目的：分析白内障超声乳化(PHACO)联合人工晶状体植入术治疗高度近视白内障疗效的影响因素。

方法：回顾性分析2016-02/2019-03本院行超声乳化人工晶状体植入术的高度近视白内障患者80例91眼的临床资料，依据术后3mo最佳矫正视力情况将其分为低视力组(最佳矫正视力<0.3)、正常组(最佳矫正视力≥0.3)，对比两组患者术前临床资料，分析影响视力恢复的因素。

结果：所有患者均顺利完成手术，手术前后BCVA比较有差异(P<0.001)，未见角膜失代偿、继发性青光眼、人工晶状体移位等严重并发症。低视力组年龄、近视时间、眼轴长度、术前眼压、角膜散光度、前囊口面积、中央前房深度、晶状体核分级及合并糖尿病视网膜病变、后巩膜葡萄肿、黄斑变性、术后黄斑水肿发生率与正常组比较均有差异(P<0.05)； 多因素Logistic回归分析显示，眼轴长度>30mm、术前眼压≥21mmHg、角膜散光度≥1.30D、晶状体核分级Ⅲ～Ⅳ级、术前合并糖尿病视网膜病变、合并黄斑变性为影响高度近视白内障患者术后视力恢复的独立危险因素(P<0.05)。

结论：超声乳化人工晶状体植入术治疗高度近视白内障效果显著，但也受眼轴长度、术前眼压、角膜散光度、晶状体核分级、术前合并糖尿病视网膜病变、合并黄斑变性等因素影响而视力恢复不佳，术前应对此类因素提高警惕。

METHODS: The clinical data of 80 cases patients(91 affected eyes)with cataract and high myopia who underwent phacoemulsification and intraocular lens implantation in the hospital from February 2016 to March 2019 were analyzed retrospectively. According to the best corrected visual acuity(BCVA)at 3mo after operation, the patients were divided into low vision group(BCVA<0.3)and normal group(BCVA≥0.3). The preoperative clinical data of the two groups were compared, and the factors affecting visual recovery were analyzed.

RESULTS: All patients completed surgery successfully, and there were statistically significant differences in BCVA before and after surgery(P<0.001). No serious complications such as corneal decompensation, secondary glaucoma and intraocular lens displacement were found. There were significant differences in age, myopia time, axial length, preoperative intraocular pressure, corneal astigmatism, anterior capsular opening area, central anterior chamber depth, grade of lens nucleus and incidence rates of diabetic retinopathy, posterior scleral staphyloma, macular degeneration and postoperative macular edema between the low vision group and the normal group(P<0.05). Multivariate Logistic regression analysis showed that axial length >30 mm, preoperative intraocular pressure ≥21mmHg, corneal astigmatism ≥1.30D, grade Ⅲ-Ⅳ lens nucleus, preoperative diabetic retinopathy and macular degeneration were the independent risk factors for postoperative visual recovery in patients with high myopia and cataract(P<0.05).

CONCLUSION: PHACO combined with intraocular lens implantation is markedly effective in the treatment of high myopia with cataract. However, the curative effect is affected by axial length, preoperative intraocular pressure, corneal astigmatism, grade of lens nucleus, preoperative diabetic retinopathy and macular degeneration, which deserves attention.