本文關(guān)鍵詞： 有晶體眼 前房人工晶體 房角支撐 近視　出處：《福建醫(yī)科大學(xué)》2010年碩士論文　論文類型：學(xué)位論文

【摘要】： 目的:探討有晶體眼房角支撐型前房人工晶體植入治療高度近視的有效性、預(yù)測性和安全性。 方法:2004年6月至2007年4月在本院接受前房晶狀體植入術(shù)治療高度近視的患眼共15只。手術(shù)前后觀察患眼的視力、屈光狀態(tài)、眼壓、房角、角膜內(nèi)皮計(jì)數(shù)及精確測量生物參數(shù),裂隙燈觀察角膜、瞳孔、透明晶狀體、人工晶體情況,檢眼鏡觀察眼底情況,并進(jìn)行比較分析。術(shù)后隨訪2.7~5.6年,中位數(shù)3年。 結(jié)果:15只眼均成功植入前房型人工晶狀體。術(shù)前平均裸眼視力0.06±0.03,術(shù)后3年平均裸眼視力0.58±0.26,與術(shù)前平均裸眼視力相比(t=--7.602,P0.01)有統(tǒng)計(jì)學(xué)意義;術(shù)前平均最佳矯正視力0.54±0.18,術(shù)后3年平均最佳矯正視力0.74±0.26,相比(Z=-2.214,P0.05)有統(tǒng)計(jì)學(xué)意義;術(shù)前平均等效球鏡度數(shù)(-16.75±3.66)D,術(shù)后3年殘余屈光度為(-1.75～1.25)D,平均等效球鏡度數(shù)(-0.38±0.87)D,與術(shù)前平均等效球鏡度數(shù)相比(t=-16.840 ,P0.01)有統(tǒng)計(jì)學(xué)意義;術(shù)前平均角膜內(nèi)皮細(xì)胞計(jì)數(shù)(2934±455)個(gè)/mm2,術(shù)后3年角膜內(nèi)皮計(jì)數(shù)為(2485±812)個(gè)/mm2,相比(t=1.869,P0.05)無統(tǒng)計(jì)學(xué)意義,平均下降15.3%。1只眼(6.7%)術(shù)后有眩光,瞳孔直徑大于人工晶狀體光學(xué)部,其晶體有1攀入虹膜周切口,晶狀體光學(xué)中心稍偏移;1只眼(6.7%)晶體后表面周邊條帶狀虹膜色素播散,其1攀入虹膜周切口,晶狀體光學(xué)中心稍偏移;2只眼(13.3%)瞳孔稍變形呈橢圓形。但對視力均無明顯影響。手術(shù)的安全性指數(shù)為1.37,有效性指數(shù)為1.08,預(yù)測性指數(shù)為-0.023。所有病人對術(shù)后視力表示滿意。 結(jié)論:本組有晶體眼房角支撐型前房人工晶體植入治療超高度近視的病人術(shù)后隨訪示對術(shù)后裸眼視力滿意度較高,生活質(zhì)量明顯改善,術(shù)后3年手術(shù)的預(yù)測性指數(shù)-0.023,有效性指數(shù)為1.08,安全性指數(shù)為1.37,并發(fā)癥相對較少,但術(shù)后3年角膜內(nèi)皮計(jì)數(shù)有一定的丟失,未發(fā)生角膜內(nèi)皮失代償,術(shù)后角膜內(nèi)皮細(xì)胞自然丟失率情況有待進(jìn)一步觀察。該術(shù)簡單易行,具有良好的可預(yù)測性,確切的有效性,安全性較好,是高度近視矯正可供選擇的方法之一。
[Abstract]:Objective: to evaluate the efficacy, predictability and safety of anterior chamber intraocular lens implantation with lens angle support in the treatment of high myopia. Methods: from June 2004 to April 2007, 15 eyes with high myopia were treated with anterior chamber lens implantation. The visual acuity, refractive state, intraocular pressure, angle of atrium, corneal endothelium count and biological parameters were observed before and after operation. The cornea, pupil, transparent lens, intraocular lens and ocular fundus were observed by slit lamp and compared and analyzed. The follow-up was 2.7 ~ 5.6 years (median 3 years). Results all 15 eyes were successfully implanted with anterior chamber intraocular lens. The mean uncorrected visual acuity was 0.06 鹵0.03 before operation and 0.58 鹵0.26 in 3 years postoperatively. The mean BCVA was 0.54 鹵0.18 before operation and 0.74 鹵0.26 after 3 years. The mean preoperative equivalent spherical degree was -16.75 鹵3.66 d, the postoperative residual refraction was -1.75 鹵1.25 Dand the mean equivalent spherical degree was -0.38 鹵0.87 d, which was significantly higher than that of preoperative mean equivalent spherical degree (t = -16.840 vs P 0.01). The mean corneal endothelial cell count was 2934 鹵455 / m2 before operation and 2485 鹵812 / s / mm-2 in 3 years postoperatively. There was no significant difference in corneal endothelial cell count compared with 1.869 (P0.05). The mean decrease of corneal endothelial cell count was 15.3.1 eyes (6.7mm). The pupil diameter was larger than that of intraocular lens (IOL), and the diameter of pupil was larger than that of intraocular lens (IOL). Its crystal has 1 incision around the iris, and the optical center of the lens is slightly deviated from the center of the lens. One of the crystals has a band of iris pigment spread around the posterior surface of the crystal, and one of the crystals climbs into the incision around the iris. The pupil was slightly deformed in oval shape, but had no obvious effect on the visual acuity. The safety index, effectiveness index and predictive index were 1.37, 1.08 and -0.023 respectively. All the patients were satisfied with the postoperative visual acuity. Conclusion: the follow-up of the patients with angle support anterior chamber intraocular lens implantation for ultra-high myopia showed that the patients were satisfied with the naked eyesight and the quality of life was improved obviously. The predictive index (-0.023), the effectiveness index (1.08), the safety index (1.37), the complications were relatively few, but the corneal endothelium count was lost and no corneal endothelium decompensation occurred 3 years after operation. The rate of spontaneous loss of corneal endothelial cells remains to be further observed. The procedure is simple, predictable, effective and safe. It is one of the alternative methods for correction of high myopia.
【學(xué)位授予單位】：福建醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2010
【分類號】：R779.6

【參考文獻(xiàn)】

相關(guān)期刊論文 前6條

1 廖榮豐;汪永;周艷峰;劉倫;劉興華;封利霞;;有晶體眼后房型人工晶體植入治療高度近視及散光[J];安徽醫(yī)學(xué);2009年08期

2 牟章兵,杜之渝;有晶狀體眼人工晶狀體植入術(shù)研究進(jìn)展[J];眼科新進(jìn)展;2005年01期

3 王勤美,黃芳,沈麗君,徐明;40歲以上高度近視屈光性晶狀體搞出人工晶狀體植入術(shù)與LASIK的比較[J];眼科研究;2001年04期

4 陳偉蓉,劉奕志,陳秀琦,程冰,劉玉華;超聲生物顯微鏡觀察彈性開放襻前房型人工晶狀體對眼前段結(jié)構(gòu)的影響[J];中華眼科雜志;2001年01期

5 姚克,徐雯,于建春,張偉英,潘永稱,杜新華,陳佩卿,易虹,萬迪玲,李增琦,葉宏斌;晶狀體眼前房型人工晶狀體植入術(shù)矯正高度近視的臨床研究[J];中華眼科雜志;2003年06期

6 王曉瑛,褚仁遠(yuǎn),周行濤,張紅霞,周傳清,任秋實(shí);晶狀體眼前房型人工晶狀體植入術(shù)矯正高度近視后放大率與視力的關(guān)系[J];中華眼科雜志;2005年11期

，

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