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(xué)》2011年碩士論文

【摘要】：目的：探討利用iTrace像差儀觀察白內(nèi)障超聲乳化聯(lián)合人工晶狀體(intraocular lens, IOL)植入術(shù)前后角膜高階像差的變化；根據(jù)白內(nèi)障超聲乳化聯(lián)合植入三組非球面IOL術(shù)后不同全眼球差,比較不同全眼球差在不同空間頻率下球差影響下的MTF值,分析保留多少球差值可使患者獲得更好視覺質(zhì)量,為非球面IOL的球差設(shè)計及人眼的最佳球差值提供理論依據(jù)。 方法：選取50例(56眼)年齡相關(guān)性白內(nèi)障患者行2.8mm透明角膜切口的超聲乳化白內(nèi)障吸除聯(lián)合折疊型人工晶體植入術(shù),分別于術(shù)前1天,術(shù)后7天、1個月及3個月利用iTrace視覺功能分析儀測量角膜高階像差(包括總的高階像差、球差、彗差、三葉草以及3-6階像差),選取瞳孔直徑為3.0 mm、6.0mm范圍內(nèi)的高階像差,將角膜高階像差按直徑范圍不同分為兩組,對其進(jìn)行比較。用具有一個重復(fù)測量的兩因素設(shè)計定量資料方差分析方法對兩組數(shù)據(jù)分別進(jìn)行統(tǒng)計學(xué)分析。 選取行白內(nèi)障超聲乳化聯(lián)合IOL植入術(shù)的患者107例120眼,根據(jù)植入非球面IOL類型分為ZA9003 IOL組35例41眼,PY60AD IOL組39例43眼,ADAPT-AO IOL組33例36眼,術(shù)后三個月為患者行裸眼視力,最佳矯正視力(BCVA)檢查；應(yīng)用iTrace視覺功能分析儀檢查記錄3.0 mm、6.0mm瞳孔直徑下的全眼高階像差成分及球差影響下的調(diào)制解調(diào)函數(shù)(modulation transfer function, MTF)值。 結(jié)果：術(shù)前3.0mm、6.0mm直徑的角膜球差分別為(0.027±0.037)μm、(0.287±0.154)μm,術(shù)后1w時(0.037±0.059)μm、(0.306±0.131)μm,術(shù)后1m時(0.034±0.048)μm、(0.310±0.232)μm,術(shù)后3m時(0.032±0.041)μm、(0.291±0.224)μm,手術(shù)前后差異無統(tǒng)計學(xué)意義(P0.05),其余各項高階像差及總高階像差手術(shù)前后的變化與球差的變化相似。 三組患者的裸眼視力及最佳矯正視力差異均無統(tǒng)計學(xué)意義(P0.05)。在3.0mm瞳孔直徑下,三組非球面IOL全眼高階像差各成分,差異無統(tǒng)計學(xué)意義(P0.05)；在6.0mmm瞳孔直徑下,三組非球面IOL全眼高階像差各成分,除球差外,差異均無統(tǒng)計學(xué)意義(P0.05)。 在3.0mm瞳孔直徑下,三組非球面IOL球差影響下的MTF值的比較,差異無統(tǒng)計學(xué)意義(P0.05)；在6.0mmm瞳孔直徑下,三組非球面IOL球差影響下的MTF值的比較,空間頻率為5cpd、10cpd.、15cpd、20cpd時,三組間差異有統(tǒng)計學(xué)意義(P0.05),且三組間MTF值大小為:PY-60ADZA9003 ADAPT-AO;在空間頻率為25cpd、30cpd時,PY-60AD與其他兩組比較差異均有統(tǒng)計學(xué)意義(P0.05)；ZA9003與ADAPT-AO兩組相比差異無統(tǒng)計學(xué)意義(P0.05). 結(jié)論：超聲乳化白內(nèi)障吸除術(shù)后角膜前表面高階像差的變化不影響術(shù)后患者的視覺質(zhì)量。為本研究第二部分白內(nèi)障超聲乳化聯(lián)合植入不同IOL后導(dǎo)致全眼像差變化來自植入的非球面人工晶狀體提供理論基礎(chǔ),從而進(jìn)一步評價不同非球面IOL植入術(shù)后的視覺質(zhì)量。非球面IOL植入術(shù)后全眼球差保留約0.1μm時,患者可具有較高視覺質(zhì)量。
[Abstract]:Objective: to investigate the changes of corneal higher-order aberrations before and after phacoemulsification combined with intraocular lens implantation (IOL) with iTrace aberration instrument, according to the different total aberrations after cataract phacoemulsification combined with aspherical IOL implantation.To compare the MTF values of different total eyeball aberrations under the influence of spherical aberration at different spatial frequencies, to analyze how many ball differences can be retained to make the patients obtain better visual quality, and to provide a theoretical basis for the spherical aberration design of aspheric IOL and the best spherical differential value for human eyes.Methods: 50 patients (56 eyes) with age-related cataract underwent phacoemulsification and foldable intraocular lens implantation with 2.8mm transparent corneal incision.High order aberrations (including total high order aberration, spherical aberration, coma, clover and 3-6 order aberration) were measured by iTrace visual function analyzer 7 days, 1 month and 3 months after operation.The high order aberrations of cornea were divided into two groups according to the diameter range.Two groups of data were statistically analyzed by two factors design quantitative analysis of variance method with a repeated measurement.107 cases (120 eyes) with cataract phacoemulsification combined with IOL implantation were divided into ZA9003 IOL group (35 cases, 41 eyes), ZA9003 IOL group (39 cases, 43 eyes) and ADAPT-AO IOL group (33 cases, 36 eyes).The iTrace visual function analyzer was used to record the high order aberration components of the eyes under the pupil diameter of 3.0 mm to 6.0 mm and the modulation and demodulation function (MTF) under the influence of spherical aberration.Results: the corneal spherical aberration was 0.027 鹵0.037) 渭 m before operation, 0.037 鹵0.059) 渭 m at 1 week after operation, 0.034 鹵0.232 渭 m at 1m, 0.310 鹵0.232 渭 m at 1m and 0.291 鹵0.224 渭 m at 3m 鹵0.041) 渭 m. There was no significant difference before and after operation. The changes of other high order aberrations and high order aberrations were similar to those before and after operation.There was no significant difference in uncorrected visual acuity and best corrected visual acuity between the three groups (P 0.05).Under the pupil diameter of 3.0mm, there was no significant difference in the components of higher order aberration of aspherical IOL in the three groups (P 0.05), but there was no significant difference in all the components of high order aberration of aspherical IOL under the pupil diameter of 6.0mmm with the exception of spherical aberration (P 0.05).Under the influence of 3.0mm pupil diameter, there was no significant difference in MTF value between the three groups under the influence of aspheric IOL spherical aberration, and there was no significant difference between the three groups under the pupil diameter of 6.0mmm. When the space frequency was 5cpd10cpd.n 15cpd20cpd, the MTF value under the influence of aspheric spherical IOL spherical aberration was compared between the three groups under the pupil diameter of 3.0mm.The difference among the three groups was statistically significant (P 0.05), and the MTF value of the three groups was: PY-60ADZA9003 ADAPT-AO.There was no significant difference between PY-60AD and the other two groups when the spatial frequency was 25cpdl 30cpd and there was no significant difference between the three groups (P0.05A9003 and ADAPT-AO).Conclusion: the changes of high-order aberrations on the anterior corneal surface after phacoemulsification do not affect the visual quality of the patients after phacoemulsification.The second part of this study provides a theoretical basis for the change of the aberration of the whole eye caused by phacoemulsification combined with the implantation of different IOL, thus further evaluating the visual quality of different aspheric IOL implants.After Aspheric IOL implantation, the visual quality of the patients was higher when the difference of the whole eyeball was kept about 0. 1 渭 m.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2011
【分類號】：R779.6

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