目的：探讨白内障患者超声乳化白内障摘除联合人工晶状体植入术(Phaco+IOL)术后眼前节结构变化及相关性分析。

方法：回顾性病例研究。纳入北京大学第三医院眼科2018-01/2022-12间接受Phaco+IOL手术且在手术前后愿意接受超声生物显微镜(UBM)检查的白内障患者44例88眼，记录患者的性别、年龄、眼轴、角膜曲率和IOL资料。采用UBM测量手术前后各眼前节参数，包括前房深度(ACD)、巩膜睫状突角(SCPA)、虹膜晶状体接触距离(ILCD)、睫状体最大厚度(CBTmax)和巩膜突睫状体厚度(CBT0)，图像处理软件Image J计算后房面积(PCA)。

结果：术后ACD为3.50(2.89，3.68)mm，CBTmax为1.199±0.233 mm，CBT0为1.11(0.964，1.23)mm，PCA为1.21(0.926，1.57)mm²，较术前明显增大(均P<0.001)。术后ILCD为0.00(0.00，0.794)mm，较术前明显减小(P<0.001)。术后SCPA为37.9°(33.4°，46.6°)，较术前无显著变化(P=0.908)。PCA增量在性别间存在差异(P=0.045)，术后男性平均PCA增量为0.679 mm²，女性平均PCA增量为0.304 mm²。年龄与术后SCPA、CBTmax、CBT0显著相关(P=0.002、0.004、0.009)。

结论：Phaco+IOL术后后房面积扩大，CBTmax和CBT0均有显著增长，ACD增加，ILCD减小。术后PCA增加量与年龄、术前ACD、SCPA呈正相关，与术前CBT0呈负相关。不同品牌IOL对眼前节结构影响无显著差异。

METHODS: Retrospective case study. A total of 44 cases(88 eyes)of cataract patients who underwent Phaco+IOL surgery at ophthalmology department of the Peking University Third Hospital from January 2018 to December 2022 and consented to pre- and postoperative ultrasound biomicroscopy(UBM)were included. Patients' sex, age, axial length, corneal curvature, and IOL parameters were collected. UBM was utilized to measure various anterior segment parameters pre- and post-surgery, including anterior chamber depth(ACD), scleral ciliary process angle(SCPA), iris-lens contact distance(ILCD), maximum ciliary body thickness(CBTmax), and ciliary body thickness at 0 mm from the scleral spur(CBT0). The posterior chamber area(PCA)was calculated using Image J software.

RESULTS: Significant increases in ACD 3.50(2.89, 3.68)mm, CBTmax 1.199±0.233 mm, CBT0 1.11(0.964, 1.23)mm, and PCA 1.21(0.926, 1.57)mm² were identified postoperatively compared with preoperative values(all P<0.001). The postoperative ILCD was significantly reduced to 0.00(0.00, 0.794)mm(P<0.001). There was no significant change in the postoperative SCPA 37.9°(33.4°, 46.6°; P=0.908). The increase in PCA varied significantly between genders(P=0.045), with males showing a greater mean postoperative increase(0.679 mm²)than females(0.304 mm²). Age significantly correlated with postoperative SCPA, CBTmax, and CBT0(P=0.002, 0.004, 0.009, respectively).

CONCLUSION: Phaco+IOL surgery resulted in an enlargement of the PCA, significant increases in ACD, CBTmax, and CBT0, and a reduction in ILCD. The post-surgery increase of PCA was influenced by multiple factors, with age, preoperative ACD and SCPA being positively correlated, and preoperative CBT0 being negatively correlated. No significant differences were observed in the impact of different IOL brands on the structural changes of the anterior segment.