本文選題：人工晶狀體 + 屈光度�。� 參考：《昆明醫(yī)科大學(xué)》2017年碩士論文

【摘要】：[目的]通過白內(nèi)障超聲乳化吸除術(shù)聯(lián)合人工晶體(Intraocular lens,IOL)植入術(shù),觀察術(shù)前術(shù)后患者前房深度(Anterior chamber depth,ACD)變化間接了解Zeiss603P和AMOZA90003非球面人工晶狀體在眼內(nèi)有效人工晶體位置(effective lens position,ELP)的變化規(guī)律,為臨床個(gè)性化選擇兩種IOL屈光度提供參考。[方法]選取就診于我科的年齡相關(guān)性白內(nèi)障患者60例(75眼),隨機(jī)分為兩組:A組40例(54眼)植入一片式三襻型ZEISS 603P非球面IOL;B組20例(21眼)植入三片式AMOZA9003非球面IOL。術(shù)前使用IOL master測量眼軸長度(axial length,AL)、角膜曲率及前房深度,所有患者均使用SRK-T公式、Haigis公式計(jì)算預(yù)測的IOL度數(shù),術(shù)后1天、7天、1月、3月驗(yàn)光測量最佳矯正視力(best corrected visual acuity,BCVA)、屈光度,使用前節(jié)光學(xué)相干斷層掃描技術(shù)(optical coherence tomography,OCT)測量 ACD,比較兩種 IOL 術(shù)前、術(shù)后1天、7天、1月、3月ACD的差異,比較SRK-T公式及Haigis公式預(yù)測屈光度與術(shù)后實(shí)際屈光度的差異,分析兩種不同類型IOL在不同AL長度和不同IOL度數(shù)時(shí)ACD的變化規(guī)律。[結(jié)果]1.術(shù)后ACD的變化:Zeiss603P植入術(shù)后ACD深度在第1周內(nèi)隨時(shí)間的推移有逐漸加深的趨勢(p0.05),1周后至3個(gè)月ACD基本處于穩(wěn)定狀態(tài)(p0.05);AMOZA9003植入術(shù)后ACD深度在三個(gè)月內(nèi)處于穩(wěn)定狀態(tài)(p0.05)。2.屈光誤差:Zeiss603P及AMOZA9003兩組術(shù)前預(yù)測屈光度與術(shù)后屈光度結(jié)果顯示兩者預(yù)測屈光度與實(shí)際值符合(p0.05)。3.晶體度數(shù)與ACD的關(guān)系:實(shí)驗(yàn)通過分析IOL度數(shù)和相應(yīng)ACD變化觀察到,Zeiss603P 組中,當(dāng) IOL 為 18≤P21D、21 ≤P24D 及 P≥24D 時(shí),ACD 隨時(shí)間加深(p0.05);術(shù)后3月時(shí)P≥24D組較其他三組ACD值更大,與其余三組差異有統(tǒng)計(jì)學(xué)意義(P0.05);植入AMOZA9003時(shí)術(shù)后四個(gè)時(shí)間點(diǎn)的ACD無變化(p0.05)。4.眼軸與ACD的關(guān)系:Zeiss603P組,當(dāng)22≤AL24mm,ACD隨時(shí)間加深(P0.05),術(shù)后3月時(shí),22≤AL23mm組ACD變化明顯大于23≤AL24mm組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。AMOZA9003組術(shù)后四個(gè)時(shí)間點(diǎn)的ACD處于穩(wěn)定狀態(tài)(p0.05)。5.公式預(yù)測屈光度的準(zhǔn)確性:術(shù)后3月實(shí)際屈光狀態(tài)與Haigis公式和SRK-T公式預(yù)測的屈光結(jié)果相符合(p0.05)。[結(jié)論]1.ZEISS603P和AMOZA9003植入術(shù)后三個(gè)月ACD穩(wěn)定,術(shù)后屈光度與預(yù)測值一致。2.術(shù)眼屈光度受ACD變化的影響,ZEISS603P組在術(shù)后一周內(nèi)IOL后移,光學(xué)面貼向后囊膜,伴隨近視漂移,一周后ACD變化穩(wěn)定。3.ZEISS603P使用的IOL度數(shù)越大越容易產(chǎn)生后移,度數(shù)越小ACD變化越小。4.ZEISS603P在短眼軸時(shí)較正常眼軸更易產(chǎn)生后移。5.AMOZA9003術(shù)后ACD變化不受IOL度數(shù)大小及眼軸長短的影響。6.Haigis公式和SRK-T公式在預(yù)測IOL度數(shù)方面未體現(xiàn)出差異,均能準(zhǔn)確預(yù)測術(shù)后屈光度。
[Abstract]:[objective] to investigate the application of phacoemulsification combined with intraocular lens implantation (IOL). To observe the changes of anterior chamber depth (chamber) in patients with intraocular lens (IOL) before and after operation, and to understand indirectly the change rule of Zeiss603P and AMOZA90003 aspherical intraocular lens (AMOZA90003) in the position of effective intraocular lens (IOL) and to provide reference for clinical individualized selection of two IOLs. [methods] Sixty patients (75 eyes) with age-related cataract in our department were randomly divided into two groups: group A (n = 40, n = 54) and group B (n = 20, n = 20) with AMOZA9003 aspheric IOL. The axial length, corneal curvature and anterior chamber depth were measured by master before operation. All patients were calculated with SRK-T formula and Haigis formula. The best corrected visual acuity (BCV) was measured in 1 day, 7 days, 1 month and 3 months after operation, and the diopter was used to measure the best corrected visual acuity. The optical coherence tomography (Oct) technique was used to measure ACD. The difference of ACD between the two kinds of IOLs was compared before operation, 1 day, 1 day and 3 months after operation. The difference between the predicted diopter of SRK-T formula and Haigis formula was compared with the actual diopter after operation. The changes of ACD in two different types of IOLs with different AL lengths and degrees of IOL were analyzed. [result] 1. The changes of ACD after the implantation of: Zeiss603P showed that the depth of ACD gradually deepened with the passage of time in the first week. After 1 week to 3 months, the ACD was in a stable state (p0.05 / AMOZA9003) and the depth of ACD was in a stable state within three months. Refractive error: Zeiss603P and AMOZA9003. The results of preoperative and postoperative diopter showed that the predicted diopter and the actual value were in agreement with that of P0.05. 3. The relationship between crystal degree and ACD: in the Zeiss603P group, when the IOL was 18 鈮，

本文編號：2011136