本文選題：多焦點(diǎn)人工晶狀體 + 瞳孔　； 參考：《鄭州大學(xué)》2011年碩士論文

【摘要】：背景與目的 隨著白內(nèi)障超聲乳化手術(shù)的日益完善和人工晶狀體設(shè)計(jì)技術(shù)的不斷進(jìn)步,白內(nèi)障手術(shù)由單純的復(fù)明手術(shù)向屈光性手術(shù)轉(zhuǎn)變。多焦點(diǎn)人工晶狀體在臨床上應(yīng)用日益廣泛,最新研究表明多焦點(diǎn)人工晶狀體術(shù)后視覺質(zhì)量與瞳孔直徑有關(guān)。Acrysof ReSTOR漸進(jìn)衍射型多焦點(diǎn)人工晶狀體(愛爾康公司)是新型的衍射-折射型多焦點(diǎn)人工晶狀體,本文主要觀察研究瞳孔大小與植入Acrysof ReSTOR漸進(jìn)衍射型多焦點(diǎn)人工晶狀體術(shù)后視力以及對(duì)比敏感度相關(guān)關(guān)系,旨在提高多焦點(diǎn)人工晶狀體的臨床效果。 方法 本研究系前瞻性臨床研究,選擇收集2008年12月～2010年10月在鄭州大學(xué)二附屬醫(yī)院眼科行白內(nèi)障超聲乳化吸出聯(lián)合植入Acrysof ReSTOR漸進(jìn)衍射型多焦點(diǎn)人工晶狀體的單純性年齡相關(guān)性白內(nèi)障病例,共63例(126眼)。術(shù)前按瞳孔直徑分組,瞳孔直徑2～3.5mm為A組,共44例(88眼)；瞳孔直徑3.6-5.5mm為B組,共19(38眼)。術(shù)后3月檢查術(shù)眼單眼和雙眼最佳矯正遠(yuǎn)、近視力,并測(cè)量2-3.5mm、4-6mm、8mm三種瞳孔直徑下遠(yuǎn)距對(duì)比敏感度。遠(yuǎn)視力檢查距離為5m,近視力檢查距離為33cm。對(duì)比敏感度采用OPTEC 6500視功能分析儀,選擇5種空間頻率1.5 cpd、3 cpd、6 cpd、12 cpd和18 cpd,分別在明視(光照度為85cd/m2)和暗視(光照度為3cd/m2)2種光照度下檢查無(wú)眩光和有眩光時(shí)的對(duì)比敏感度。 結(jié)果 瞳孔直徑與單眼最佳矯正遠(yuǎn)視力存在正相關(guān)關(guān)系(r=0.440,P0.01),與單眼最佳近視力存在負(fù)相關(guān)關(guān)系(r=-0.365,P0.01)。單眼和雙眼最佳矯正遠(yuǎn)視力2組差異有統(tǒng)計(jì)學(xué)意義(χ2=7.461,P0.05；χ2=4.398,P0.05),B組優(yōu)于A組。單眼最佳矯正近視力2組差異有統(tǒng)計(jì)學(xué)意義(χ2=10.006,P0.05),A組優(yōu)于B組。雙眼最佳矯正近視力2組差異無(wú)統(tǒng)計(jì)學(xué)意義(χ2=0.154,P0.05)。3種瞳孔狀態(tài)下明視對(duì)比敏感度在各個(gè)空間頻率差異有統(tǒng)計(jì)學(xué)意義(P0.05)。大瞳孔(4～6mm)狀態(tài)下明視對(duì)比敏感度優(yōu)于小瞳孔(2～3.5mm)和8mm瞳孔直徑；暗視下兩種瞳孔狀態(tài)的對(duì)比敏感度在各個(gè)空間頻率差異均有統(tǒng)計(jì)學(xué)意義(P0.05),瞳孔直徑為8mm狀態(tài)下的對(duì)比敏感度要低于瞳孔直徑為4-6mm時(shí)的對(duì)比敏感度(P0.05)。 結(jié)論 植入ReSTOR多焦點(diǎn)人工晶狀體后較大瞳孔直徑時(shí)最佳矯正遠(yuǎn)視力更好,單眼最佳矯正近視力隨瞳孔直徑的增加而下降。較大瞳孔組和小瞳孔組雙眼矯正近視力相似。遠(yuǎn)距對(duì)比敏感度較大瞳孔直徑(4～6mm)時(shí)優(yōu)于較小瞳孔直徑。
[Abstract]:Background and purposeWith the improvement of phacoemulsification and the development of intraocular lens design technique, cataract surgery has changed from simple recuperation operation to refractive surgery.Multi-focus intraocular lens is widely used in clinic.Recent studies have shown that postoperative visual quality of multi-focus intraocular lens is related to pupil diameter. Acrysof ReSTOR diffractive multifocal intraocular lens (Alcon) is a new type of diffractation-refraction multi-focus intraocular lens.The relationship between pupil size and visual acuity and contrast sensitivity after implantation of Acrysof ReSTOR progressive diffractive multi-focus intraocular lens was studied in order to improve the clinical effect of multi-focus intraocular lens.MethodThis study is a prospective clinical study,From December 2008 to October 2010, a total of 63 patients (126 eyes) with simple age-related cataract underwent phacoemulsification combined with Acrysof ReSTOR progressive diffractive multi-focus intraocular lens implantation in the second affiliated Hospital of Zhengzhou University.Before operation, the pupil diameter was divided into two groups: group A (n = 44) with pupil diameter 2~3.5mm (n = 88) and group B (n = 19) with pupil diameter 3.6-5.5mm (n = 19).Three months after operation, the best corrected distance and near visual acuity of single eye and both eyes were examined, and the distance contrast sensitivity of 3 kinds of pupil diameter (2-3.5mm ~ 4-6mm ~ 8mm) was measured.The distance of distant visual acuity examination was 5 m, and the distance of close vision examination was 33 cm.ResultThere was a positive correlation between the pupil diameter and the best corrected far visual acuity of a single eye (P 0.01) and a negative correlation between the pupil diameter and the best near visual acuity of a single eye.There was significant difference between the two groups in the best corrected far visual acuity of one eye and two eyes (蠂 2 7.461% P 0.05, 蠂 2 4.398 P 0.05) and group B was better than group A (P 0.05).There was significant difference in the best corrected near visual acuity between the two groups (蠂 2: 10.006). Group A was better than group B (P 0.05).There was no significant difference in the best corrected near visual acuity between the two groups (蠂 ~ 2 = 0.154U, P 0.05.3).The contrast sensitivity was better in large pupil (4 ~ 6 mm) than in small pupil (2 ~ 3.5 mm) and 8mm pupil diameter.The contrast sensitivity of two kinds of pupil states under dark vision was significantly different in each space frequency (P 0.05). The contrast sensitivity of pupil diameter with 8mm was lower than that with pupil diameter of 4-6mm.ConclusionThe best corrected far visual acuity was better when ReSTOR polyfocal intraocular lens was implanted with larger pupil diameter, and the best corrected near visual acuity of single eye decreased with the increase of pupil diameter.The corrected near visual acuity was similar in the larger pupil group and the small pupil group.The sensitivity of long-distance contrast was better than that of small pupil when the diameter of pupil was 4 ~ 6 mm.
【學(xué)位授予單位】：鄭州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2011
【分類號(hào)】：R779.66

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