本文選題：非球面人工晶狀體　切入點：球面像差　出處：《南方醫(yī)科大學(xué)》2012年碩士論文

【摘要】：目的 通過前瞻性研究,探索基于角膜球面像差的個體化非球面IOL植入的效果和可行性。 方法 在實施白內(nèi)障超聲乳化手術(shù)的患者中,術(shù)前運用Pentacam眼前節(jié)分析系統(tǒng)測定6mm直徑范圍內(nèi)的角膜球面像差,以此為基礎(chǔ),在三種球面像差不同的非球面人工晶狀體中選擇一種,使得術(shù)后總球面像差趨向0μm。這三種非球面人工晶狀體包括：Akreos Adapt AO (BauschLomb), AcrySof1Q SN60WF (Alcon Laboratories Inc)和Tecnis ZA9003(Advanced Medical Optics [AMO])。術(shù)后3月回訪時,再次測定6mm直徑范圍內(nèi)的角膜像差,并用Zywave像差儀(BauschLomb)測定6mm直徑范圍內(nèi)全眼球面像差。通過與非個體化及其他個體化研究的比較評估本實驗個體化方案的植入效果。通過對預(yù)測值和實測的球面像差之間的差異比較及誤差分析評估個體化方案的可行性。 利用SPSS13.0對各參數(shù)進行統(tǒng)計分析。術(shù)前與術(shù)后球面像差及高階像差的比較采用Wilcoxon符號秩檢驗；采用Spearman秩相關(guān)分析全眼球面像差與預(yù)測值,全眼球面像差預(yù)測誤差與術(shù)源性角膜球面像差、術(shù)前角膜球面像差,術(shù)前角膜球面像差與術(shù)源性角膜球面像差等的相關(guān)性。所有實驗數(shù)據(jù)以x±s表示,P0.05為差異有統(tǒng)計學(xué)意義。 結(jié)果 共53人(60眼)納入實驗。6眼(10.0%)植入Akreos Adapt AO,17眼(28.3%)植入AcrySof IQ SN60WF,37眼(61.7%)植入Tecnis ZA9003。所有納入研究的60眼術(shù)前及術(shù)后6mm直徑范圍內(nèi)角膜球面像差(Z4,0)分別為為0.250±0.111μm和0.250±0.107μm,二者差異無統(tǒng)計學(xué)意義。術(shù)后全眼球面像差為0.0365±0.0654u m較預(yù)測值(0.027±0.0714μm)略大,但差異無統(tǒng)計學(xué)意義(P=0.299)。全眼球面像差的預(yù)測誤差為-0.009±0.092μm,其中小于±0.10μm的有49眼(81.7%),小于±0.05um的有34眼(56.7%)。 結(jié)論 基于角膜球面像差個體化選擇非球面人工晶狀體可以減小術(shù)后全眼像差,并使全眼像差更接近預(yù)設(shè)值。由于手術(shù)對角膜球面像差的影響很小,且術(shù)源性角膜球差與預(yù)測誤差不具相關(guān)性,我們認為在有效控制傾斜、偏中心及測量誤差的前提下這種個體化的方法具有可行性。
[Abstract]:PurposeTo explore the effect and feasibility of individualized aspherical IOL implantation based on corneal spherical aberration through prospective studies.MethodAmong the patients undergoing cataract phacoemulsification, the corneal spherical aberration in the range of 6mm diameter was measured by Pentacam anterior segment analysis system before operation. Based on this, one of the three aspherical intraocular lenses with different spherical aberrations was selected.The total spherical aberration tends to be 0 渭 m after operation.These three kinds of aspheric intraocular lenses include: 1: Akreos Adapt AO Bausch Lombb, AcrySof1Q SN60WF Alcon Laboratories Inc. and Tecnis ZA9003(Advanced Medical Optics [AMO].The corneal aberrations in the range of 6mm diameter were measured again at 3 months after operation, and the total face aberrations in the range of 6mm diameter were measured by Zywave aberration instrument (Bausch Lomb).To evaluate the implantation effect of this individualized scheme by comparing with non-individualized and other individualized studies.The feasibility of individualized scheme is evaluated by comparing the difference between the predicted value and the measured spherical aberration and analyzing the error.The parameters were statistically analyzed by SPSS13.0.The preoperative and postoperative spherical aberrations and higher-order aberrations were compared by Wilcoxon sign rank test, the Spearman rank correlation analysis was used to analyze the total ocular surface aberration and prediction value, the prediction error between the total ocular surface aberration and the postoperative corneal spherical aberration, the preoperative corneal spherical aberration, and the preoperative corneal spherical aberration.The correlation between preoperative spherical aberration and postoperative spherical aberration.All the experimental data were expressed as x 鹵s (P 0.05) and the difference was statistically significant.ResultA total of 53 patients (60 eyes) were included in the experiment. 6 eyes (10.0 eyes) were implanted with Akreos Adapt AOA (17 eyes and 28.3 eyes) AcrySof IQ SN60WFF7 eyes (61.7 eyes) Tecnis ZA9003 were implanted.The corneal spherical aberrations in 60 eyes were 0.250 鹵0.111 渭 m and 0.250 鹵0.107 渭 m in the 6mm diameter range before and after the study, respectively. There was no significant difference between the two groups.The total ocular face aberration of 0.0365 鹵0.0654u m was slightly larger than that of the predicted value of 0.027 鹵0.0714 渭 m, but the difference was not statistically significant.The prediction error of total ocular surface aberration was -0.009 鹵0.092 渭 m, of which 49 eyes were less than 鹵0.10 渭 m and 34 eyes were less than 鹵0.05um.ConclusionThe choice of aspherical intraocular lens based on corneal spherical aberration can reduce the postoperative total ocular aberration and make the whole ocular aberration closer to the preset value.Because surgery has little effect on corneal spherical aberration, and there is no correlation between corneal spherical aberration and prediction error, we think that this individualized method is feasible under the premise of effectively controlling tilt, center deviation and measurement error.
【學(xué)位授予單位】：南方醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R779.6

【共引文獻】

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1 趙曉金;近視眼人群角膜Q值及其相關(guān)因素分析[D];鄭州大學(xué);2010年

2 侯杰;準(zhǔn)分子激光角膜屈光手術(shù)前后角膜非球面性變化的研究[D];天津醫(yī)科大學(xué);2010年

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本文編號：1726470