本文選題：外傷性白內(nèi)障 + 非球面人工晶狀體��； 參考：《鄭州大學(xué)》2011年碩士論文

【摘要】：目的觀察零球差非球面人工晶狀體應(yīng)用于外傷性白內(nèi)障術(shù)后的視覺(jué)質(zhì)量。 資料和方法選取我院外傷性白內(nèi)障患者60例(60眼),其中角膜穿孔傷52例(52眼),鈍挫傷8例(8眼),入選標(biāo)準(zhǔn)：患者年齡8-30周歲；散光度數(shù)在3D以內(nèi)；角膜傷口或瘢痕位于周邊部；虹膜損傷而致大瞳孔、瞳孔變形或移位；角膜內(nèi)皮計(jì)數(shù)在1000個(gè)/mm2以上；后囊膜完整或者破損較輕人工晶狀體可囊袋內(nèi)或睫狀溝固位而不需要縫線固定；術(shù)中術(shù)后均未出現(xiàn)并發(fā)癥。排除標(biāo)準(zhǔn)：角膜傷口或瘢痕位于瞳孔區(qū)或者傷口較大,愈合后瘢痕明顯,對(duì)視力有嚴(yán)重影響者；術(shù)前存在玻璃體內(nèi)異物、視網(wǎng)膜脫離以及裂孔、視神經(jīng)視網(wǎng)膜挫傷等情況明顯影響視功能的恢復(fù)；有青光眼、葡萄膜炎、糖尿病、自身免疫性疾病病史者。所選患者隨機(jī)分成兩組,30例(30眼)植入零球差非球面人工晶狀體(Akreos AO)作為實(shí)驗(yàn)組,30例(30眼)植入傳統(tǒng)球面人工晶狀體(Akreos adapt)作為對(duì)照組,所有手術(shù)均由同一高年資醫(yī)師完成,手術(shù)過(guò)程順利,術(shù)中術(shù)后無(wú)并發(fā)癥。術(shù)后3個(gè)月、6個(gè)月對(duì)比觀察兩組患者的裸眼視力(uncorrected visual acuity, UCVA)、最佳矯正視力(best corrected visual acuity, BCVA)、立體視覺(jué)、對(duì)比敏感度(contrast sensitivity, CS),并對(duì)患者生存質(zhì)量滿意度進(jìn)行問(wèn)卷調(diào)查。采用SPSS 17.0統(tǒng)計(jì)學(xué)軟件進(jìn)行統(tǒng)計(jì)分析,兩組術(shù)前一般情況比較采用卡方檢驗(yàn),術(shù)后視力比較采用Kruskal Wallis檢驗(yàn),對(duì)比敏感度和立體視覺(jué)比較均采用Wilcoxon秩和檢驗(yàn),取P0.05為檢驗(yàn)水準(zhǔn),表示差異具有統(tǒng)計(jì)學(xué)意義。 結(jié)果術(shù)后3個(gè)月、6個(gè)月兩組患者裸眼視力、最佳矯正視力相比較差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)；術(shù)后6個(gè)月實(shí)驗(yàn)組患者遠(yuǎn)近立體視覺(jué)均優(yōu)于對(duì)照組,但兩組相比較差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)；術(shù)后6個(gè)月實(shí)驗(yàn)組各空間頻率對(duì)比敏感度均高于對(duì)照組,特別是眩光對(duì)比敏感度,實(shí)驗(yàn)組明顯優(yōu)于對(duì)照組,兩組相比較差異均有統(tǒng)計(jì)學(xué)意義(P0.05)；問(wèn)卷調(diào)查顯示,實(shí)驗(yàn)組術(shù)后24例較滿意,滿意度高達(dá)80%,對(duì)照組16例較滿意,滿意度為53.3%。 結(jié)論1.零球差非球面人工晶狀體應(yīng)用于外傷性白內(nèi)障,其術(shù)后的視覺(jué)質(zhì)量?jī)?yōu)于傳統(tǒng)的球面人工晶狀體。2.對(duì)于角膜瘢痕較小且位于周邊、晶狀體囊袋或后囊環(huán)相對(duì)完整、視網(wǎng)膜功能良好的外傷性白內(nèi)障患者,可植入零球差非球面人工晶狀體,這樣就可以利用其光學(xué)特性,最大限度地保存和提高患者外傷后的視覺(jué)質(zhì)量,同時(shí)也提高了患者術(shù)后的生存質(zhì)量。
[Abstract]:Objective to observe the visual quality of zero spherical aspherical intraocular lens in traumatic cataract surgery. Materials and methods 60 cases of traumatic cataract in our hospital were selected, including 52 cases of corneal perforation injury (52 eyes) and 8 cases of blunt contusion (8 eyes). The inclusion criteria were: age 8-30 years, astigmatism within 3D, corneal wound or scar located in peripheral part; Due to iris injury, the pupil was deformed or shifted; the corneal endothelium was more than 1000 / mm2; the complete posterior capsule or light intraocular lens could be retained in the capsule or ciliary sulcus without suture fixation. No complications occurred during and after operation. Exclusion criteria: the corneal wound or scar is located in the pupil area or the wound is larger, the scar is obvious after healing, which has serious influence on visual acuity; there are intravitreous foreign bodies, retinal detachment and rupture before operation, The optic nerve and retina contusion obviously affected the recovery of visual function in patients with glaucoma, uveitis, diabetes mellitus and autoimmune diseases. The selected patients were randomly divided into two groups: 30 patients (30 eyes) were divided into two groups (30 cases) were divided into two groups: (1) A group of 30 cases (30 eyes) were implanted with zero spherical aberration aspheric intraocular lens (Akreos AOL) (30 cases) were implanted with traditional spherical intraocular lens (Akreos adapt) as control group. The procedure was smooth and there were no complications after operation. At 3 months and 6 months after operation, the uncorrected visual acuity, UCVA, best corrected visual acuity, BCVAn, stereoscopic vision, contrast sensitivity, CSA were compared between the two groups, and the satisfaction of the patients with quality of life was investigated by questionnaire. Statistical software SPSS 17.0 was used for statistical analysis. The general situation of the two groups was compared by chi-square test before operation, Kruskal Wallis test was used for postoperative visual acuity comparison, Wilcoxon rank sum test was used for contrast sensitivity and stereoscopic vision comparison, and P0.05 was taken as test level. The difference is statistically significant. Results there was no significant difference in uncorrected visual acuity and best corrected visual acuity between the two groups at 3 months and 6 months after operation (P 0.05), and the distance and near stereo vision in the experimental group was better than that in the control group at 6 months after operation. The spatial frequency contrast sensitivity of the experimental group was higher than that of the control group 6 months after operation, especially the glare contrast sensitivity, and the experimental group was obviously superior to the control group. The questionnaire survey showed that 24 cases in the experimental group were satisfied and the satisfaction was as high as 80 cases, while 16 cases in the control group were satisfactory, and the satisfaction degree was 53.3%. Conclusion 1. Zero spherical aberration aspherical intraocular lens was used in traumatic cataract, and its visual quality was better than that of traditional spherical intraocular lens. 2. For traumatic cataract patients whose corneal scar is small and located in the periphery, the lens capsule or posterior capsule is relatively intact, and the retina functions well, the zero-spherical aspheric intraocular lens can be implanted, so that its optical properties can be utilized. The visual quality of patients after trauma is preserved and improved to the maximum extent, and the quality of life after operation is also improved.
【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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本文編號(hào)：1870276