本文選題：波前像差引導(dǎo)的SBK手術(shù) + 波前像差�。� 參考：《河北醫(yī)科大學(xué)》2011年碩士論文

【摘要】：目的:觀察屈光不正患者行前彈力層下角膜磨鑲術(shù)(SBK)術(shù)前及術(shù)后視力、波前像差及角膜地形圖特點(diǎn)、并發(fā)癥及其影響因素,為屈光不正患者進(jìn)一步提高視覺質(zhì)量提供新型手術(shù)方式。 方法:回顧分析16例(32只眼)行波前像差引導(dǎo)的個(gè)體化SBK手術(shù)治療的屈光不正患者的臨床資料。所有患者在術(shù)前和術(shù)后均行常規(guī)檢查,包括裸眼視力(UCVA)、最佳矯正視力(BCVA)、眼壓、屈光度、角膜厚度、角膜地形圖以及波前像差檢查,并對(duì)患者術(shù)前、術(shù)后的觀測(cè)指標(biāo)的變化進(jìn)行對(duì)比研究,從而全面評(píng)價(jià)波前像差引導(dǎo)的個(gè)體化SBK手術(shù)的療效。 結(jié)果:術(shù)后未見影響視力的嚴(yán)重并發(fā)癥。16例患者中(32眼)有5例(31.25%)訴夜間“光暈”和“星芒”現(xiàn)象,1例(6.25%)訴夜間有眩光。術(shù)后1月及6月裸眼視力除1例患者(2眼)外,其余都達(dá)到1.0以上,且30眼(93.75%)的屈光矯正在預(yù)計(jì)矯正視力0.5D范圍內(nèi);32眼均未出現(xiàn)術(shù)后BCVA降低;14眼(43.75%)BCVA提高1行,4眼(12.5%)BCVA提高2行;術(shù)后角膜曲率及角膜厚度較術(shù)前降低,差異有統(tǒng)計(jì)學(xué)意義;術(shù)后角膜后表面高度較術(shù)前未見增高,差異無統(tǒng)計(jì)學(xué)意義;術(shù)后各高價(jià)像差比例顯著增加,以彗差和球差為主,三葉草的變化無統(tǒng)計(jì)學(xué)意義。 結(jié)論: 1波前像差引導(dǎo)的SBK術(shù)后裸眼視力位于預(yù)期矯正度數(shù)±0.5D之內(nèi),在屈光矯正方面具有良好的可預(yù)測(cè)性。 2個(gè)體化SBK手術(shù)可提高部分患者BCVA,尤其是高度近視者。 3個(gè)體化SBK術(shù)后角膜后表面高度均無顯著增加,無明顯角膜膨隆,安全性較高。 4個(gè)體化SBK術(shù)后眼高價(jià)像差均有所增加,以彗差和球差的增加為主,手術(shù)前后差異具有統(tǒng)計(jì)學(xué)意義,但對(duì)術(shù)后視覺質(zhì)量無明顯影響。
[Abstract]:Objective: To observe the preoperative and postoperative visual acuity, wavefront aberration and corneal topography, complications and its influencing factors, and to provide a new mode of operation for the patients with ametropia to further improve the visual quality of the patients with ametropia (SBK).
Methods: the clinical data of 16 patients (32 eyes) of 16 patients with ametropia guided by traveling wave front aberration were reviewed. All patients underwent routine examination before and after operation, including naked eye (UCVA), best corrected visual acuity (BCVA), intraocular pressure, refractive index, corneal thickness, corneal topography and wavefront aberration. Preoperative and postoperative changes in the observational indicators were compared to evaluate the effect of wavefront guided individualized SBK surgery.
Results: there was no serious complication after operation in.16 patients (32 eyes), 5 cases (31.25%) complained of night "halo" and "star awn" phenomenon, 1 cases (6.25%) complained of night glare. The rest of the eyes in January and June except 1 cases (2 eyes), the rest were up to 1, and 30 eyes (93.75%) of refractive correction in the range of corrected visual acuity of 0.5D range. In the 32 eyes, there were no postoperative BCVA reduction, 14 eyes (43.75%), 1 lines, 4 eyes (12.5%) BCVA, and 2 lines. The corneal curvature and thickness of the cornea were lower than those before the operation. The posterior surface height of the cornea was not significantly higher than that before the operation, and the difference was not statistically significant after the operation; the proportion of high price aberrations increased significantly after the operation, with comet difference and ball difference. There is no significant change in the change of clover.
Conclusion:
1 after wavefront guided SBK, the corrected visual acuity is within the expected degree of correction (0.5D), and has good predictability in refractive correction.
2 individualized SBK surgery can improve BCVA in some patients, especially those with high myopia.
3 after SBK, there was no significant increase in posterior corneal surface height, no obvious corneal bulge and high safety.
4 after SBK, the ocular high value aberrations were increased, mainly with the increase of comet difference and spherical aberration, and the difference was statistically significant before and after operation, but there was no obvious effect on visual quality after operation.

【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2011
【分類號(hào)】：R779.63

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本文編號(hào)：1869328