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目的 研究重硅油填充对眼屈光状态的影响.方法 采用Gullstrand-Emsley模型眼计算重硅油填充眼的屈光状态,在无晶状体眼模型上设计3种后囊膜状态,计算不同状态对屈光的影响.对21例重硅油填充眼视网膜复位患者进行检影,研究重硅油填充眼屈光状态理论和实际差异.结果 重硅油填充可导致有晶状体眼屈光度增加+6.33 D.对于无晶状体眼,后囊膜前凸时镜片屈光度增加+11.30 D,后囊膜为平面时镜片屈光度增加+14.70 D,后囊膜后凸时镜片屈光度增加+19.10 D.重硅油可导致人工晶状体眼屈光度增加约+7.28 D.有晶状体眼、无晶状体眼、人工晶状体眼重硅油填充后实际屈光度增加约(+6.25±3.27)D、(+7.94±3.83)D、(+4.40±1.34)D.结论 重硅油填充使眼球屈光状态向远视方向变化,实际测量值均低于理论计算值,无晶状体重硅油填充眼屈光状态与后囊膜形态密切相关.

Objective To study the refractive changes induced by intraocular heavy silicone oil.Methods The theoretical refractive state of eyes with heavy silicone oil was calculated with the parameter of Gullstrand-Emsley model eye.Three shape models of posterior capsule in aphakic eyes were taken to evaluate their influence on ocular refraction.Retinoscopy was performed on 21 heavy silicone oil tamponade eyes and theoretical and experimental differences were study.Results Theoretically phakic Gullstrand-Emsley model eye showed+6.33D increase in spectacle refraction induced by intraocular heavy silicone oil.There was a+11.30D alteration in spectacle refraction with a convex forward posterior capsule,a+14.70D alteration with a flat posterior capsule and a+19.10D alteration with a convex backward posterior capsule in aphakic heavy silicone oil tamponade eyes.There was a+7.28D alteration in heavy silicone oil tamponade eyes with IOL.Experimental postoperative diopter in phakic heavy silicone oil tamponade eyes increased(+6.25±3.27)D,in aphakic heavy silicone oil tamponade eyes increased(+7.94±3.83)D and in heavy silicone oil tamponade eyes with IOL increased(+4.40±1.34)D.Conclusions Hyperopic changes are found in heavy silicone oil tamponade eyes,and the clinical measured values are lower than the theoretical ones.Refractive state of aphakic heavy silicone oil tamponade eyes is closely related with the shape of posterior capsule.