本文關(guān)鍵詞：不同顏色人工晶體全視野視網(wǎng)膜電圖差異性探討　出處：《大連醫(yī)科大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 白內(nèi)障 全視野視網(wǎng)膜電圖 藍(lán)光濾過型人工晶狀體 視網(wǎng)膜光損傷

【摘要】：目的：伴隨著藍(lán)光越來越多的被應(yīng)用于我們的日常生活，藍(lán)光引起的視網(wǎng)膜光損傷效應(yīng)已經(jīng)逐漸被人們所意識(shí)到，白內(nèi)障術(shù)后患者由于缺少了晶狀體的光線濾過，尤其應(yīng)該重視藍(lán)光造成的視網(wǎng)膜光損傷。本研究通過比較透明單焦點(diǎn)人工晶體與藍(lán)光濾過型單焦點(diǎn)人工晶狀體在全視野視網(wǎng)膜電圖方面的差異性，來評(píng)價(jià)不同人工晶狀體對(duì)人眼視網(wǎng)膜功能的影響以及藍(lán)光濾過型人工晶狀體的視網(wǎng)膜保護(hù)作用。 方法：選取2013年3月至2013年12月于大連醫(yī)科大學(xué)附屬第二醫(yī)院眼科行白內(nèi)障超聲乳化吸出聯(lián)合人工晶體植入術(shù)患者，滿足入選及排除標(biāo)準(zhǔn)，隨機(jī)將其分為兩組，對(duì)照組植入Rayner SuperflexR（透明非球面單焦點(diǎn)人工晶狀體），實(shí)驗(yàn)組植入HOYA PY-60AD（藍(lán)光濾過型非球面單焦點(diǎn)人工晶狀體），對(duì)其進(jìn)行隨訪，資料完整者76人（82只眼）。其中對(duì)照組共36人（40只眼），男性18例21只眼，女性18例19只眼，Emery核硬度分級(jí)Ⅱ級(jí)核15只眼，Ⅲ級(jí)核18只眼，Ⅳ級(jí)核7只眼。實(shí)驗(yàn)組共40人（42只眼），男性20例20眼，女性20例22只眼。Emery核硬度分級(jí)Ⅱ級(jí)核16只眼，Ⅲ級(jí)核19只眼，Ⅳ級(jí)核7只眼。分別于術(shù)前1天、術(shù)后1個(gè)月、術(shù)后3個(gè)月12:00-14:00，由同一名熟練操作者操作，運(yùn)用羅蘭視覺電生理系統(tǒng)，進(jìn)行全視野視網(wǎng)膜電圖檢查。觀察國(guó)際標(biāo)準(zhǔn)化方案的六項(xiàng)指標(biāo)，并進(jìn)行統(tǒng)計(jì)學(xué)分析。 結(jié)果：（1）對(duì)照組暗適應(yīng)0.01ERG、暗適應(yīng)3.0ERG、暗適應(yīng)10.0ERG、暗適應(yīng)3.0振蕩電位p波振幅、明適應(yīng)3.0ERG、明適應(yīng)3.0閃爍ERG術(shù)后隱含期較術(shù)前縮短、振幅升高，差別有統(tǒng)計(jì)學(xué)意義（P0.05），術(shù)后一個(gè)月與術(shù)后三個(gè)月之間差別無統(tǒng)計(jì)學(xué)意義（P0.05）。暗適應(yīng)3.0振蕩電位p波隱含期術(shù)前、術(shù)后一個(gè)月、術(shù)后三個(gè)月之間差別無統(tǒng)計(jì)學(xué)意義（P0.05）。 （2）實(shí)驗(yàn)組暗適應(yīng)0.01ERG、暗適應(yīng)3.0ERG、暗適應(yīng)10.0ERG、暗適應(yīng)3.0振蕩電位、明適應(yīng)3.0ERG、明適應(yīng)3.0閃爍ERG術(shù)后較術(shù)前差別有統(tǒng)計(jì)學(xué)意義（P0.05），術(shù)后一個(gè)月與術(shù)后三個(gè)月之間差別無統(tǒng)計(jì)學(xué)意義（P0.05）。其中，，除暗適應(yīng)10.0b波隱含期術(shù)后較術(shù)前延長(zhǎng)外，術(shù)后隱含期均較術(shù)前縮短，振幅術(shù)后均較術(shù)前升高。 （3）對(duì)照組暗適應(yīng)10.0ERG較暗適應(yīng)3.0ERG a波隱含期縮短，a波振幅升高，差別有統(tǒng)計(jì)學(xué)意義（P0.05），b波差別無統(tǒng)計(jì)學(xué)意義（P0.05）。實(shí)驗(yàn)組暗適應(yīng)10.0ERG較暗適應(yīng)3.0ERG隱含期縮短，a波振幅升高，差別有統(tǒng)計(jì)學(xué)意義（P0.05），b波振幅差別無統(tǒng)計(jì)學(xué)意義（P0.05）。 （4）術(shù)后一個(gè)月，實(shí)驗(yàn)組暗適應(yīng)3.0b波隱含期、暗適應(yīng)10.0b波隱含期較對(duì)照組延長(zhǎng)，差別有統(tǒng)計(jì)學(xué)意義（P0.05）；暗適應(yīng)10.0a波振幅、暗適應(yīng)振蕩電位p波振幅、明適應(yīng)3.0閃爍ERG振幅較對(duì)照組升高，差別有統(tǒng)計(jì)學(xué)意義（P0.05）。余指標(biāo)兩組之間差別無統(tǒng)計(jì)學(xué)意義（P0.05）。 術(shù)后三個(gè)月，實(shí)驗(yàn)組暗適應(yīng)3.0b波隱含期、暗適應(yīng)10.0b波隱含期較對(duì)照組延長(zhǎng)，差別有統(tǒng)計(jì)學(xué)意義（P0.05）；暗適應(yīng)振蕩電位p波隱含期較對(duì)照組縮短，差別有統(tǒng)計(jì)學(xué)意義；暗適應(yīng)振蕩電位p波振幅、明適應(yīng)3.0閃爍ERG振幅較對(duì)照組升高，差別有統(tǒng)計(jì)學(xué)意義（P0.05）。余指標(biāo)兩組之間差別無統(tǒng)計(jì)學(xué)意義（P0.05）。 結(jié)論：白內(nèi)障會(huì)引起全視野視網(wǎng)膜電圖隱含期延長(zhǎng)、振幅縮短。給予高強(qiáng)度光照射可以減少由白內(nèi)障引起的全視野視網(wǎng)膜電圖的改變，有利于對(duì)白內(nèi)障患者視網(wǎng)膜情況的評(píng)估及術(shù)后視力的預(yù)測(cè)。藍(lán)光濾過型人工晶狀體由于濾過了部分藍(lán)光，使患者暗適應(yīng)隱含期延長(zhǎng)，影響其暗視敏感度。藍(lán)光濾過型人工晶狀體在小樣本術(shù)后三個(gè)月的隨訪中，顯現(xiàn)出對(duì)黃斑區(qū)及內(nèi)層視網(wǎng)膜的保護(hù)作用，期待日后大樣本長(zhǎng)期隨訪的臨床試驗(yàn)加以證實(shí)。
[Abstract]:Objective: with the blue light are used more and more in our daily life, blue light caused by light induced retinal damage effect has been gradually recognized, after cataract surgery patients due to the lack of a light filtering lens, especially should pay attention to the blue light from the light induced retinal injury. This study compares the transparent single focus intraocular lens and blue filtration type single focus intraocular lens differences in full field ERG aspects, to evaluate the effects of different intraocular lens on human retinal function and blue light filtering intraocular lens retina protection.
Methods: from March 2013 to December 2013 in the Second Affiliated Hospital of Dalian Medical University ophthalmology patients underwent phacoemulsification combined with intraocular lens implantation, meet the inclusion and exclusion criteria, were randomly divided into two groups, the control group SuperflexR implanted Rayner (transparent aspheric monofocal intraocular lens implanted in the experimental group, HOYA PY-60AD) (blue lightfiltering aspheric surface single focus intraocular lens), were followed up for the complete data of 76 people (82 eyes) in the control group. A total of 36 people (40 eyes), 18 cases of male 21 cases, female 18 cases 19 eyes, Emery nuclear hardness grade II III nuclear nuclear 15 eyes, 18 eyes, nuclear grade 7 eyes of experimental group. A total of 40 people (42 eyes), 20 eyes of 20 cases of male, female 20 cases 22 eyes of.Emery nuclear hardness grade II III nuclear nuclear 16 eyes, 19 eyes, 7 eyes respectively. Nuclear grade 1 day before surgery, 1 months after surgery, 3 months after the operation 12:00-14:00, The operation was performed by the same skilled operator. The whole field electroretinogram was examined by Loran's visual electrophysiological system. Six indexes of the international standardization program were observed and analyzed statistically.
Results: (1) the control group 0.01ERG 3.0ERG dark adaptation, dark adaptation, dark adaptation 10.0ERG, dark adaptation 3 oscillatory potentials of P wave amplitude, photopic 3.0ERG, light adaptation 3 scintillation after ERG implicit time were shorter, the amplitude increased, the difference was statistically significant (P0.05), the difference between three months after operation one month after surgery and had no statistical significance (P0.05). 3 dark adapted oscillatory potentials of P wave implicit time before operation, one month after the operation, the postoperative difference between three months was not statistically significant (P0.05).
(2) 0.01ERG dark adaptation of the experimental group, the dark adaptation 3.0ERG, dark adaptation 10.0ERG, dark adaptation 3 oscillatory potentials, photopic 3.0ERG, light adaptation 3 flashing ERG after operation there was a statistically significant difference (P0.05), postoperative difference between three months and one month after surgery had no statistical significance (P0.05) in addition to dark adaptation. The 10.0b wave implicit time after operation is extended, implicit time were shortened after operation, postoperative amplitude increase significantly.
(3) the control group 10.0ERG was dark adaptation dark adaptation 3.0ERG a wave latent period is shortened, the amplitude of a wave increased, the difference was statistically significant (P0.05), b wave had no significant difference (P0.05). The experimental group was dark adaptation dark adaptation 10.0ERG 3.0ERG implied period is shortened, the amplitude of a wave increased, the difference was statistically significant (P0.05), b wave amplitude difference was not statistically significant (P0.05).
(4) a month after the operation, the experimental group of dark adaptation of 3.0b wave implicit time, dark adaptation of the 10.0b wave implicit time longer than the control group, the difference was statistically significant (P0.05); dark adaptation of 10.0a wave amplitude, P wave amplitude of oscillatory potentials of dark adaptation, photopic 3 scintillation amplitude of ERG increased compared with the control group, there was statistical significant differences (P0.05). Other indexes between the two groups had no significant difference (P0.05).
Three months after surgery, the experimental group of dark adaptation of 3.0b wave implicit time, dark adaptation of the 10.0b wave implicit time longer than the control group, the difference was statistically significant (P0.05); dark adaptation of oscillatory potentials of P wave implicit time shorter than the control group, the difference was statistically significant; the dark adaptation of the oscillatory potentials of P wave amplitude, 3 flashing light adaptation the amplitude of ERG increased compared with the control group, the difference was statistically significant (P0.05). Other indexes between the two groups had no significant difference (P0.05).
Conclusion: the cataract caused by full field ERG implicit period, amplitude is reduced. Given the high intensity light irradiation can reduce the electroretinogram changes caused by cataract, visual acuity assessment and prediction for surgery for cataract patients after retinal conditions. Blue light filtering intraocular lens due to the filtering some blue, make the patient the implicit dark adaptation period is prolonged, affecting the scotopic sensitivity. Blue light filtering intraocular lens in the follow-up of three months after the operation in the small sample, showing protective effect on macular and inner retina, look forward to days after long-term follow-up of large sample clinical trials to confirm.

【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R779.6

【參考文獻(xiàn)】

相關(guān)期刊論文 前9條

1 曹燕,常寶琴,萬貝貝,石一寧;白內(nèi)障手術(shù)前視覺電生理測(cè)定的意義[J];國(guó)際眼科雜志;2005年02期

2 曲 勃,馬立威,張勁松;黃色晶狀體AcrysofNatural對(duì)急性視網(wǎng)膜光損傷保護(hù)作用的形態(tài)學(xué)研究(英文)[J];國(guó)際眼科雜志;2005年04期

3 李文娟;彭清華;;年齡相關(guān)性黃斑變性的病因?qū)W研究進(jìn)展[J];國(guó)際眼科雜志;2011年09期

4 袁野;何書喜;;視頻終端對(duì)視覺質(zhì)量的影響及機(jī)制[J];國(guó)際眼科雜志;2012年05期

5 程凱堯,趙云娥;視網(wǎng)膜視力測(cè)定在眼科的應(yīng)用[J];國(guó)外醫(yī)學(xué).眼科學(xué)分冊(cè);2005年05期

6 金婉卿;毛欣杰;李序;;鍍膜鏡片過濾藍(lán)光對(duì)大鼠視網(wǎng)膜功能的影響[J];實(shí)用醫(yī)學(xué)雜志;2007年12期

7 居家奇;林燕丹;;LED汽車前照燈藍(lán)光成分與不舒適眩光[J];中國(guó)照明電器;2006年07期

8 生暉;盧奕;卿鳳翎;;藍(lán)光及藍(lán)光濾過型人工晶狀體對(duì)體外培養(yǎng)人視網(wǎng)膜色素上皮細(xì)胞的影響[J];眼視光學(xué)雜志;2008年03期

9 王煊，倪偉，郝安平，石一寧;白內(nèi)障視電生理檢查對(duì)術(shù)后視力的預(yù)測(cè)[J];中國(guó)實(shí)用眼科雜志;1994年12期

本文編號(hào)：1356452