本文選題：iTrace像差儀 + Toric人工晶狀體　； 參考：《天津醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的研究和評價:1、iTrace像差儀在白內(nèi)障患者角膜曲率測量的重復(fù)穩(wěn)定性及其與Lenstar900、IOL-Master測量結(jié)果的差異2、iTrace像差儀內(nèi)置Toric計算器的準(zhǔn)確性和設(shè)計理念。3、iTrace像差儀在Toric人工晶狀體植入術(shù)后晶狀體軸位測量中的應(yīng)用價值。方法選擇在2015年6月至2016年2月在我院接受超聲乳化白內(nèi)障吸出術(shù)聯(lián)合Toric人工晶狀體植入的白內(nèi)障患者35例(45只眼)。1、所有患者在術(shù)前均進(jìn)行iTrace像差儀、IOL-Master、Lenstar900角膜曲率(Ks、Kf、Km)的測量。分析iTrace像差儀在測量角膜曲率的重復(fù)穩(wěn)定性并將結(jié)果和IOL-Master、Lenstar900所測結(jié)果分別進(jìn)行配對t檢驗(yàn)。2、將iTrace像差儀所測量的角膜曲率數(shù)據(jù)(瞳孔直徑為3.0mm)分別代入iTrace計算器與Acry Sof Toric計算器進(jìn)行計算,分析兩者計算結(jié)果中角膜平面所需矯正散光值和角膜平面預(yù)期殘余散光值的差異以及推薦Toric人工晶狀體型號和植入軸位的差異。3、所有患者均在術(shù)后1周進(jìn)行隨訪并進(jìn)行iTrace像差儀的檢查。用iTrace像差儀所測出的眼內(nèi)像差散光軸位進(jìn)行換算,計算出術(shù)后Toric人工晶狀體軸位。將計算結(jié)果與傳統(tǒng)裂隙燈法測得的Toric人工晶狀體軸位做比較,分析兩者的統(tǒng)計學(xué)差異及相關(guān)性。結(jié)果1、iTrace像差儀所測量的Ks、Kf、Km參數(shù)的組內(nèi)相關(guān)系數(shù)(intraclass correlation coefficient,ICC)均大于0.9。iTrace像差儀所測量的Ks、Kf、Km分別為(44.82±1.43)、(43.97±1.31)、(44.41±1.30),分別與Lenstar 900、IOL-Master所測結(jié)果進(jìn)行配對T檢驗(yàn),結(jié)果之間差異沒有統(tǒng)計學(xué)意義。2.、Acry Sof Toric計算器與iTrace計算器計算得出角膜平面所需矯正的散光值分別為(2.03±0.63)D、(2.03±0.63)D,結(jié)果之間差異沒有統(tǒng)計學(xué)意義(t=-1.431,P=0.160);術(shù)后角膜平面預(yù)期殘留散光值為(0.24±0.11)D、(0.16±0.06)D,結(jié)果之間差異有統(tǒng)計學(xué)意義(t=4.14,P0.001)。Toric人工晶狀體植入軸位分別為(87.89°±69.56°)、(87.93°±69.50°),結(jié)果之間差異沒有統(tǒng)計學(xué)意義(t=-1.431,P=0.160)。17眼(38%)在兩種Toric計算器所得出的推薦Toric人工晶狀體型號之間存在差異。3、患者在術(shù)后1周時,裸眼視力與術(shù)后最佳矯正視力分別為(0.19±0.12)Log MAR和(0.10±0.09)Log MAR。42眼(93.3%)的裸眼視力≥20/40。iTrace法傳統(tǒng)與裂隙燈法測得的晶狀體軸位旋轉(zhuǎn)分別為(4.44°±3.42°)、(3.13°±2.86°);兩者比較有統(tǒng)計學(xué)差異(t=2.321,P=0.025)。兩種方法測得的Toric人工晶狀體軸位差值的絕對值為3.67°±3.59°(0~14°),其中32眼(71.1%)5°,9眼(20%)位于5至10°,4眼(8.9%)10°。兩種方法測得的人工晶狀體軸位直線相關(guān)性分析成線性正相關(guān)(r=0.926,P0.01)。結(jié)論1、iTrace像差儀在測量角膜曲率(Ks、Kf、Km)時,其測量重復(fù)穩(wěn)定性較好,與臨床常用的Lenstar900、IOL-Master相比較結(jié)果差異沒有統(tǒng)計學(xué)意義。數(shù)值可以用于代入Toric人工晶狀體型號和植入軸位的計算。2、iTrace像差儀內(nèi)置的Toric計算器計算準(zhǔn)確,與Acry Sof Toric計算器相比偏好于患者術(shù)后獲得最小預(yù)期殘留散光值,不考慮術(shù)前術(shù)后散光類型的變化。3、運(yùn)用iTrace像差儀可以在不散瞳的情況下準(zhǔn)確測量Toric人工晶狀體的軸位,其結(jié)果具有一定的參考價值及臨床應(yīng)用價值。
[Abstract]:Objective study and evaluation: 1, the repeatability of corneal curvature measurement in cataract patients and the difference between iTrace and Lenstar900, IOL-Master measurement results 2, the accuracy and design concept of Toric calculator built in iTrace aberration instrument,.3, the application price of iTrace aberration instrument in the axial measurement of lens after Toric artificial crystal implantation Methods 35 cases (45 eyes) of.1 were selected from June 2015 to February 2016 in our hospital with phacoemulsification combined with Toric intraocular lens implantation. All patients were measured by iTrace aberration, IOL-Master, Lenstar900 corneal curvature (Ks, Kf, Km) before operation. Analysis of the corneal curvature by the iTrace aberration meter. The results were paired with the results of the paired t test and the results measured by IOL-Master and Lenstar900 respectively. The corneal curvature data (the pupil diameter of the pupil) measured by the iTrace aberration meter was replaced by the iTrace calculator and the Acry Sof Toric calculator respectively. The corrected astigmatism and cornea needed for the corneal plane were analyzed. The difference in plane expected residual astigmatism and the difference between the recommended Toric IOL model and the difference in the axial position of the implant were.3. All patients were followed up at 1 weeks after the operation and examined by the iTrace aberration instrument. The axial position of the intraocular aberration of the intraocular aberration measured by the iTrace aberration instrument was converted to calculate the axial position of the Toric intraocular lens after the operation. The results were calculated. The statistical difference and correlation between the two Toric IOL axes measured by the traditional slit lamp method were compared. Results 1, the intra group correlation coefficient (intraclass correlation coefficient, ICC) measured by the iTrace aberration meter (intraclass correlation coefficient, ICC) was greater than the Ks of the 0.9.iTrace aberration meter, and (44.82 + 1.43), respectively, (43.97 + 1). .31), (44.41 + 1.30), paired T test with Lenstar 900 and IOL-Master respectively, the difference between the results was not statistically significant.2., Acry Sof Toric calculator and iTrace calculator calculated that the corrected astigmatism required by the corneal plane was (2.03 + 0.63) D, (2.03 + 0.63) D, and there was no significant difference between the results (t=-1.431). The expected residual astigmatism of corneal plane after operation was (0.24 + 0.11) D, (0.16 + 0.06) D, and the difference between the results was statistically significant (t=4.14, P0.001).Toric IOL implantation axis was (87.89 + 69.56 degrees) and (87.93 [87.93] 69.50 degrees), and there was no statistical significance (t=-1.431, P=0.160).17 eye (38%) in two Toric calculations. There was a difference between the recommended Toric IOL models and.3. At 1 weeks after the operation, the patients' visual acuity and the best corrected visual acuity were (0.19 + 0.12) Log MAR and (0.10 + 0.09) Log MAR.42 eyes (93.3%) of the naked eye vision > 20/40.iTrace method and the gap light method, respectively (4.44? 3.42). There was a statistical difference (t=2.321, P=0.025). The absolute value of the axial difference of the Toric intraocular lens measured by the two methods was 3.67 [3.67] 3.59 degrees (0~14 degrees), of which 32 eyes (71.1%) 5, 9 eyes (20%) located in 5 to 10 degrees and 4 eyes (8.9%). Conclusion (r=0.926, P0.01). Conclusion 1, when measuring the corneal curvature (Ks, Kf, Km), the measurement repeatability of the iTrace aberration meter is better. There is no statistical difference compared with the commonly used Lenstar900, IOL-Master. The numerical value can be used to replace the Toric artificial crystal model and the calculation.2 for the implantation axis, and the Toric meter built in the iTrace aberration meter. The calculator is accurate. Compared with the Acry Sof Toric calculator, the minimum expected residual astigmatism is obtained after the operation, and the change of astigmatism is not considered before the operation. The iTrace aberration meter can be used to accurately measure the axis of the Toric IOL in the absence of mydriasis. The results have a certain reference value and clinical application price. Value.
【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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