Objective  To observe myopia shift in idiopathic macular hole(IMH) combined with cataract(CAT) patients after combined surgical treatment (vitrectomy combined with phacoemulsification and intraocular lens implantation), and to analyze its related factors.

  Methods  A total of 75 patients with IMH combined with CAT were retrospective selected as observation group(given combined surgeries), and 75 patients with CAT alone underwent phacoemulsification combined with intraocular lens implantation were selected as control group. The improvement of refractive indexes before and after treatment and occurrence of myopia shift between the two groups were compared, the factors related to the occurrence of myopia shift in the observation group were analyzed.

  Results  After surgery, logarithm of the minimum angle of resolution of best-corrected visual acuity (LogMAR BCVA) in both groups was higher, and anterior chamber depth (ACD) was higher than those before surgery, the differences were statistically significant (P < 0.05). After surgery, the mean refractive prediction error (ME) of the observation group was (-0.28±0.16) D drift, and (0.08±0.65) D drift in the control group, the difference was statistically significant (P < 0.05). The incidence of myopia drift in the observation group was 66.7% (50/75), which was higher than 28.0% (21/75) in the control group, and the difference was statistically significant (χ²=22.491, P < 0.05). Logistics analysis was used to analyze the influencing factors of myopia shift, and the results showed that there were no related factors for myopic drift in CAT patients with IMH after combined surgeries.

  Conclusion  IMH patients with CAT have higher probability to present myopia drift after combined surgeries, but there are no significant correlated factors, which may be related to intraoperative changes in vitreous refractive indexes. It is recommended to reserve appropriate hyperopia 0.3 to 0.5 D for preoperative lens estimation to reduce the occurrence of postoperative myopia drift.