本文關(guān)鍵詞： 微小切口 超聲乳化 散光 白內(nèi)障　出處：《吉林大學》2011年碩士論文　論文類型：學位論文

【摘要】：白內(nèi)障是最常見的致盲眼病之一,其有效、確切的治療方法是手術(shù)摘除混濁的晶狀體。隨著科學技術(shù)的進步,白內(nèi)障手術(shù)治療從傳統(tǒng)的白內(nèi)障針撥術(shù)、白內(nèi)障囊內(nèi)摘除(Intracapsular cataract extraction ICCE)和白內(nèi)障囊外摘除術(shù)(Extracapsular cataract extraction ECCE)等術(shù)式發(fā)展至今天的白內(nèi)障超聲乳化技術(shù)已經(jīng)取得了質(zhì)的進步。自1967年Kelman醫(yī)生發(fā)明白內(nèi)障超聲乳化技術(shù)以來,該項技術(shù)得到了不斷的完善和迅速的發(fā)展,該手術(shù)方式以切口小,術(shù)后反應(yīng)輕,視力恢復更快,并發(fā)癥少等優(yōu)點已成為公認的治療白內(nèi)障的主要方式,近幾十年來,隨著科學技術(shù)的發(fā)展,先進的儀器和手術(shù)技巧不斷改進,給白內(nèi)障患者帶來了福音。如超聲乳化機器的改進、手術(shù)切口的縮小、新型人工晶體的出現(xiàn)等使白內(nèi)障手術(shù)日臻完善,如何使白內(nèi)障手術(shù)切口進一步縮小以消除手術(shù)造成的散光及提高手術(shù)的安全性成了白內(nèi)障手術(shù)的一大發(fā)展趨勢。本研究擬通過觀察2.2 mm微切口白內(nèi)障同軸超聲乳化聯(lián)合人工晶狀體植入術(shù)的臨床效果,并與傳統(tǒng)3.2mm切口同軸超聲乳化手術(shù)進行比較,為指導臨床提供客觀資料。 研究對象選擇在吉大二院眼科醫(yī)院就診的年齡相關(guān)性白內(nèi)障患者80例,核硬度按LOCS II晶狀體混濁分類體系分級,隨機分2組,眼部檢查排除角膜白斑、青光眼、糖尿病性視網(wǎng)膜病變、年齡相關(guān)性黃斑病變等。Ⅰ組行2.2mm微切口白內(nèi)障超聲乳化聯(lián)合人工晶狀體植入術(shù),Ⅱ組行傳統(tǒng)3.2mm角膜切口同軸超聲乳化聯(lián)合人工晶狀體植入術(shù)。兩組患者均使用美國Alcon公司的Infiniti超聲乳化設(shè)備,手術(shù)由同一術(shù)者完成,植入晶體均為非球面人工晶體AcrySof SN60WF (AcrySofIQ),術(shù)中記錄超聲乳化累積釋放能量,術(shù)后第1天、第1周和第1個月觀察隨訪,記錄術(shù)前術(shù)后的裸眼視力、散光改變和手術(shù)并發(fā)癥,術(shù)后1個月時檢查對比敏感度。 結(jié)果：術(shù)后1d裸眼視力兩組有顯著性差異(p=0.047,p＜0.05),且微小切口組高于正常超乳組；術(shù)后1d、1w、1m散光值,微小切口組散光值低于正常超乳組,有顯著性差異(P0.05),其他方面無明顯差異(P0.05). 結(jié)論：與3.2mm透明角膜切口超乳組比較,2.2mm透明角膜微小切口組白內(nèi)障超聲乳化術(shù)術(shù)源性散光少,術(shù)后視力提高更快；通過特殊的的Alcon MONARCHⅢ推進器配以D型夾頭,在不擴大切口的情況下,通過微切口可將AcrySofIQ可折疊晶體順利植入后房,實現(xiàn)微小切口白內(nèi)障手術(shù),安全可行。
[Abstract]:Cataract is one of the most common causes of blindness. It is effective and the exact treatment is to remove the opacity of the lens. With the development of science and technology, cataract surgery begins with the traditional cataract needle removal. The development of cataract phacoemulsification techniques, such as intra capsular cataract extraction ICCEE and extracapsular cataract extraction Ecce, has made qualitative progress. Since the invention of cataract phacoemulsification by Dr. Kelman in 1967, This technique has been continuously improved and developed rapidly. The advantages of this technique are small incision, light postoperative response, faster visual recovery and fewer complications. In recent decades, it has become the main way to treat cataract. With the development of science and technology, advanced instruments and surgical techniques have been improved, which bring good news to cataract patients. For example, the improvement of phacoemulsification machine, the reduction of surgical incision and the appearance of new intraocular lens make cataract surgery more and more perfect. How to further reduce the incision of cataract surgery to eliminate astigmatism caused by surgery and improve the safety of cataract surgery has become a major development trend of cataract surgery. This study intends to observe the 2.2 mm microincision cataract coaxial phacoemulsification. Clinical effect of intraocular lens implantation, And compared with the traditional 3. 2 mm incision coaxial phacoemulsification operation to provide objective data for clinical guidance. Participants of the study included 80 age-related cataract patients in the second Eye Hospital of Jida. The nuclear hardness was classified according to the LOCS II lens opacity classification system. The patients were randomly divided into two groups. The ocular examination excluded corneal leukoplakia and glaucoma. Diabetic retinopathy, age-related macular lesion, etc. Group 鈪，

本文編號：1552253