目的：研究影响高度近视眼合并白内障患者行超声乳化及人工晶状体植入术后屈光状态的原因。 方法：对30例38眼轴性高度近视合并白内障患者行超声乳化及人工晶状体植入术，术后3mo测量患者屈光状态，和预期屈光状态对比，进行统计学分析。 结果：患者38眼术前平均预期屈光度为-1.39±0.47D，术后实际屈光度平均值为-0.87±0.93D，两者屈光度平均差值为-0.67±0.74D，两者比较差异有显著意义（t=3.375,P=0.002）。其中术后偏远视的有25眼，占66%。屈光度绝对差值与角膜曲率低度相关（r=0.443）,与眼轴长高度正相关（r=0.909），随眼轴长增长，绝对差值加大。眼轴长为26～＜29mm的术眼屈光度平均绝对差值为0.61±0.39D，眼轴长≥29mm的术眼屈光度平均绝对差值为1.37±0.84D，两者比较差异有显著意义（t=2.8601,P=0.005）。在绝对差值分布上，眼轴长为26～＜29mm的术眼中所有差值均＜2.00D;眼轴长≥29mm的术眼中6眼差值≥2.00D，占32%。 结论：影响高度近视眼合并白内障患者的术后屈光状态原因有多种，眼轴长是最重要的原因之一。

AIM:To study the factors influencing the refraction of high myopia patients with cataract after phacoemulsification and intraocular lens implantation. METHODS:Phacoemulsification and intraocular lens implantation were performed on 30 patients (38 eyes) with axial high myopia and cataract. Three months after operation, postoperation refractions were measured and compared with predictive refractions. RESULTS: The average predictive refraction of 38 eyes was -1.39±0.47D.The average postoperative refraction was -0.87±0.93D.The average refraction error was -0.67±0.74D.There was significant statistical difference (t=3.375,P=0.002). There was low correlation between absolute refraction error and k-reading (r=0.443), and there was high positive correlation between refraction error and axial length (r=0.909). The absolute refraction error increased with the axial length growth. The average refraction error in eyes with axial length of 26-29mm was 0.61±0.39D, and with axial length ≥29mm was 1.37±0.84D.The difference was statistically significant (t=2.8601,P=0.005). The absolute refraction errors in eyes with axial length of 26-29mm were all less than 2.00D, and the refraction errors of six eyes with axial length of ≥ 29mm were ≥ 2.00D, accounting for 32%. CONCLUSION: The axial length is one of the most important factors which influence the postoperative refractive error of high myopia with cataract surgery.