山东大学耳鼻喉眼学报 ›› 2022, Vol. 36 ›› Issue (2): 83-89.doi: 10.6040/j.issn.1673-3770.0.2021.365

• • 上一篇    下一篇

Kappa与Alpha角在白内障手术前后的变化分析

胡颖峰1,贾玉叶3,王艳1,张嵘1,王峥1,叶向彧1,2   

  1. 1. 福州眼科医院 白内障科, 福建 福州 350007;
    2. 福州市第二医院 眼科, 福建 福州 350007;
    3. 青岛市第八人民医院 眼科, 山东 青岛 266100
  • 发布日期:2022-04-15
  • 通讯作者: 叶向彧. E-mail:609546088@qq.com
  • 基金资助:
    福建省自然科学基金面上项目(2019J01547)

Changes of kappa angle and alpha angle before and after cataract surgery

HU Yingfeng1, JIA Yuye3, WANG Yan1, ZHANG Rong1, WANG Zheng1, YE Xiangyu1,2   

  1. 1. Department of Cataract, Fuzhou Eye Hospital, Fuzhou 350007, Fujian, China;
    2. Department of Ophthalmology, the Second Hospital of Fuzhou, Xiamen University, Fuzhou 350007, Fujian, China;
    3. Department of Ophthalmology, the Eighth People's Hospital of Qingdao, Qingdao 266100, Shandong, China
  • Published:2022-04-15

摘要: 目的 比较分析白内障患者术前与术后Kappa角及Alpha角的变化情况。 方法 回顾性分析2020年行白内障超声乳化摘除手术的患者101例(101眼),每例患者采用OPD-Scan Ⅲ测量术前与术后的Kappa角(PDist、MDist)、Alpha角(LDist)的大小及方向,术前的明视及暗视的瞳孔直径;术前的眼轴(AL)、平均曲率(Km)、前房深度(ACD)、晶体厚度(LT)等生物学参数均使用OA-2000测量。计算手术前后Kappa角、Alpha角的矢量均值(CentroidPDist、CentroidMDist、CentroidLDist)。使用配对t检验分析手术前后Kappa角、Alpha角之间的差异;通过Pearson分析各生物测量参数与手术前后Kappa角差值(DPDist、DMDist)及Alpha角差值(DLDist)之间、术前与术后Kappa角及Alpha角大小之间的相关性。 结果 术前PDist为(0.24±0.15)mm、MDist为(0.27±0.14)mm、LDist为(0.41±0.20)mm,术后PDist为(0.21±0.14)mm、MDist为(0.22±0.14)mm、LDist为(0.41±0.22)mm;手术前后PDist、MDist大小比较差异有统计学意义,术后的PDist、MDist小于术前;手术前后LDist大小比较无统计学差异。术前与术后PDist、MDist无明显相关性,手术前后LDist呈正相关; DPDist与LT呈正相关;DMDist与明视瞳孔直径、暗视瞳孔直径呈正相关,DLDist与年龄呈正相关。 结论 与Kappa角相比,Alpha角手术前后的大小及分布变化较小,且术前与术后正相关,术前使用Alpha角评估更具有可靠性;但术前裸眼视力差或瞳孔偏大的患者可能导致术后Kappa角及Alpha角发生较大的大小变化,评估可靠性下降。

关键词: Kappa角, Alpha角, 矢量分析

Abstract: Objective To compare and analyze the changes of kappa angle and alpha angle in patients before and after cataract surgery. Methods 101 patients who underwent phacoemulsification in our hospital in 2020 were analyzed retrospectively. OPD scan Ⅲ was used to measure the size and direction of kappa angle(PDist、 MDist)and alpha angle(LDist)before and after the surgery. The pupil diameter of bright and dark environment were also measured by OPD scan Ⅲ. Preoperative biological parameters such as axial(AL), mean keratometry(Km), anterior chamber depth(ACD)and lens thickness(LT)were measured by OA-2000. The centroid kappa angle and centroid alpha angle before and after surgery were calculated. Paired sample t-test was used to analyze the difference of kappa angle and alpha angle before and after surgery. The correlation of preoperative kappa angle, postoperative kappa angle, preoperative alpha angle, postoperative alpha angle was analyzed by pearson correlations, and the correlation of pupil diameter, AL, Km, ACD, LT, DPDist, DMDist, DLDist was analyzed by pearson correlations. Results The preoperative PDist was(0.24±0.15)mm, the preoperative MDist was(0.27±0.14)mm, the preoperative LDist was(0.41±0.20)mm. The postoperative PDist was(0.21±0.14)mm, the postoperative MDist was(0.22±0.14)mm, the postoperative LDist was(0.41±0.22)mm. There was significant difference in PDist and MDist before and after surgery. PDist and MDist were decreased after surgery. There was no significant difference in LDist before and after surgery. There was no significant correlation between PDist and MDist before and after surgery. Postoperative LDist was positively correlated with preoperative LDist.DPDist was positively correlated with LT. DMDist was positively correlated with bright pupil diameter and dark pupil diameter. DLDist was positively correlated with age. Conclusion There was no significant change in the size and distribution of alpha angle before and after surgery,and was a positive correlation between preoperative and postoperative alpha angle. Compared with kappa angle, preoperative alpha angle evaluation is more reliable. However, patients with poor uncorrected visual acuity or abnormal pupil diameter before the surgery may cause large changes in kappa angle and alpha angle after surgery.

Key words: Kappa Angle, Alpha Angle, Vector analysis

中图分类号: 

  • R776
[1] de Vries NE, Webers CAB, Touwslager WRH, et al. Dissatisfaction after implantation of multifocal intraocular lenses[J]. J Cataract Refract Surg, 2011, 37(5): 859-865. doi:10.1016/j.jcrs.2010.11.032.
[2] Wang L, Guimaraes de Souza R, Weikert MP, et al. Evaluation of crystalline lens and intraocular lens tilt using a swept-source optical coherence tomography biometer[J]. J Cataract Refract Surg, 2019, 45(1): 35-40. doi:10.1016/j.jcrs.2018.08.025.
[3] Woodward MA, Randleman JB, Stulting RD. Dissatisfaction after multifocal intraocular lens implantation[J]. J Cataract Refract Surg, 2009, 35(6): 992-997. doi:10.1016/j.jcrs.2009.01.031.
[4] Walkow L, Klemen UM. Patient satisfaction after implantation of diffractive designed multifocal intraocular lenses in dependence on objective parameters[J]. Graefe's Arch Clin Exp Ophthalmol, 2001, 239(9): 683-687. doi:10.1007/s004170100348.
[5] Prakash G, Prakash DR, Agarwal A, et al. Predictive factor and kappa angle analysis for visual satisfactions in patients with multifocal IOL implantation[J]. Eye(Lond), 2011, 25(9): 1187-1193. doi:10.1038/eye.2011.150.
[6] 魏佩佩. 多焦点人工晶体植入术后的视觉质量及并发症[J]. 山东大学耳鼻喉眼学报, 2021, 35(2): 141-146. doi:10.6040/j.issn.1673-3770.0.2020.164. WEI Peipei. Visual quality and complications after implantation of multifocal intraocular lens[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(2): 141-146. doi:10.6040/j.issn.1673-3770.0.2020.164.
[7] Karhanová M, Pluhá cek F, Ml cák P, et al. The importance of angle kappa evaluation for implantation of diffractive multifocal intra-ocular lenses using pseudophakic eye model[J]. Acta Ophthalmol, 2015, 93(2): e123-e128. doi:10.1111/aos.12521.
[8] Qi YY, Lin J, Leng L, et al. Role of angle κ in visual quality in patients with a trifocal diffractive intraocular lens[J]. J Cataract Refract Surg, 2018, 44(8): 949-954. doi:10.1016/j.jcrs.2018.05.026.
[9] 马健利, 王文亭, 姜雅琴, 等. Alpha角对多焦点人工晶状体植入术后视觉质量影响[J]. 中华眼视光学与视觉科学杂志, 2019, 21(12): 906-909. doi:10.3760/cma.j.issn.1674-845X.2019.12.005. MA Jianli, WANG Wenting, JIANG Yaqin, et al. Effect of angle alpha on visual quality after multifocal intraocular lens implantation[J]. Chinese Journal of Optometry Ophthalmology and Visual Science, 2019, 21(12): 906-909. doi:10.3760/cma.j.issn.1674-845X.2019.12.005.
[10] 胡颖峰, 王艳, 张嵘, 等. 白内障患者术前Alpha角的分布特点及相关因素分析[J]. 福建医药杂志, 2021, 43(1): 3-6.doi:10.3969/j.issn.1002-2600.2021.01.002. HU Yingfeng, WANG Yan, ZHANG Rong, et al. The distribution and relevant factors of preoperative angel alpha in cataract patients[J]. Fujian Medical Journal, 2021, 43(1): 3-6.doi:10.3969/j.issn.1002-2600.2021.01.002.
[11] Kim JW, Eom Y, Chung HW, et al. Factors for good near and distance visual outcomes of multifocal intraocular lens with inferior segmental near add[J]. Graefes Arch Clin Exp Ophthalmol, 2020, 258(8): 1735-1743. doi:10.1007/s00417-020-04761-1.
[12] Holladay JT, Simpson MJ. Negative Dysphotopsia: causes and rationale for prevention and treatment[J]. J Cataract Refract Surg, 2017, 43(2): 263-275. doi:10.1016/j.jcrs.2016.11.049.
[13] Moshirfar M, Hoggan RN, Muthappan V. Angle Kappa and its importance in refractive surgery[J]. Oman J Ophthalmol, 2013, 6(3): 151-158. doi:10.4103/0974-620X.122268.
[14] Karhanová M, Mare sová K, Pluhá cek F, et al. The importance of angle kappa for centration of multifocal intraocular lenses[J]. Cesk Slov Oftalmol, 2013, 69(2): 64-68.
[15] Garzón N, García-Montero M, López-Artero E, et al. Influence of angle κ on visual and refractive outcomes after implantation of a diffractive trifocal intraocular lens[J]. J Cataract Refract Surg, 2020, 46(5): 721-727. doi:10.1097/j.jcrs.0000000000000156.
[16] 李孟琼, 毛祖红, 张广斌. 白内障患者Kappa角特点及明暗状态下的变化[J]. 中华眼视光学与视觉科学杂志, 2019, 21(7): 499-506. doi:10.3760/cma.j.issn.1674-845X.2019.07.004. LI Mengqiong, MAO Zuhong, ZHANG Guangbin. Characteristics of angle kappa in cataract patients and changes under photopic and mesopic conditions[J]. Chinese Journal of Optometry Ophthalmology and Visual Science, 2019, 21(7): 499-506. doi:10.3760/cma.j.issn.1674-845X.2019.07.004.
[17] 王睿, 龙潭, 马挺. 白内障患者术前Kappa角和Alpha角相关性研究[J]. 临床医学研究与实践, 2018, 3(34): 1-3. doi:10.19347/j.cnki.2096-1413.201834001. WANG Rui, LONG Tan, MA Ting. Correlation between Alpha angle and Kappa angle in cataract patients[J]. Clinical Research and Practice, 2018, 3(34): 1-3. doi:10.19347/j.cnki.2096-1413.201834001.
[18] 温凯, 张红, 孙靖, 等. kappa角在人群中的分布: 基于iTrace像差仪的研究[J]. 眼科新进展, 2018, 38(3): 265-268. doi:10.13389/j.cnki.rao.2018.0062. WEN Kai, ZHANG Hong, SUN Jing, et al. Distribution of kappa angle measured by iTrace in a population of China[J]. Recent Advances in Ophthalmology, 2018, 38(3): 265-268. doi:10.13389/j.cnki.rao.2018.0062.
[19] Meng JQ, Du Y, Wei L, et al. Distribution of angle α and angle κ in a population with cataract in Shanghai[J]. J Cataract Refract Surg, 2021, 47(5): 579-584. doi:10.1097/j.jcrs.0000000000000490.
[20] 周丹, 朱怡, 朱浩斌, 等. 超声乳化联合IOL植入术围手术期瞳孔直径和反应的变化[J]. 中华眼视光学与视觉科学杂志, 2019, 21(12): 910-916. doi:10.3760/cma.j.issn.1674-845X.2019.12.006. ZHOU Dan, ZHU Yi, ZHU Haobin, et al. Changes in pupil diameter and reactions during the phacoemulsification stage with posterior chamber intraocular lens implantation[J]. Chinese Journal of Optometry Ophthalmology and Visual Science, 2019, 21(12): 910-916. doi:10.3760/cma.j.issn.1674-845X.2019.12.006.
[21] Yang YB, Thompson K, Burns SA. Pupil location under mesopic, photopic, and pharmacologically dilated conditions[J]. Invest Ophthalmol Vis Sci, 2002, 43(7): 2508-2512.
[22] Wang L, Guimaraes de Souza R, Weikert MP, et al. Evaluation of crystalline lens and intraocular lens tilt using a swept-source optical coherence tomography biometer[J]. J Cataract Refract Surg, 2019, 45(1): 35-40. doi:10.1016/j.jcrs.2018.08.025.
[23] Ranka MP, Steele MA. Esotropia associated with high myopia[J]. Curr Opin Ophthalmol, 2015, 26(5): 362-365. doi:10.1097/ICU.0000000000000180.
[24] Basmak H, Sahin A, Yildirim N, et al. Measurement of angle kappa with synoptophore and Orbscan II in a normal population[J]. J Refract Surg, 2007, 23(5): 456-460. doi:10.3928/1081-597X-20070501-06.
[1] 刘振,周维维,刘涵婧,张艺,朱玉广,朱艳. 人工晶状体Alpha角对连续视程人工晶状体眼视觉质量的影响[J]. 山东大学耳鼻喉眼学报, 2026, 40(1): 47-53.
[2] 周维维,刘振,张艺,刘涵婧,朱艳,朱玉广. OPD Overview模式检测Toric IOL轴位准确性及影响因素分析[J]. 山东大学耳鼻喉眼学报, 2025, 39(4): 174-180.
[3] 孙璐,张顺华,吴昱舟,陈露璐,曹迪,干霖洋. 关于Alpha角0.5~0.8 mm的患者植入区域折射型人工晶状体的短期临床观察[J]. 山东大学耳鼻喉眼学报, 2022, 36(6): 32-37.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!