本文選題：超聲乳化白內(nèi)障吸除術(shù) + 白內(nèi)障��； 參考：《天津醫(yī)科大學》2010年碩士論文

【摘要】： 目的：探討根據(jù)患者術(shù)前角膜球差植入合適的非球面人工晶狀體fintraocular lens,IOL)使其術(shù)后全眼球差為零這一方法的可行性。并評價術(shù)前角膜球差大于等于0.33μm與小于0.33μm的年齡相關(guān)性白內(nèi)障患者在植入Tecnis ZA9003非球面人工晶狀體(intraocular lens,IOL)術(shù)后視覺質(zhì)量。 方法：前瞻性系列病例研究。對46例(57眼)年齡相關(guān)性白內(nèi)障患者術(shù)前1d利用iTrace視覺功能分析儀測量6.0mm直徑下角膜球差(Z40),為使患者術(shù)后總球差接近于零,對角膜球差小于0.1μm者植入Sofport Advanced Optic(AO)IOL(10眼),0.1μm到0.235μm者植入AcrySof IQ IOL(20眼),大于0.235μm者植入Tecnis ZA9003 IOL(27眼)�；颊呔�3.2 mm透明角膜切口的超聲乳化白內(nèi)障吸除聯(lián)合非球面IOL植入術(shù),術(shù)后3個月觀察患者的裸眼視力、最佳矯正視力(best corrected visual acuity,BCVA).6.0mm瞳孔直徑時的全眼及內(nèi)眼(主要是IOL)球差。采用t檢驗和方差分析對獲得的數(shù)據(jù)進行統(tǒng)計學分析。 對48例(60眼)年齡相關(guān)性白內(nèi)障患者術(shù)前1d利用iTrace視覺功能分析儀測量6.0mm直徑的角膜球差,將角膜球差大于等于0.33μm設(shè)為觀察組,小于0.33μm者為對照組,所有患者均行3.2 mm透明角膜切口的超聲乳化白內(nèi)障吸除聯(lián)合Tecnis ZA9003非球面IOL植入術(shù),術(shù)后3個月觀察患者的裸眼視力、最佳矯正視力、對比敏感度及3.0mm和6.0mm瞳孔直徑下的全眼像差及5、10、15、20、25、30周/度(cycles per degree,cpd)空間頻率下的調(diào)制傳遞函數(shù)。采用配對t檢驗對獲得的數(shù)據(jù)進行統(tǒng)計學分析。 結(jié)果：術(shù)后所有患者6.0mm瞳孔直徑時的全眼球差為0.015±0.056μm(Sofport:0.081±0.013μm；AcrySofIQ:0.006±0.038μm；Tecnis:0.007±0.070μm)；所有患者術(shù)后全眼球差的預(yù)測值與實際值的差異無統(tǒng)計學意義：t=1.983,P= 0.052(Sofport:t=1.957,P=0.082；AcrySofIQ:t=0.030,P=0.976；Tecnis:t =2.031,P=0.053):所有患者全眼球差的預(yù)測值與實際值的差值為：0.014±0.044μm(Sofport:0.006±0.012gm；AcrySofIQ:-0.000±0.037μm；Tecnis: 0.027±0.052μm,F=2.626,P=0.082)。術(shù)后三組患者的裸眼視力、BCVA差異均無統(tǒng)計學意義(F=0.901,2.416,P=0.412,0.099)。 術(shù)前6.0mm直徑的角膜球差,觀察組(0.362±0.075μm)大于對照組(0.231±0.056μm),差異有統(tǒng)計學意義(t=7.694,P=0.000)。術(shù)后3個月,6.0mm瞳孔時的全眼球差觀察組(0.088±0.046um)大于對照組(-0.038±0.062μm),差異有統(tǒng)計學意義(t=8.939,P=0.000)。兩組患者的裸眼視力及最佳矯正視力差異均無統(tǒng)計學意義(P0.05)。觀察組的對比敏感度值優(yōu)于對照組,在暗視(3cpd)及暗視加眩光(1.5、6cpd)下兩組差異均有統(tǒng)計學意義(P0.05)。觀察組在3.Omm和6.0mm瞳孔直徑下各頻段的調(diào)制傳遞函數(shù)值均高于對照組(P0.05)。 結(jié)論：本研究根據(jù)患者術(shù)前的角膜球差植入合適的非球面IOL,術(shù)后均能夠獲得較滿意的目標球差,為相對個性化植入非球面IOL這一方法的可行性提供臨床依據(jù)。非球面IOL植入術(shù)后預(yù)留少量的正球差可能會提高患者的視覺質(zhì)量。
[Abstract]:Objective: to investigate the feasibility of preoperative corneal spherical aberration implantation (fintraocular lens lensus IOL) to zero the postoperative total eyeball difference.The visual quality of patients with age-related cataract whose corneal spherical aberration was greater than 0.33 渭 m or less than 0.33 渭 m was evaluated after implantation of Tecnis ZA9003 aspherical intraocular lens (Tecnis ZA9003 intraocular lens).Methods: a series of prospective case studies.In order to make the total spherical aberration of cornea near zero after operation, 46 cases (57 eyes) of age-related cataract were measured with iTrace visual function analyzer to measure the corneal spherical aberration under the diameter of 6.0mm 1 day before operation.AcrySof IQ IOL(20 eyes were implanted in Sofport Advanced Optic(AO)IOL(10 eyes with corneal spherical aberration less than 0.1 渭 m to 0.235 渭 m, and Tecnis ZA9003 IOL(27 eyes were implanted with more than 0.235 渭 m.All patients were treated with phacoemulsification and aspherical IOL implantation with 3.2mm transparent corneal incision. The uncorrected visual acuity was observed 3 months after operation. The best corrected visual acuity of BCVA was 6.0mm in diameter of pupil, and the spherical aberration of the whole eye and the inner eye (mainly IOL) was observed.T-test and ANOVA were used to analyze the data.The corneal spherical aberration of 6.0mm diameter was measured by iTrace visual function analyzer 1 day before operation in 48 patients with age-related cataract. The corneal spherical aberration greater than or equal to 0.33 渭 m was set as the observation group and the control group was less than 0.33 渭 m.All patients were treated with phacoemulsification and Tecnis ZA9003 aspherical IOL implantation with 3.2mm transparent corneal incision. The uncorrected visual acuity and the best corrected visual acuity were observed 3 months after operation.Contrast sensitivity, the whole eye aberration at the pupil diameter of 3.0mm and 6.0mm and the modulation transfer function at the spatial frequency of 510101520 / C 2530 cycles per cycles.The data obtained were statistically analyzed by paired t test.緇撴灉:鏈悗鎵，

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