AIM: To investigate the changes in anterior chamber depth(ACD), axial length(AL), and corneal curvature(K)after operation in patients with high axial myopia combined with cataract, and the effect on postoperative mean refractive error(MFE)by different surgical approaches.

METHODS: A total of 126 patients(126 eyes)performed cataract combined with intraocular lens(IOL)implantation were selected and divided into 3 groups according to different surgical approaches and axial length. Group A included 42 patients(42 eyes)who had cataract combined with high myopia and were performed cataract phacoemulsification combined with IOL implantation; Group B included 42 patients(42 eyes)who had cataract combined with high myopia and underwent small incision cataract extracapsular extraction combined with IOL implantation; Group C included 42 patients(42 eyes)who had cataract with normal axial length and underwent cataract phacoemulsification combined with IOL implantation. Then, the ACD, AL, K value and visual acuity of the three groups at 1d before operation and 3mo after operation were measured, and statistical analysis was performed.

RESULTS: The differences in the mean values of preoperative and postoperative changes in ACD(△ACD)and AL(△AL)between groups A and B showed no statistical significance. The differences in the mean values of △ACD and △AL between groups A and C and groups B and C were both statistically significant(both P<0.01). △ACD and △AL in all three groups showed positive correlation(r_A=0.855, r_B=0.856, r_C=0.639, all P<0.05). Furthermore, preoperative AL, △AL, △ACD and MFE in all three groups showed positive correlation(r_A=0.874, 0.877, 0.858, r_B=0.875, 0.879, 0.858, r_C=0.428, 0.766, 0.862, all P<0.05). The standardized regression coefficients of groups A and B were △AL>△ACD(1.32 and 1.31 times), and the standardized regression coefficients of group C were △ACD>△AL(1.66 times).

CONCLUSION: Different surgical procedures had no significant effect on the postoperative K value and MFE in patients with high axial myopia combined with cataract, of which main influencing factor is the change in the AL before and after surgery. The postoperative MFE in patients with normal AL was more due to the change of ACD.