本文選題：高度近視 + 白內(nèi)障手術(shù)��； 參考：《天津醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的探討高度近視白內(nèi)障患者行超聲乳化吸除聯(lián)合人工晶狀體(Intraocular lens,IOL)植入術(shù)預(yù)留-3D術(shù)后早期視力及屈光狀態(tài)的變化。方法本研究為前瞻性病例對照研究,連續(xù)收集2016年10月至2017年1月期間在天津市眼科醫(yī)院接受白內(nèi)障超聲乳化吸除聯(lián)合IOL植入術(shù)的高度近視白內(nèi)障患者21例(31只眼),除外合并有角膜病、青光眼、視網(wǎng)膜脫離、糖尿病性視網(wǎng)膜病變等疾病者。術(shù)后隨訪1月,對比術(shù)前與術(shù)后1天,術(shù)后1天、1周、1個月的裸眼視力(Uncorrected Visual Acuity,UCVA)、最佳矯正視力(Best Corrected Visual Acuity,BCVA)、最佳閱讀近視力(Best Reading Near Visual Acuity,BRNVA)、眼軸(Axial Length,AL)、平均角膜曲率(Average Corneal Curvature,K)、角膜散光(Corneal Astigmatism,CA)、前房深度(Anterior Chamber Depth,ACD)、等效球鏡屈光度數(shù)(Spherical Equivalent,SE)、球鏡及柱鏡度數(shù)的變化。1.術(shù)后基本情況:所有患者術(shù)眼術(shù)后IOL均位于囊袋內(nèi),無偏心及移位,連續(xù)環(huán)形撕囊口居中,無青光眼、后發(fā)性白內(nèi)障(Posterior capsular opacification,PCO)、角膜失代償、視網(wǎng)膜脫離等并發(fā)癥發(fā)生。2.UCVA:患者術(shù)后1天較術(shù)前提高,差異有統(tǒng)計學(xué)意義(Z=-4.379,P0.01);術(shù)后1天、1周和1個月UCVA保持穩(wěn)定狀態(tài),無明顯差異(Z1=-0.458,P10.05;Z2=-0.142,P20.05;Z3=-0.975,P30.05)。3.BCVA:術(shù)后1月較術(shù)前明顯提高,差異有統(tǒng)計學(xué)意義(Z=-3.829,P0.01),在術(shù)后隨訪1周和1個月的BCVA均保持穩(wěn)定狀態(tài),無明顯變化(Z=-0.53,P0.05)。4.BRNVA:術(shù)后1周和1個月的BRNVA較術(shù)后1天提高,差異有明顯統(tǒng)計學(xué)意義(Z1=-2.670,Pl0.01;Z2=-2.694,P20.01),術(shù)后1周和1個月的BRNVA保持穩(wěn)定狀態(tài),無明顯差異(Z=-1.558,P0.05)。5.AL:患者術(shù)后1天AL與術(shù)前比較,無顯著性差異(t=-0.352,P0.05);術(shù)后1天、1周和1個月AL保持穩(wěn)定狀態(tài),無明顯差異(t1=-1.196,P10.05;t2=-0.212,P20.05;t3=0.645,P30.05)。6.K:患者術(shù)后1天與術(shù)前比較,無顯著性差異(t=2.19,P0.05);術(shù)后1天、1周和1個月的K值保持穩(wěn)定狀態(tài),無明顯差異(t1=0.88,P10.05;t2=0.995,P20.05;t3=0.484,P30.05)。7.CA:患者術(shù)后1天與術(shù)前比較無顯著性差異(Z=-0.889,P0.05);術(shù)后1天、1周和1個月CA維持穩(wěn)定狀態(tài),無明顯差異(Z1=-0.7,P10.05;Z2=-1.156,P20.05;Z3=-0.065,P30.05)。8.ACD:患者術(shù)后1天、1周和1個月ACD無顯著差異(t1=0.143,P10.05;t2=1.329,P20.05;t3=1.651,P30.05)。9.SE:患者術(shù)后1天、1周和1個月SE無顯著差異(t1=1.582,P10.05;t2=1.503,P20.05;t3=0,P30.05)。10.球鏡度數(shù):患者術(shù)后1天、1周和1個月球鏡度數(shù)無顯著差異(t1=0.526,P10.05;t2=0.157,P20.05;t3=-0.629,P30.05)。11.柱鏡度數(shù):患者術(shù)后1天與術(shù)前比較,無顯著差異(Z=-0.271,P0.05);患者術(shù)后1天、1周和1個月柱鏡度數(shù)無顯著差異(Z1=-0.933,P10.05;Z2=-1.273,P20.05;Z3=-1.243,P30.05)。結(jié)論1.高度近視白內(nèi)障患者手術(shù)預(yù)留-3D術(shù)后早期屈光狀態(tài)基本穩(wěn)定;2.高度近視白內(nèi)障患者手術(shù)預(yù)留-3D術(shù)后早期UCVA基本穩(wěn)定;3.高度近視白內(nèi)障患者手術(shù)預(yù)留-3D術(shù)后BRNVA有提高趨勢。
[Abstract]:Objective to investigate the changes of early visual acuity and refractive state in patients with high myopia cataract after phacoemulsification combined with intraocular lens implantation (IOL).Methods this study was a prospective case-control study.From October 2016 to January 2017, 21 patients with high myopia cataract underwent phacoemulsification combined with IOL implantation in Tianjin Eye Hospital, with the exception of corneal diseases, glaucoma and retinal detachment.Diabetic retinopathy and other diseases.All patients were followed up for 1 month, compared with 1 day before and 1 day after operation.The changes of spherical Evalentate, spherical and Cylindrical degrees.After operation, IOL was located in the pouch without eccentricity and displacement, continuous circular capsulorhexis in the middle, no glaucoma, posterior capsular opacification, corneal decompensation.The difference was statistically significant (P 0.01). The BCVA remained stable at 1 week and 1 month after operation, and there was no significant change in BRNVA. The BRNVA of 1 week and 1 month after operation was higher than that of 1 day after operation.There was no significant difference between the two groups. There was no significant difference between the two groups. The K values of the patients remained stable at 1 week and 1 month after operation, and there was no significant difference between the two groups on the first day after operation, and the K values at 1 week and 1 month after operation remained stable, and there was no significant difference between the patients and the patients before operation on the first day after the operation, and there was no significant difference between the patients and the patients before the operation on the first day after the operation, and the K values remained stable at 1 week and 1 month after the operation.The degree of spherical endoscopy: there was no significant difference in the degree between 1 week after operation and 1 day after operation. There was no significant difference in the degree between the first week and the first day after operation. There was no significant difference in the degree between the two groups (P 10.05 t _ (2)) 0.157 (P 20.05) t _ (3) ~ (-0.629) (P _ 30.05) 路11.Conclusion 1.The early refractive state of patients with high myopia cataract after operation reservation-3 D operation is basically stable.Early UCVA was stable in patients with high myopia cataract.The BRNVA of high myopia cataract patients after-3 D operation has a tendency to increase.
【學(xué)位授予單位】：天津醫(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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