本文選題：ICL + 瞳孔直徑　； 參考：《浙江大學(xué)》2012年碩士論文

【摘要】：[目的]評(píng)估有晶體眼后房型人工晶體(ICL)植入術(shù)對(duì)明視和暗視下瞳孔直徑的影響。 [方法]采集2011年12月至2012年2月在浙江大學(xué)醫(yī)學(xué)院附屬第二醫(yī)院眼科中心進(jìn)行ICL植入術(shù)的所有病例共7例14眼。分別于術(shù)前3天和術(shù)后1月進(jìn)行隨訪,利用波前像差儀測(cè)量明視下瞳孔直徑和暗視下瞳孔直徑,利用超生生物顯微鏡(UBM)測(cè)量前房深度、ICL與角膜的距離、ICL拱高和瞳孔直徑,并分析各瞳孔直徑指標(biāo)與ICL拱高、年齡及ICL矯正的等效球鏡度的相關(guān)性。數(shù)據(jù)采用SPSS18.0軟件進(jìn)行統(tǒng)計(jì)分析,P0.05認(rèn)為差異存在統(tǒng)計(jì)學(xué)意義。 [結(jié)果]波前像差儀測(cè)量ICL術(shù)眼暗視下瞳孔直徑術(shù)前3天為5.54±1.17mm(3,83~7.16mm),術(shù)后1月為5.20±0.97mm(3.17~5.99mm),兩者差異為-0.35±0.59mm(-1.26~0.70mm),差異有統(tǒng)計(jì)學(xué)意義(t=2.226,P0.05)。明視下瞳孔直徑術(shù)前3天為3.92±0.67mm(3.02-4.84mm),術(shù)后1月為4.37±0.99mm(2.73~5.5mm),兩者差異為0.44±0.54mm(-0.29~1.71mm),差異有統(tǒng)計(jì)學(xué)意義(t=-3.083,P0.01)。明暗視瞳孔直徑差異為暗視下的瞳孔直徑與明視下的瞳孔直徑的差值,術(shù)前3天為1.62±0.72mm(0.74-3.19mm),術(shù)后1月為0.82±0.34mm(0.22~1.29mm),兩者差異為-0.80±0.86mm(-2.82~0.30mm),差異有統(tǒng)計(jì)學(xué)意義(t=3.46I,P0.01)。UBM測(cè)量ICL術(shù)眼術(shù)前3天瞳孔直徑為3.43±0.79mm(2.15~4.63mm),術(shù)后1月瞳孔直徑為3.66±1.03mm(1.66~4.69mm),兩者差異為0.22±0.45mm(-0.51~1.19mm),差異無(wú)統(tǒng)計(jì)學(xué)意義(t=-1.881,P0.05)。UBM測(cè)量ICL術(shù)眼前房深度術(shù)前3天為3.05±0.22mm(2.78~3.43mm),術(shù)后1月前房深度為3.03±0.22mm(2.77~3.48mm),兩者差異為-0.02±0.11mm(-0.210.18mm),差異無(wú)統(tǒng)計(jì)學(xué)意義(t=0.577,P0.05)。術(shù)后1月ICL拱高為0.44±0.28mm(0.03~0.92mm),ICL與角膜的距離為2.32±0.22mm(1.79~2.60mm)。波前像差儀測(cè)量ICL術(shù)眼明視下瞳孔直徑術(shù)前術(shù)后變化、UBM測(cè)量ICL術(shù)眼瞳孔直徑術(shù)前術(shù)后變化,與ICL拱高的相關(guān)性均存在統(tǒng)計(jì)學(xué)意義(P0.05)。波前像差儀測(cè)量ICL術(shù)眼暗視下瞳孔直徑術(shù)前術(shù)后變化、明暗視瞳孔直徑差異術(shù)前術(shù)后變化,與ICL拱高的相關(guān)性均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。波前像差儀測(cè)量ICL術(shù)眼明視下瞳孔直徑術(shù)前術(shù)后變化,與年齡的相關(guān)性均存在統(tǒng)計(jì)學(xué)意義(P0.05)。波前像差儀測(cè)量ICL術(shù)眼暗視下瞳孔直徑術(shù)前術(shù)后變化、明暗視瞳孔直徑差異術(shù)前術(shù)后變化及UBM測(cè)量ICL術(shù)眼瞳孔直徑術(shù)前術(shù)后變化,與年齡的相關(guān)性均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。波前像差儀測(cè)量ICL術(shù)眼暗視下瞳孔直徑術(shù)前術(shù)后變化、明暗視瞳孔直徑差異術(shù)前術(shù)后變化,與ICL矯正的等效球鏡度的相關(guān)性均存在統(tǒng)計(jì)學(xué)意義(P0.01)。波前像差儀測(cè)量ICL術(shù)眼明視下瞳孔直徑術(shù)前術(shù)后變化、UBM測(cè)量ICL術(shù)眼瞳孔直徑術(shù)前術(shù)后變化,與ICL矯正的等效球鏡度的相關(guān)性均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。 [結(jié)論]本研究表明高度近視眼ICL植入術(shù)后1月較術(shù)前3天暗視下瞳孔直徑減小,明視下瞳孔直徑增大,明暗視瞳孔直徑差異減小,提示ICL植入術(shù)限制虹膜肌肉的活動(dòng),而影響瞳孔的自然收縮狀態(tài)。本研究進(jìn)一步提示ICL術(shù)眼瞳孔自然收縮狀態(tài)的改變與ICL拱高、患者年齡及手術(shù)矯正度數(shù)可能相關(guān)。
[Abstract]:[Objective] to evaluate the effect of implantation of posterior chamber intraocular lens (ICL) on the pupil diameter of the patients with open vision and dark vision.
[Methods] 7 cases of 14 eyes were collected from December 2011 to February 2012 at the ophthalmology center of the Second Affiliated Hospital of Zhejiang University medical college. They were followed up at 3 days before and after operation in January. The diameter of the pupil and the pupil diameter of the pupil were measured by the wavefront aberration instrument, and the previsual microscopes (UBM) were used to measure the diameter of the pupil. The depth of the room, the distance between ICL and the cornea, the height of ICL arch and the diameter of the pupil, and the correlation between the pupil diameter index and the ICL arch height, the age and the equivalent spherical mirror degree corrected by ICL. The data were statistically analyzed with the SPSS18.0 software, and P0.05 thought the difference was statistically significant.
[results] the wavefront aberration measurement was 5.54 + 1.17mm (3,83~7.16mm) 3 days before the operation of ICL eye pupil diameter, and 5.20 + 0.97mm (3.17~5.99mm) after operation in January. The difference was -0.35 + 0.59mm (-1.26~0.70mm). The difference was statistically significant (t=2.226, P0.05). 3.92 + 0.67mm (3.02-4.84mm) was 3 days before the operation of the pupil diameter under the open vision, and 4.37 + after the operation. 0.99mm (2.73~5.5mm), the difference was 0.44 + 0.54mm (-0.29~1.71mm), the difference was statistically significant (t=-3.083, P0.01). The difference between pupil diameter and pupil diameter under dark vision was 1.62 + 0.72mm (0.74-3.19mm) at the 3 day before operation, and 0.82 + 0.34mm (0.22~1.29mm) in January after operation, and the difference was -0.80 + 0.86mm. (-2.82~0.30mm), the difference was statistically significant (t=3.46I, P0.01).UBM in the 3 days of ICL surgery, the pupil diameter was 3.43 + 0.79mm (2.15~4.63mm), and the pupil diameter was 3.66 + 1.03mm (1.66~4.69mm) in January, and the difference was 0.22 + 0.45mm (-0.51~1.19mm). The difference was not statistically significant for 3 days before the anterior chamber depth of the surgery. For 3.05 + 0.22mm (2.78~3.43mm), the anterior chamber depth was 3.03 + 0.22mm (2.77~3.48mm) before January, and the difference was -0.02 + 0.11mm (-0.210.18mm). The difference was not statistically significant (t=0.577, P0.05). The height of the ICL arch in January was 0.44 + 0.28mm (0.03~0.92mm), and the distance between the cornea and the cornea was 2.32 +. The changes of pupil diameter before and after operation, UBM measured the changes of pupil diameter before operation in ICL, and the correlation with the height of ICL arch (P0.05). The wavefront aberration meter measured the changes of pupil diameter before operation in ICL eyes, and the difference between the pupil diameter and the diameter of the pupil before and after the operation, and the correlation with the height of ICL arch had no statistical significance (P 0.05. The wavefront aberration was used to measure the preoperative and postoperative changes in the visual pupil diameter of ICL, and the correlation with age was statistically significant (P0.05). The wavefront aberration was used to measure the changes in the pupil diameter of the eyes under the ICL operation, the difference of the pupil diameter before and after the operation, and the changes of the pupil diameter before and after the ICL operation by UBM. The correlation of age was not statistically significant (P0.05). The wavefront aberration was used to measure the changes in the pupil diameter of the eyes under the ICL operation, and the difference between the pupil diameter before and after the operation was statistically significant (P0.01). The wavefront aberration instrument was used to measure the preoperative visual pupil diameter of ICL. There was no significant difference in the pupil diameter before and after ICL operation and the corrected spherical equivalent of ICL corrected by UBM (P0.05).
[Conclusion] this study showed that the pupil diameter of the pupil decreased in January 3 days after the implantation of high myopia, the diameter of the pupil in the lower eye pupil increased and the difference of the pupil diameter of the light and shade decreased. It suggested that the ICL implantation limit the activity of the iris muscles and influence the natural contraction of the pupil. This study further hints that the pupil of the ICL eye is naturally contracted. The change of state may be related to ICL arch height, patient age and surgical correction degree.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R779.6

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