本文關(guān)鍵詞： 白內(nèi)障超聲乳化吸除術(shù) 屈光漂移 眼前節(jié)　出處：《廣西醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:應(yīng)用Pentacam三維眼前節(jié)分析系統(tǒng)量化白內(nèi)障超聲乳化吸除術(shù)聯(lián)合人工晶體植入術(shù)前后患者的角膜曲率(Km)、前房容積(ACV)、前房深度(ACD)、前房角度(ACA),分析它們的變化與術(shù)后屈光漂移的相關(guān)關(guān)系。方法:在術(shù)前,術(shù)后1天,術(shù)后1周,術(shù)后1月,應(yīng)用Pentacam三維眼前節(jié)分析系統(tǒng)測量40例(42眼)白內(nèi)障患者的Km、ACV、ACD、ACA等,同時進(jìn)行驗光記錄屈光狀態(tài)。使用重復(fù)測量資料的方差分析法、單樣本t檢驗、Pearson線性相關(guān)分析,對所得數(shù)據(jù)進(jìn)行統(tǒng)計學(xué)分析。結(jié)果:患者白內(nèi)障超聲乳化吸除術(shù)后1天的平均屈光度為(-0.43±0.50)D、術(shù)后1周為(-0.71±0.54)D、術(shù)后1月為(-0.50±0.46)D,術(shù)后1天時患者屈光度接近手術(shù)目標(biāo)屈光度-0.5D,但術(shù)后1周時近視度比術(shù)后1天增加,于術(shù)后1月近視度數(shù)再次接近目標(biāo)屈光度,與術(shù)后1天相比無明顯差異(P〉0.05)。Pentacam三維眼前節(jié)分析系統(tǒng)檢查顯示患者ACD術(shù)后1天為(3.99±0.53)mm、術(shù)后1周為(3.81±0.50)mm、術(shù)后1月為(3.53±0.38)mm,ACV術(shù)后1天為(152.05±26.75)mm3、術(shù)后1周為(139.71±26.65)mm3、術(shù)后1月為(127.83±25.37)mm3,ACA術(shù)后1天為(45.44±6.45)°、術(shù)后1周為(43.83±5.81)°、術(shù)后1月為(43.82±4.58)°,術(shù)后1周、1月的ACD和ACV均比術(shù)后1天顯著減少(均為P〈0.05),而術(shù)后1周、1月的ACA與術(shù)后1天相比無明顯差異(P〉0.05)。患者術(shù)前Km為(42.74±1.06)、術(shù)后1天為(42.75±1.05)、術(shù)后1周為(42.73±1.00)、術(shù)后1月為(42.73±1.01),術(shù)前及術(shù)后各時間段的Km無明顯差異(P〉0.05)�；颊咝g(shù)后1周屈光度變化為(-0.28±0.60)D、術(shù)后1月屈光度變化為(-0.07±0.68)D,術(shù)后屈光度變化與ACD變化呈正相關(guān)(r1周=0.73,r1月=0.83,均為P〈0.05),術(shù)后1周屈光度變化與術(shù)后1周ACA變化呈弱相關(guān)(r1周=0.31,P〈0.05),而術(shù)后1月屈光度變化和ACA變化的相關(guān)性無統(tǒng)計學(xué)意義(P〉0.05)。屈光度變化與ACV變化無明顯相關(guān)性(P〉0.05)。屈光度變化與Km變化無明顯相關(guān)性(P〉0.05)。結(jié)論:白內(nèi)障超聲乳化吸除術(shù)后早期患者出現(xiàn)屈光漂移,手術(shù)后1天的屈光狀態(tài)接近于手術(shù)目標(biāo)屈光度,此后屈光度向近視漂移,術(shù)后1個月時近視漂移程度減輕。白內(nèi)障術(shù)后早期的屈光漂移與ACD的變化密切相關(guān)。
[Abstract]:Objective: to quantify the corneal curvature of patients before and after phacoemulsification combined with intraocular lens implantation (IOL) with Pentacam three-dimensional anterior segment analysis system. The correlation of postrefractive drift. Methods: before operation, On 1 day, 1 week and January after operation, 40 patients with cataract were measured by Pentacam three-dimensional anterior segment analysis system. The refractive state of 40 patients with cataract were recorded by optometry and the variance analysis method of repeated measurements was used. Single sample t-test Pearson linear correlation analysis, Results: the average diopter after phacoemulsification was 0.43 鹵0.50 d, 0.71 鹵0.54 D at 1 week after phacoemulsification, and -0.50 鹵0.46 Don on January. The diopter of the patient was close to the operation target at 1 day after phacoemulsification. -0.5D, but the myopia at 1 week after operation was higher than that on the first day after operation. On January, the myopia degree was close to the target diopter again, There was no significant difference (P > 0.05). Pentacam three-dimensional anterior segment analysis showed that ACD was 3.99 鹵0.53 mm on day 1, 3.81 鹵0.50 mm at 1 week after operation, 152.05 鹵26.75 mm 3 on January, 139.71 鹵26.65 mm 3 at 1 week after operation, 127.83 鹵25.37 mm 3mm after operation on January, 152.05 鹵26.75 mm 3 on 1 day after operation, 139.71 鹵26.65 mm 3 at 1 week after operation, and 127.83 鹵25.37 mm / 3mm on January after operation. At 1 week after operation, ACD and ACV in January were significantly lower than those in 1 day after operation (P < 0.05), but there was no significant difference in ACA between 1 week after operation and 1 day after operation (P > 0.05). The km before operation was 42.74 鹵1.06m, and on the first day after operation, there was no significant difference (P > 0.05) between the first week after operation and the first day after operation (P > 0.05). The preoperative km of the patients was 42.74 鹵1.06m, and that of postoperative day 1 was significantly lower than that of the first day after operation (P < 0.05), and there was no significant difference between ACA of January and postoperative day 1 (P > 0.05). There was no significant difference in km between before and after operation (P > 0.05). The diopter was -0.28 鹵0.60D at 1 week after operation, and the diopter was -0.07 鹵0.68D on January. There was a positive correlation between the change of diopter and the change of ACD. There was a weak correlation between the diopter change at 1 week after operation and the change of ACA at 1 week after operation (P < 0.05), but there was no significant correlation between diopter change and ACA change on January after operation (P > 0.05). There was no significant correlation between diopter change and ACV change. There was no significant correlation between the diopter change and km change (P > 0.05). Conclusion: the refractive drift was observed in early patients after phacoemulsification. One day after operation, the refractive state was close to the target diopter, then the diopter drifted to myopia, and the myopia drift reduced at 1 month after cataract. The early refractive drift was closely related to the change of ACD.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R779.66

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