光力增加而加深，角膜直径随角膜屈光力增加而减小，但前房容积及前房角无明显变化。.