本文選題：眩光 + 眩光幻影　； 參考：《汕頭大學》2011年碩士論文

【摘要】：目的探討應(yīng)用同視機閃爍眩光源適應(yīng)性訓(xùn)練治療人工晶體眼眩光幻影的臨床療效。 方法2009年1月至10月在惠州市中心人民醫(yī)院行白內(nèi)障超聲乳化術(shù)聯(lián)合人工晶體植入術(shù),術(shù)后一周自訴眩光、光暈等眩光幻影癥狀明顯的年齡相關(guān)性白內(nèi)障患者,按照入選標準和排除標準共選取24例(32只眼)做為研究對象。研究入選標準:(1)術(shù)前診斷為年齡相關(guān)性白內(nèi)障;(2)手術(shù)方法為白內(nèi)障超聲乳化術(shù)聯(lián)合人工晶體植入術(shù);(3)術(shù)后一周眩光癥狀分級為中重度。選取對象隨機分兩組,結(jié)果采用盲法評定。治療組(12例)接受同視機下閃爍眩光源適應(yīng)性訓(xùn)練,對照組(12例)不接受治療。治療組從術(shù)后第二周開始訓(xùn)練,每周一次,連續(xù)三周,每次20分鐘。。在術(shù)后3個月和術(shù)后18個月對兩組患者進行視覺質(zhì)量評估。視覺質(zhì)量評價包括視覺癥狀嚴重程度(眩光、光暈分級)、視功能障礙程度(視功能和生存質(zhì)量量表評估)和整體視覺評價(視覺滿意度和視覺困難程度)。 結(jié)果術(shù)后1周、3個月、18個月治療組和對照組間視功能與生存質(zhì)量量表、視覺滿意度和視覺憂慮程度分級、光暈程度分級結(jié)果的差異均無統(tǒng)計學意義。術(shù)后3個月兩組間眩光程度分級差異有統(tǒng)計學意義。眩光適應(yīng)性訓(xùn)練之前,治療組和對照組發(fā)生中重度眩光的比例為100%。治療組經(jīng)過訓(xùn)練,3個月后發(fā)生中重度眩光的比例明顯減少,而對照組的比例同樣降低,但兩組變化的差異有統(tǒng)計學意義(P=0.046),術(shù)后18個月與術(shù)后1周比較,兩組間差異則無統(tǒng)計學意義(P=0.44)。對于發(fā)生光暈的患者而言,隨著時間延長,兩組發(fā)生光暈的患者比例逐漸減少,兩組變化的差異無論是短期還是長期都無統(tǒng)計學意義(P0.05)。 結(jié)論人工晶體眼異常眩光幻影患者早期應(yīng)用同視機閃爍眩光源適應(yīng)性訓(xùn)練可以有效減少患者眩光適應(yīng)的時間,改善早期眩光患者的眩光癥狀,但不能改善光暈癥狀。18個月的長期觀察顯示,早期光適應(yīng)治療對持續(xù)性眩光患者無明顯臨床療效。
[Abstract]:Objective to investigate the clinical effect of adaptive training on glare source in intraocular lens (IOL) eyes. Methods from January to October 2009, cataract phacoemulsification combined with intraocular lens implantation was performed in Huizhou Central people's Hospital. One week after operation, patients with age-related cataract with obvious glare symptoms, such as glare and halo, were treated with phacoemulsification and intraocular lens implantation. A total of 24 patients with 32 eyes were selected according to the inclusion criteria and exclusion criteria. One week after cataract phacoemulsification combined with intraocular lens implantation was performed for cataract patients with moderate to severe glare symptoms. The subjects were randomly divided into two groups, and the results were evaluated by blind method. The treatment group (n = 12) received adaptive training of flicker glare under the same vision machine, while the control group (n = 12) received no treatment. Treatment group from the second week of training, once a week, three consecutive weeks, each 20 minutes. Visual quality was evaluated 3 months after operation and 18 months after operation. Visual quality assessment included the severity of visual symptoms (glare, halo grading), visual dysfunction (visual function and quality of life scale) and overall visual evaluation (visual satisfaction and visual difficulties). Results there was no significant difference in visual function and quality of life scale, visual satisfaction degree, visual anxiety degree and halo grade between the treatment group and the control group 1 week, 3 months and 18 months after operation. There was significant difference in the degree of glare between the two groups 3 months after operation. Before glare adaptation training, the proportion of moderate to severe glare in the treatment group and the control group was 100. After training, the proportion of moderate and severe glare in the treatment group decreased significantly after 3 months, while the proportion in the control group was also decreased, but the difference between the two groups was statistically significant, 18 months after operation and 1 week after operation, the difference between the two groups was statistically significant. There was no significant difference between the two groups (P = 0.44). For the patients with halo, the proportion of patients with halo in the two groups gradually decreased with the prolongation of time. The difference between the two groups was not statistically significant in the short or long term. Conclusion the early application of adaptive training of blinking glare source in patients with abnormal glare of intraocular lens can effectively reduce the time of glare adaptation and improve the glare symptoms of early glare patients. The long-term observation of 18 months showed that early photoadaptation therapy had no obvious clinical effect on persistent glare patients.
【學位授予單位】：汕頭大學
【學位級別】：碩士
【學位授予年份】：2011
【分類號】：R779.6

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