發(fā)布時(shí)間：2018-03-25 20:04

  本文選題：角膜磨鑲術(shù)　切入點(diǎn)：激光原位　出處：《鄭州大學(xué)》2011年碩士論文

【摘要】：背景與目的 準(zhǔn)分子激光原位角膜磨鑲術(shù)治療近視以其安全性和有效性,已成為當(dāng)今角膜屈光手術(shù)的首選術(shù)式。然而角膜屈光手術(shù)矯正屈光不正的同時(shí)改變了原來角膜的正常形態(tài),這就可能引起術(shù)后視覺質(zhì)量的下降,出現(xiàn)對比敏感度下降、眩光、光暈以及夜視力差等癥狀。隨著患者對術(shù)后視覺質(zhì)量的不滿,臨床醫(yī)生逐漸認(rèn)識(shí)到有關(guān)對比敏感度研究的重要性與必要性,尤其是暗環(huán)境下的對比敏感度。對比敏感度是評價(jià)人眼視功能的重要指標(biāo),并且它的變化早于視野、眼底和視力的改變,能夠準(zhǔn)確、及時(shí)地反映視功能的變化,還能對手術(shù)方式和術(shù)后療效作出準(zhǔn)確的評價(jià)。在眼科領(lǐng)域,國內(nèi)外雖然有對比敏感度的研究報(bào)道,但對于高度近視準(zhǔn)分子激光原位角膜磨鑲術(shù)后暗環(huán)境下對比敏感度的研究較少,并且結(jié)果不盡相同。 本研究收集術(shù)前等值球鏡為(-6.00--12.75)D的近視患者66例(129眼)進(jìn)行前瞻性研究,旨在探討高度近視行準(zhǔn)分子激光原位角膜磨鑲術(shù)治療后的臨床療效,對比敏感度度的變化及與其他參數(shù)如術(shù)前屈光度、瞳孔直徑,手術(shù)切削光區(qū)直徑、性別、年齡和眩光的相關(guān)性。 方法 連續(xù)收集2010年5月至2010年8月在我院準(zhǔn)分子激光治療中心接受準(zhǔn)分子激光原位角膜磨鑲術(shù)治療的66例129只高度近視眼,進(jìn)行前瞻性研究。所有患者均進(jìn)行術(shù)前和術(shù)后1、3、6個(gè)月裸眼視力、最佳矯正視力和屈光度的檢查,采用CSV-1000E型對比敏感度測試儀進(jìn)行暗環(huán)境下對比敏感度的檢查,觀察高度近視準(zhǔn)分子激光原位角膜磨鑲術(shù)后對比敏感度的變化,并分析與其相關(guān)的術(shù)前屈光度、手術(shù)切削光區(qū)直徑和眩光等因素的關(guān)系。 采用SPSS17.0統(tǒng)計(jì)軟件進(jìn)行數(shù)據(jù)統(tǒng)計(jì)學(xué)分析,均數(shù)用(x±s)表示,對比敏感度變化用單因素方差分析(ANOVA),眩光對對比敏感度影響用配對t檢驗(yàn),相關(guān)性分析用Pearson相關(guān),P0.05作為差異有統(tǒng)計(jì)學(xué)意義的標(biāo)準(zhǔn)。 結(jié)果 1.術(shù)后6個(gè)月95只眼(73.60%)裸眼視力≥1.0,有效指數(shù)0.996,安全性指數(shù)1.052,122只眼(94.57%)屈光度在±1.00D之內(nèi),97只眼(75.19%)屈光度在±0.50D之內(nèi)。 2.術(shù)后1個(gè)月低頻段(3c/d)、中(6、12c/d)和高頻段(18c/d)對比敏感度均有明顯下降；術(shù)后6個(gè)月低頻段對比敏感度可恢復(fù)至術(shù)前水平(二者差異無統(tǒng)計(jì)學(xué)意義,P0.05),但中、高頻段對比敏感度尚未恢復(fù)至術(shù)前水平(差異均有統(tǒng)計(jì)學(xué)意義P0.05)。 3.術(shù)前屈光度與術(shù)前和術(shù)后對比敏感度均呈負(fù)相關(guān),尤其是中、高頻段對比敏感度；手術(shù)切削光區(qū)直徑的大小與術(shù)后對比敏感度呈正相關(guān),尤其是暗視情況下的低、中頻段對比敏感度；有眩光時(shí)對比敏感度均較無眩光時(shí)對比敏感度低,所有空間頻段差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。 4.對比敏感度與性別、年齡和瞳孔直徑均不相關(guān)。 結(jié)論 1.高度近視準(zhǔn)分子激光原位角膜磨鑲術(shù)后暗環(huán)境下對比敏感度均較術(shù)前下降；術(shù)后6個(gè)月時(shí),低頻段對比敏感度已恢復(fù)至術(shù)前水平,但中、高頻段對比敏感度均未恢復(fù)至術(shù)前水平。 2.暗環(huán)境下對比敏感度與術(shù)前屈光度呈負(fù)相關(guān)、與手術(shù)切削光區(qū)直徑呈正相關(guān),有眩光時(shí)對比敏感度比無眩光時(shí)對比敏感度低。
[Abstract]:Background and purpose
Excimer laser in situ keratomileusis for its safety and effectiveness, has become the preferred technique in corneal refractive surgery and corneal refractive surgery. However, ametropia correction has changed the original corneal normal form, which may decrease the postoperative visual quality, contrast sensitivity decreased, glare, halo night vision and other symptoms. Patients with poor dissatisfaction with the visual quality after the surgery, doctors gradually realized the importance and necessity of studying on contrast sensitivity, especially the contrast sensitivity in the dark environment. The sensitivity is an important index for evaluating the human visual function, and it changes early in the field of vision, fundus and the change of visual acuity, accurately, timely reflect the changes of visual function, can make an accurate evaluation on the efficacy of surgery and after surgery. In the field of Ophthalmology at home and abroad, although the statistic Sensitivity studies have been reported. However, there are few studies on the contrast sensitivity in the dark environment after laser in situ keratomileusis for high myopia, and the results are different.
This study collected the preoperative spherical equivalent (-6.00--12.75) for 66 cases of D patients with myopia (129 eyes) were prospectively studied to explore clinical effect of high myopia excimer laser in situ keratomileusis corneal treatment, changes of contrast sensitivity degree and other parameters such as preoperative diopter, pupillary diameter. Surgical ablation diameter, gender, age and correlation of glare.
Method
From May 2010 to August 2010 to accept continuous laser in situ keratomileusis for treatment of 66 cases of 129 eyes with high myopia after excimer laser treatment center in our hospital were prospectively studied. All patients underwent preoperative and postoperative 1,3,6 months uncorrected visual acuity, best corrected visual acuity and refraction examination, used CSV-1000E contrast sensitivity tester for mesopic contrast sensitivity examination, observation of high myopia after laser in situ keratomileusis contrast sensitivity changes, and analyze the related preoperative refraction, the relationship between surgery ablation diameter and glare and other factors.
The data were analyzed by SPSS17.0 statistical software, with mean (x + s) said that the analysis of the changes of contrast sensitivity with single factor variance (ANOVA), paired t test on the effect of glare contrast sensitivity, correlation analysis using Pearson correlation, P0.05 as statistically significant.
Result
1. 6 months after surgery, 95 eyes (73.60%) uncorrected visual acuity 1, effective index 0.996, security index in 1.052122 eyes (94.57%) diopter within 1.00D, 97 eyes (75.19%) diopter within 0.50D.
2.鏈悗1涓湀浣庨孌，

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