目的：基于Pentacam眼前节分析系统测量白内障手术不同时期角膜后表面屈光力及角膜后表面散光的变化。方法：选取2019-01/2020-01在我院眼科收治的年龄相关性白内障患者96例116眼为研究对象，所有患者均行白内障超声乳化联合人工晶状体植入术，术后1wk，1、3mo进行随访行Pentacam检查，获取角膜前表面屈光力、后表面屈光力、总屈光力的平坦子午线屈光力、陡峭子午线屈光力、平均屈光力、角膜前表面散光、后表面散光、总散光等参数值。Spearman秩相关对各眼前节参数进行相关性分析。结果：术后1wk角膜前表面屈光力(平坦值、陡峭值、平均值)均较术前变小，在术后1、3mo逐渐趋于术前水平； 术后1wk角膜后表面屈光力、总屈光力(平坦值、陡峭值、平均值)较术前增大，均在术后3mo趋于稳定。术后1wk角膜前表面散光、后表面散光、总散光较术前增大，后逐渐降低至术后3mo稳定。角膜前表面屈光力与角膜总屈光力呈显著正相关，角膜后表面屈光力与角膜总屈光力呈显著负相关，与其绝对值呈显著正相关(P<0.05)。角膜总散光术前，术后1wk，3mo与角膜前表面散光相对应时期呈明显正相关(P<0.01)，与角膜后表面散光相关性较小。结论：白内障手术导致的角膜后表面屈光力及角膜后表面散光变化发生在术后3mo内，Pentacam眼前节分析系统可准确评估术前及术后角膜前后表面屈光力及散光的动态变化，具有很大的临床价值。

AIM: To investigate dynamic changes of posterior corneal power and astigmatism after cataract surgery based on Pentacam three-dimensional anterior eye segment analyzer.METHODS: Totally 96 elderly patients(116 eyes)with cataract underwent phacoemulsification combined with intraocular lens implantation in our hospital from January 2019 to January 2020 were selected. Parameters including anterior corneal power, posterior corneal power, flat keratometry, steep keratometry, mean keratometry, anterior corneal astigmatism, posterior corneal astigmatism, and total corneal astigmatism were obtained using Pentacam three-dimensional anterior eye segment analyzer system at postoperative 1wk, 1mo and 3mo. Spearan correlation analysis was performed on the anterior segment. RESULTS: The anterior corneal power(flat keratometry, steep keratometry, mean keratometry)was lower at postoperative 1wk than that before operation, and began to return to the preoperative level at postoperative 1mo and 3mo. The posterior corneal power and total corneal power(flat keratometry, steep keratometry, mean keratometry)were higher at postoperative 1wk than before operation, and began to stabilize at postoperative 3mo. The anterior corneal astigmatism, posterior corneal astigmatism, and total corneal astigmatism were also higher at postoperative 1wk than before operation, and began to decrease and stabilize at postoperative 3mo. The anterior corneal power was significantly positively correlated with total corneal power; The posterior corneal power was significantly negatively correlated with the total corneal power, and was significantly positively correlated with its absolute value(P<0.05). The total corneal astigmatism before operation and at postoperative 1wk and 3mo was significantly positively correlated with anterior corneal astigmatism at corresponding time points(P<0.01), while showed no significant correlation with posterior corneal astigmatism.CONCLUSION: Changes of posterior corneal power and astigmatism can be observed with 3mo of cataract surgery, and Pentacam three-dimensional anterior eye segment analyzer system can accurately assess the dynamic changes of anterior and posterior corneal power and astigmatism before and after operation, which is of great clinical value.

新疆卫生健康青年医学科技人才专项科研项目(No.WJWY-202039)