非球面與球面人工晶體的臨床應(yīng)用研究
發(fā)布時間：2018-07-16 19:31
【摘要】：目的 對比研究白內(nèi)障超聲乳化吸出分別植入德國人類光學(xué)MCX11ASP非球面人工晶體與AS球面人工晶體術(shù)后裸眼視力、最佳矯正視力、對比敏感度與像差的差異。 方法 1、采用前瞻性臨床對照研究。連續(xù)選取2011年6月——2011年12月在我院確診的年齡相關(guān)性白內(nèi)障患者并進行常規(guī)白內(nèi)障術(shù)前檢查(例如裂隙燈顯微鏡眼前節(jié)檢查、眼底檢查、(A、B)超、角膜曲率、眼壓、電生理等),術(shù)前排除角膜病變、青光眼、葡萄膜炎、晶狀體半脫位、視網(wǎng)膜疾病、中高度近視。術(shù)前按照患者意愿分成兩組。A組植入德國人類光學(xué)MCX11ASP非球面人工晶體；B組植入AS球面人工晶體。 2、術(shù)后篩選標(biāo)準(zhǔn)：術(shù)后門診隨訪患者,進行眼科常規(guī)檢查,無裂隙燈顯微鏡下可見的角膜病理改變,虹膜無萎縮、無色素脫落,瞳孔直接、間接對光反射正常,人工晶體位于囊袋內(nèi),居中,無明顯傾斜,人工晶體表面無明顯色素沉著,無混濁,無表面損傷裂隙,后囊膜無混濁,玻璃體及視網(wǎng)膜無病理性改變。 3、A、B兩組分別用普通視力表測量裸眼視力、最佳矯正視力。術(shù)后三個月Talcagi-CGT-1000自動眩光對比敏感度檢查儀進行非眩光及眩光對比敏感度檢查,Nidek驗光儀檢查屈光狀態(tài),用OPD-Scan波前像差儀檢查兩組術(shù)后三個月的像差。 4、統(tǒng)計學(xué)方法采用SPSS13.0軟件包,對兩組測量結(jié)果行T檢驗與X2檢驗。 結(jié)果 1、術(shù)后一周所有研究對象進行各項檢查。術(shù)后隨訪一月時3例患者(4眼)因外出失訪,其中A組2例(3眼),B組1例(1眼)。術(shù)后隨訪三個月時5例患者(7眼)因外出失訪,其中A組2例(3眼),B組3例(4眼)。共入選78例(96眼),A組30例(36眼),B組48例(60眼)。 2、兩組患者術(shù)中植入人工晶體平均度數(shù)分別為A組21.23±2.16(D)；B組21.97±2.24(D),兩組差異無統(tǒng)計學(xué)意義(t=1.692,P＝0.0936)。其中6例患者(6眼)人工晶體輕度偏位,偏中心≤0.25mm,A組2例(2眼),B組4例(4眼)。術(shù)后三個月兩組離焦度數(shù)A組-0.1875±0.5806D(-1.25D～0.75D),B組-0.1258±0.6159D(-1.25D～1.25D),兩組差異無統(tǒng)計學(xué)意義(t＝0.000,P=1.000)。散光度數(shù)A組0.5486±0.3526D(0～1.25D),B組0.5333±0.3459D(1～1.25D),兩組差異無統(tǒng)計學(xué)意義(t＝0.2083,P＝0.8354)。 3、術(shù)后一周兩組患者裸眼視力分別為A組0.35±0.16；B組0.31±0.18,兩組差異無統(tǒng)計學(xué)意義(t＝1.1715,P＝0.2440)。術(shù)后一個月兩組患者裸眼視力分別為A組0.43±0.20；B組0.38±0.25,兩組差異無統(tǒng)計學(xué)意義(t=1.0589,P＝0.2922)術(shù)后三個月兩組患者裸眼視力分別為A組0.58±0.18；B組為0.54±0.17,兩組差異無統(tǒng)計學(xué)意義(t=1.0918,P=0.2777)。術(shù)后三個月最佳矯正視力A組為0.91±0.12；B組為0.88±0.11,兩組差異無統(tǒng)計學(xué)意義(t=1.2502,P=0.2143)。測得瞳孔大小A組3.49±0.53(mm)；B組3.48±0.53(mm),兩組差異無統(tǒng)計學(xué)意義(t=0.0895,P=0.9289)。 4、術(shù)后三個月兩組分別在非眩光與眩光條件下,在6.3°、4°、2.5°、1.6°、1°、0.7°視角測量對比敏感度。兩組比較在6.3°視角(低頻段)有顯著性差異(P0.01),A組優(yōu)于B組。 5、術(shù)后三個月測量瞳孔3～4mm時A組球差為0.003±0.015μm,慧差為0.032±0.038μm。B組球差為0.004±0.01μm,慧差為0.040±0.025μm。兩組之間的差異無統(tǒng)計學(xué)意義(t1=0.3554,P1=0.6961；t2=1.1254,P2=0.2165)。瞳孔5.0mm時測得A組球差為0.050±0.046μm,慧差為0.150±0.09μm。B組球差為0.120±0.095μm,慧差為0.202±0.129μm。兩組之間的差異有統(tǒng)計學(xué)意義(t1=4.8398,P1=0.001：t2=2.0993,P2=0.0385)。 結(jié)論 1、德國人類光學(xué)MCX11ASP非球面人工晶體眼術(shù)后三個月裸眼視力及最佳矯正視力相比AS球面人工晶體眼無顯著性差異。 2、在6.3°視角(低空間頻率)下MCX11ASP非球面人工晶體組的對比敏感度優(yōu)于AS球面人工晶體組。 3、在瞳孔直徑為5.0mmm時,MCX11ASP非球面人工晶體相比AS球面人工晶體能夠顯著減少白內(nèi)障術(shù)后總像差,提高白內(nèi)障患者術(shù)后的視覺質(zhì)量。
[Abstract]:objective
The visual acuity, the best corrected visual acuity, and the difference of contrast sensitivity and aberration were compared between the cataract phacoemulsification and the MCX11ASP aspheric intraocular lens and the AS spherical intraocular lens.
Method
1, a prospective clinical control study was carried out in a continuous selection of patients with age-related cataract in June 2011 - December 2011 in our hospital and performed routine cataract surgery (such as slit lamp microscope examination, fundus examination, A, B), corneal curvature, intraocular pressure, electrophysiology, etc., and preoperative removal of corneal lesions, glaucoma, and grapes Meningitis, subluxation of lens, retina disease, middle high myopia. Before operation, two groups of.A groups were implanted in the German human optical MCX11ASP aspheric intraocular lens, and the B group was implanted with AS spherical intraocular lens.
2, postoperative screening criteria: follow up patients after surgery, routine examination of Ophthalmology, corneal pathological changes without slit lamp microscope, no atrophy of the iris, no pigmentation, direct pupil and indirect reflection of light, the intraocular lens is located in the bag, in the middle, no obvious tilt, no apparent pigmentation, no cloudy surface of the artificial lens surface, no cloudy, no cloudy. The surface was damaged, the posterior capsule was cloudy, and there was no pathological change in vitreous and retina.
3, A, and B two groups were used to measure the visual acuity of the naked eye with the normal visual acuity, and the best corrected visual acuity. Three months after the operation, the Talcagi-CGT-1000 automatic glare contrast sensitivity test was used for the non glare and glare contrast sensitivity examination, the Nidek optometry was used to check the refractive state, and the aberration of the three months after the operation was examined by the OPD-Scan wavefront aberrometry.
4, the SPSS13.0 software package was used for statistical analysis, and T test and X2 test were used for the two groups of measurement results.
Result
1, all the subjects were examined one week after the operation. 3 patients (4 eyes) were out of visit one month after the operation, including 2 cases (3 eyes) in group A and 1 cases (1 eyes) in group B. 5 cases (7 eyes) were out of visit in 5 cases (7 eyes) and B group 3 cases (4 eyes) at three months after operation.
2, in group two, the average degree of intraocular lens implantation was 21.23 + 2.16 (D) in group A and 21.97 + 2.24 (D) in group B. There was no significant difference between the two groups (t=1.692, P = 0.0936). Among them, 6 patients (6 eyes) were slightly biased, partial center was less than 0.25mm, A group 2 (2 eyes), B group 4 cases (4 eyes). (-1.25D to 0.75D), group B -0.1258 + 0.6159D (-1.25D ~ 1.25D), the difference between the two groups was not statistically significant (t = 0, P=1.000). The degree of astigmatism in the A group was 0.5486 + 0.3526D (0 ~ 1.25D), and the group was 0.5333 + (1 to 1). The two groups had no statistical significance (0.2083, 0.8354 = 0.8354).
3, one week after the operation, the visual acuity of the two groups was 0.35 + 0.16 in group A, and in group B 0.31 + 0.18. There was no statistically significant difference between the two groups (t = 1.1715, P = 0.2440). The visual acuity was 0.58 + 0.18 in group A and 0.54 + 0.17 in group B (t=1.0918, P=0.2777). The best corrected visual acuity in group A in three months after operation was 0.91 + 0.12, group B was 0.88 + 0.11, and group two was not statistically significant (t=1.2502, P=0.2143). The pupil size A group 3.49 + 0.53 (mm), B group (mm) T=0.0895, P=0.9289.
4, in the three months after the operation, the two groups were measured in 6.3, 4, 2.5, 1.6, 1, and 0.7, respectively, under the condition of non glare and glare, and the two groups were significantly different in the 6.3 angle (P0.01), and the group A was better than the B group.
5, when the pupil was measured from 3 to 4mm three months after the operation, the spherical aberration of group A was 0.003 + 0.015 mu m, the difference was 0.004 + 0.01 u m, and the difference was 0.040 + 0.025 M. between two groups, and the difference was not statistically significant (t1=0.3554, P1=0.6961; t2=1.1254, P2=0.2165). The spherical aberration of the group m.B was 0.120 + 0.095 m, and the difference between the two groups was statistically significant (0.202, 0.129, M.) (t1=4.8398, P1=0.001:t2=2.0993, P2=0.0385).
conclusion
1, there was no significant difference in the visual acuity and best corrected visual acuity between three months after the operation of MCX11ASP aspheric intraocular lenses in Germany compared with AS spherical intraocular lenses.
2, the contrast sensitivity of MCX11ASP aspheric intraocular lens group is better than that of AS spherical intraocular lens group at 6.3 degree angle (low spatial frequency).
3, when the pupil diameter is 5.0mmm, MCX11ASP aspheric intraocular lens can significantly reduce the total aberration after cataract surgery and improve the visual quality of cataract patients after cataract surgery compared with AS spherical intraocular lens.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R779.66
本文編號：2127443
[Abstract]:objective
The visual acuity, the best corrected visual acuity, and the difference of contrast sensitivity and aberration were compared between the cataract phacoemulsification and the MCX11ASP aspheric intraocular lens and the AS spherical intraocular lens.
Method
1, a prospective clinical control study was carried out in a continuous selection of patients with age-related cataract in June 2011 - December 2011 in our hospital and performed routine cataract surgery (such as slit lamp microscope examination, fundus examination, A, B), corneal curvature, intraocular pressure, electrophysiology, etc., and preoperative removal of corneal lesions, glaucoma, and grapes Meningitis, subluxation of lens, retina disease, middle high myopia. Before operation, two groups of.A groups were implanted in the German human optical MCX11ASP aspheric intraocular lens, and the B group was implanted with AS spherical intraocular lens.
2, postoperative screening criteria: follow up patients after surgery, routine examination of Ophthalmology, corneal pathological changes without slit lamp microscope, no atrophy of the iris, no pigmentation, direct pupil and indirect reflection of light, the intraocular lens is located in the bag, in the middle, no obvious tilt, no apparent pigmentation, no cloudy surface of the artificial lens surface, no cloudy, no cloudy. The surface was damaged, the posterior capsule was cloudy, and there was no pathological change in vitreous and retina.
3, A, and B two groups were used to measure the visual acuity of the naked eye with the normal visual acuity, and the best corrected visual acuity. Three months after the operation, the Talcagi-CGT-1000 automatic glare contrast sensitivity test was used for the non glare and glare contrast sensitivity examination, the Nidek optometry was used to check the refractive state, and the aberration of the three months after the operation was examined by the OPD-Scan wavefront aberrometry.
4, the SPSS13.0 software package was used for statistical analysis, and T test and X2 test were used for the two groups of measurement results.
Result
1, all the subjects were examined one week after the operation. 3 patients (4 eyes) were out of visit one month after the operation, including 2 cases (3 eyes) in group A and 1 cases (1 eyes) in group B. 5 cases (7 eyes) were out of visit in 5 cases (7 eyes) and B group 3 cases (4 eyes) at three months after operation.
2, in group two, the average degree of intraocular lens implantation was 21.23 + 2.16 (D) in group A and 21.97 + 2.24 (D) in group B. There was no significant difference between the two groups (t=1.692, P = 0.0936). Among them, 6 patients (6 eyes) were slightly biased, partial center was less than 0.25mm, A group 2 (2 eyes), B group 4 cases (4 eyes). (-1.25D to 0.75D), group B -0.1258 + 0.6159D (-1.25D ~ 1.25D), the difference between the two groups was not statistically significant (t = 0, P=1.000). The degree of astigmatism in the A group was 0.5486 + 0.3526D (0 ~ 1.25D), and the group was 0.5333 + (1 to 1). The two groups had no statistical significance (0.2083, 0.8354 = 0.8354).
3, one week after the operation, the visual acuity of the two groups was 0.35 + 0.16 in group A, and in group B 0.31 + 0.18. There was no statistically significant difference between the two groups (t = 1.1715, P = 0.2440). The visual acuity was 0.58 + 0.18 in group A and 0.54 + 0.17 in group B (t=1.0918, P=0.2777). The best corrected visual acuity in group A in three months after operation was 0.91 + 0.12, group B was 0.88 + 0.11, and group two was not statistically significant (t=1.2502, P=0.2143). The pupil size A group 3.49 + 0.53 (mm), B group (mm) T=0.0895, P=0.9289.
4, in the three months after the operation, the two groups were measured in 6.3, 4, 2.5, 1.6, 1, and 0.7, respectively, under the condition of non glare and glare, and the two groups were significantly different in the 6.3 angle (P0.01), and the group A was better than the B group.
5, when the pupil was measured from 3 to 4mm three months after the operation, the spherical aberration of group A was 0.003 + 0.015 mu m, the difference was 0.004 + 0.01 u m, and the difference was 0.040 + 0.025 M. between two groups, and the difference was not statistically significant (t1=0.3554, P1=0.6961; t2=1.1254, P2=0.2165). The spherical aberration of the group m.B was 0.120 + 0.095 m, and the difference between the two groups was statistically significant (0.202, 0.129, M.) (t1=4.8398, P1=0.001:t2=2.0993, P2=0.0385).
conclusion
1, there was no significant difference in the visual acuity and best corrected visual acuity between three months after the operation of MCX11ASP aspheric intraocular lenses in Germany compared with AS spherical intraocular lenses.
2, the contrast sensitivity of MCX11ASP aspheric intraocular lens group is better than that of AS spherical intraocular lens group at 6.3 degree angle (low spatial frequency).
3, when the pupil diameter is 5.0mmm, MCX11ASP aspheric intraocular lens can significantly reduce the total aberration after cataract surgery and improve the visual quality of cataract patients after cataract surgery compared with AS spherical intraocular lens.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R779.66
【參考文獻】
相關(guān)期刊論文 前1條
1 畢宏生;對比敏感度在眼科的臨床應(yīng)用[J];中華眼科雜志;2004年09期
，本文編號：2127443
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