發(fā)布時間：2018-06-27 16:07

  本文選題：Bigbag人工晶狀體 + 高度近視�。� 參考：《皖南醫(yī)學院》2017年碩士論文

【摘要】：目的:高度近視白內(nèi)障患者行超聲乳化聯(lián)合人工晶狀體植入手術,對比觀察術眼植入高度近視專用蔡司Bigbag人工晶狀體及常規(guī)蔡司209M折疊人工晶狀體后,手術前后的視力中軸區(qū)后囊膜到視網(wǎng)膜的距離以及術后晶狀體后囊膜混濁視網(wǎng)膜脫離黃斑囊樣水腫等術后并發(fā)癥發(fā)生情況。研究探討應用蔡司Bigbag人工晶狀體對高度近視白內(nèi)障患者是否安全有效,及其在同類常規(guī)人工晶狀體中的優(yōu)越性。方法:本文選取2014年1月至2016年1月,于醫(yī)院眼科接受超聲乳化聯(lián)合人工晶狀體植入手術治療的高度近視白內(nèi)障患者,年齡47歲~65歲,共20例(26眼),每組10例13眼,患眼眼軸長度均≥27mm,A組植入蔡司Bigbag人工晶狀體;B組植入蔡司209M折疊人工晶狀體。回顧性分析兩組術后6個月的隨訪資料。比較分析兩組術前和隨訪時視力、中軸區(qū)后囊膜到視網(wǎng)膜的距離,觀察術后并發(fā)癥(包括晶狀體后囊膜混濁、視網(wǎng)膜脫離黃斑囊樣水腫)的發(fā)生情況,對兩組患者進行術后滿意度調(diào)查。對檢查結果用SPSS19.0統(tǒng)計軟件進行分析。結果:1.術后視力:兩組20例26眼患眼均成功植入人工晶狀體,術后視力均提高≥2行。2.并發(fā)癥:術后早期部分患者出現(xiàn)不同程度的角膜水腫,術后一周均恢復透明;術后晚期(隨訪6個月時),○1視網(wǎng)膜脫離發(fā)生情況比較:兩組術眼均無視網(wǎng)膜脫離發(fā)生;○2后囊膜混濁比較:A組術眼發(fā)生后囊膜混濁0眼,B組術眼發(fā)生后囊膜混濁數(shù)為2眼。兩組術后后囊膜混濁發(fā)生率無明顯差異(P=0.48,P0.05)。3.中軸區(qū)晶狀體后囊膜與視網(wǎng)膜距離變化:A組:術前為22.5585±1.97742,術后為24.0808±1.92194,手術前后差值為1.5223±0.16192;B組:術前為20.0438±0.98495,術后為21.7631±0.98577,手術前后差值為1.7192±0.03451。兩組手術前后中軸區(qū)晶狀體后囊膜與視網(wǎng)膜距離差變化有明顯差異(P=0.001,P0.05)。4.滿意度調(diào)查:兩組植入人工晶狀體的患者在視力提高術后舒適感等方面無明顯差異,但A組植入Bigbag人工晶狀體對預防患者夜間發(fā)生眩光現(xiàn)象明顯優(yōu)于B組(P=0.039,P0.05)。結論:與209M折疊人工晶狀體相比,Bigbag人工晶狀體進一步縮短了手術前后中軸區(qū)晶狀體后囊膜與視網(wǎng)膜距離差,更加接近生理性晶狀體位置,對眼內(nèi)環(huán)境改變更小,更好地防止后方玻璃體前涌,減少玻璃體后運動的幅度,從而能更好地預防高度近視患者術后視網(wǎng)膜脫離等眼底病的發(fā)生;能更好地降低超聲乳化摘除白內(nèi)障摘除術后晶狀體后囊膜皺褶的發(fā)生率;此外,Bigbag人工晶狀體術后眩光的發(fā)生率明顯減小。同時,因其負屈光度擁有更廣的范圍,也能較好地降低術后高度近視患者的近視屈光度殘留問題,對患者術后視力的提高有較為明顯的療效。因此,Bigbag人工晶狀體較常規(guī)209M人工晶狀體更適合高度近視白內(nèi)障患者使用。總之,Bigbag人工晶狀體及209M折疊人工晶狀體在治療高度近視白內(nèi)障患者的臨床應用中都是安全有效的。與常規(guī)蔡司209M折疊人工晶狀體相比,患者對植入Bigbag人工晶狀體的術后療效更為滿意。
[Abstract]:Objective: phacoemulsification combined with intraocular lens implantation for high myopia cataract patients, the visual acuity before and after the operation of high myopia special Bigbag intraocular lens and conventional Zeiss 209M foldable intraocular lens, the distance between the posterior capsule to the optic membrane and the posterior capsular opacification of the lens and the posterior capsular opacification of the lens after operation are compared. Postoperative complications such as retinal detachment? Macular cystoid edema and other postoperative complications. The study and discussion of the safety of the use of Zeiss Bigbag intraocular lens for high myopia cataract patients and their advantages in similar conventional intraocular lenses. Methods: This article was selected from January 2014 to January 2016 in the Department of ophthalmology to receive phacoemulsification. The patients with high myopia and cataract were treated with lens implantation, 47 years old ~65 years old, 20 cases (26 eyes), 10 cases in each group, 13 eyes, the axial length of the eyes were more than 27mm, group A was implanted with Zeiss Bigbag intraocular lens, and group B was implanted with Zeiss 209M foldable intraocular lens. The follow-up data of the two groups after 6 months were analyzed retrospectively. Comparison and analysis of the two groups before and after the operation were compared and analyzed. Visual acuity, the distance from the posterior capsule to the retina in the middle axis, the postoperative complications (including posterior capsule opacification, retinal detachment and macular edema) were observed, and the postoperative satisfaction of the two groups was investigated. The results were analyzed with SPSS19.0 software. Results: 1. postoperative visual acuity: two groups and 26 eyes in 20 eyes. After implantation of intraocular lens successfully, the postoperative visual acuity improved more than 2 lines of.2. complications: the early part of the patients had different degrees of corneal edema after the operation, and the postoperative recovery was transparent. After the operation (6 months of follow-up), the retinal detachment occurred in the two groups, no retinal detachment occurred, and the posterior capsule opacification was compared in the two group: group A surgery. Posterior capsular opacity in 0 eyes, in group B, the number of posterior capsule opacities was 2 eyes. There was no significant difference in the incidence of posterior capsule opacities in the two groups (P=0.48, P0.05) of posterior capsule and retinal distance in the axial region of.3.: group A: 22.5585 + 1.97742 before operation, 24.0808 + 1.92194 after operation, and 1.5223 + 0.16192 before and after operation; group B: preoperative 20.0438 + 0.98495, after operation was 21.7631 + 0.98577. The difference between the posterior capsule of the middle axis and the retinal distance difference before and after operation before and after operation was 1.7192 + 0.03451. two (P=0.001, P0.05).4. satisfaction survey: the two groups of intraocular lenses were improved in visual strength and there was no significant difference in postoperative comfort, but A Group implantation of Bigbag intraocular lens was better than group B (P=0.039, P0.05) in the prevention of nocturnal glare. Conclusion: compared with 209M foldable intraocular lens, Bigbag intraocular lens can further shorten the distance between the posterior capsule and the retina in the middle axis of the middle axis before and after the operation, which is closer to the position of the physiological lens, and changes the intraocular environment to the intraocular environment. Small changes, better prevention of anterior vitreous surges, reducing the amplitude of posterior vitreous movement, so as to better prevent retinal detachment in patients with high myopia, and to better reduce the incidence of posterior capsule folds after phacoemulsification and cataract extraction; in addition, after the Bigbag intraocular lens (IOL) surgery vertigo. The incidence of light is obviously reduced. At the same time, because of the wider range of the negative refraction, it can also reduce the myopia diopter residue in the patients with high myopia after operation, and it has a more obvious effect on the improvement of visual acuity after the operation. Therefore, Bigbag IOL is more suitable for the patients with high myopia and cataract than the conventional 209M IOL In conclusion, the Bigbag and 209M foldable intraocular lenses are safe and effective in the treatment of patients with high myopia and cataract. Compared with the conventional Zeiss 209M foldable intraocular lens, the patients are more satisfied with the postoperative effect of the implantation of the Bigbag intraocular lens.
【學位授予單位】：皖南醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R779.66

【參考文獻】

相關期刊論文 前10條

1 張雨霞;趙岐;李乃洋;;兩種手術方式矯治高度近視后視覺質量及效果對比分析[J];國際眼科雜志;2016年06期

2 文勇強;馬顯力;周靈;鄧水鳳;戴丹;;高度近視白內(nèi)障手術治療的臨床進展[J];中國現(xiàn)代醫(yī)生;2015年34期

3 朱子誠;溫躍春;吳章友;柯根杰;;高度近視合并白內(nèi)障患者植入不同人工晶狀體術后黃斑區(qū)視網(wǎng)膜厚度的變化[J];山東大學耳鼻喉眼學報;2015年01期

4 譚少健;蔡潔;;重視高度近視并發(fā)白內(nèi)障的治療[J];眼科新進展;2014年11期

5 楊先;趙桂秋;管洪在;孟巖;寧美真;孔慶蘭;;FGF10基因rs399501位點與中國漢族人群高度近視相關性[J];青島大學醫(yī)學院學報;2013年06期

6 王洋;韓宏光;;人工晶體材料的生物相容性特征[J];中國組織工程研究;2013年25期

7 唐東永;譚少健;梁皓;何劍;李霞;;Bigbag人工晶狀體應用于高度近視白內(nèi)障眼玻璃體后脫離的臨床觀察[J];山東大學耳鼻喉眼學報;2013年03期

8 宋建軍;;白內(nèi)障微創(chuàng)超聲乳化術48例療效觀察[J];國際眼科雜志;2012年12期

9 李書林;張英潤;;超聲乳化技術在白內(nèi)障治療中的應用研究[J];中國醫(yī)學創(chuàng)新;2012年28期

10 官蒼宇;;激光性角膜手術與眼內(nèi)屈光手術矯治超高度近視臨床效果觀察[J];中國醫(yī)藥科學;2012年15期

相關博士學位論文 前1條

1 梁厚成;眼球及屈光不正相關眼病發(fā)病機制的生物力學研究[D];第四軍醫(yī)大學;1997年

，

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