【摘要】：背景和目的 隨著白內(nèi)障手術(shù)技術(shù)的不斷完善,人們生活水平的不斷提高和人工晶狀體設(shè)計(jì)制造工藝的不斷改進(jìn),白內(nèi)障手術(shù)已由過(guò)去的單純復(fù)明手術(shù)向屈光性手術(shù)過(guò)渡。多焦點(diǎn)人工晶狀體應(yīng)用于屈光性白內(nèi)障手術(shù),可使患者獲得良好的裸眼全程視力,減少對(duì)眼鏡的依賴,但仍有部分患者術(shù)后未脫鏡,這既給患者帶來(lái)了痛苦,也加劇了臨床工作的風(fēng)險(xiǎn)。本研究旨在通過(guò)研究影響脫鏡率的因素,為臨床工作提供指導(dǎo)性意見(jiàn)。 方法 本文為回顧性研究。分析自2006年6月到2009年4月在我科行白內(nèi)障超聲乳化吸出聯(lián)合ReSTOR多焦點(diǎn)人工晶狀體植入術(shù)的患者182例(222只眼),其中年齡相關(guān)性白內(nèi)障155例(190只眼),先天性白內(nèi)障5例(10只眼),小梁切除術(shù)后白內(nèi)障患者15例(15只眼),伴有糖尿病的白內(nèi)障患者7例(7只眼)。記錄戴鏡人數(shù)及戴鏡率；戴鏡人群的屈光狀態(tài)及其裸眼遠(yuǎn)、近視力；戴鏡人群術(shù)前、術(shù)后眼球生物學(xué)測(cè)量；戴鏡人群眼部并發(fā)癥。統(tǒng)計(jì)學(xué)處理：對(duì)上述觀察指標(biāo)的結(jié)果采用t檢驗(yàn)和χ2檢驗(yàn),全部資料應(yīng)用SPSS 13.0統(tǒng)計(jì)軟件包進(jìn)行統(tǒng)計(jì)學(xué)處理。 結(jié)果 1.術(shù)后戴鏡36例(39只眼),單眼植入ReSTOR多焦點(diǎn)人工晶狀體者術(shù)后戴鏡率23.2%(33/142),雙眼植入者戴鏡率為7.5%(3/40),兩組之間差異具有統(tǒng)計(jì)學(xué)意義(χ2=4.872,P=0.027)。 2.戴鏡者裸眼遠(yuǎn)視力平均0.46,裸眼近視力平均0.41,視遠(yuǎn)矯正視力的等效球鏡度數(shù)平均(+0.38±1.25)D,等效球鏡度數(shù)與裸眼遠(yuǎn)視力、近視力顯著負(fù)相關(guān)(r=-0.615,-0.427；P0.05)。 3.年齡相關(guān)性白內(nèi)障患者術(shù)前、術(shù)后眼軸測(cè)量差異有統(tǒng)計(jì)學(xué)意義(t=3.262,P0.05),而角膜曲率測(cè)量差異無(wú)統(tǒng)計(jì)學(xué)意義(-0.248,P0.05)。 4.戴鏡者裂隙燈檢查發(fā)現(xiàn)瞳孔異常4眼,后發(fā)性白內(nèi)障6眼,人工晶狀體偏心3眼。 結(jié)論 1.雙眼植入多焦點(diǎn)人工晶狀體可降低戴鏡率 2.眼軸測(cè)量誤差可能導(dǎo)致術(shù)后戴鏡 3.角膜曲率測(cè)量對(duì)戴鏡率未造成明顯影響 4.手術(shù)并發(fā)癥可能導(dǎo)致術(shù)后戴鏡
[Abstract]:Background and objective with the continuous improvement of cataract surgery technology, people's standard of living and the design and manufacture of intraocular lens have been continuously improved. Cataract surgery has transitioned from simple recuperation to refractive surgery. The application of multi-focus intraocular lens in refractive cataract surgery can make the patients obtain good eyesight and reduce their dependence on glasses. However, some patients still have not removed the lens after surgery, which has brought pain to the patients. It also increases the risk of clinical work. The purpose of this study is to provide guidance for clinical work by studying the factors affecting the removal rate of endoscopy. Methods this article is a retrospective study. 182 cases (222 eyes) of cataract phacoemulsification combined with retor intraocular lens implantation in our department from June 2006 to April 2009 were analyzed, including 155 cases (190 eyes) with age-related cataract and congenital cataract. 5 cases (10 eyes), 15 cases (15 eyes) with cataract after trabeculectomy and 7 cases (7 eyes) with cataract with diabetes mellitus. The number of people wearing glasses and the rate of wearing glasses were recorded. The refractive state and the distant and near visual acuity of the people wearing glasses were recorded. The biological measurement of eyeball before and after operation in the group of wearing glasses and the complications of eyes in the people with glasses were also observed. Statistical processing: t test and 蠂 2 test were used for the results of the above observation indexes, and all the data were statistically processed by SPSS 13.0 statistical software package. Result 1. Among the 36 cases (39 eyes) who wore glasses, the rate of wearing glasses was 23.2% (33 / 142) in monocular eyes and 7.5% (3 / 40) in binocular implants. The difference between the two groups was statistically significant (蠂 ~ (2 +) 4.87 ~ (2) P ~ (0.027). The distance visual acuity of naked eyes was 0.46, the average of near-visual acuity was 0.41, the mean degree of distance corrected vision was (0.38 鹵1.25) D, the degree of equivalent spherical vision was negatively correlated with the distance visual acuity of naked eyes, and the near visual acuity was negatively correlated (r ~ (-0.615) ~ (-0.427) P 0.05). There was significant difference between preoperative and postoperative eye axis measurements in patients with age-related cataract (t = 3.262 P 0.05), but there was no significant difference in corneal curvature measurement (-0.248 P 0.05). 4. Slit-lamp examination showed abnormal pupil in 4 eyes, posterior cataract in 6 eyes and eccentricity of intraocular lens in 3 eyes. Conclusion 1. Binocular implantation of multi-focus intraocular lens can reduce the wear rate of 2. 5%. The measurement error of eye axis may result in wearing mirror after operation. Corneal curvature measurement had no significant effect on wear rate. Surgical complications may lead to postoperative wear of mirrors
【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

【參考文獻(xiàn)】

相關(guān)期刊論文 前6條

1 黃惠春,張少斌,周元升,鄭煜;Zeiss IOL Master測(cè)量人工晶體度數(shù)的臨床評(píng)價(jià)[J];醫(yī)學(xué)臨床研究;2004年04期

2 劉慧霞;廖榮豐;朱美玲;;白內(nèi)障超聲乳化聯(lián)合折疊式人工晶狀體植入術(shù)后角膜地形圖分析[J];臨床眼科雜志;2006年02期

3 姜燕;施玉英;楊文利;;六種人工晶狀體屈光度數(shù)計(jì)算公式的準(zhǔn)確性比較[J];眼科;2007年02期

4 李運(yùn)平!214073;白內(nèi)障超聲乳化人工晶狀體植入術(shù)后屈光誤差24例[J];眼科新進(jìn)展;2001年04期

5 王騫;鄭廣英;周尚昆;陳鵬;;不同部位透明角膜切口超聲乳化術(shù)對(duì)角膜散光的影響[J];眼科新進(jìn)展;2007年03期

6 鄭丹瑩,張振平,楊文輝,楊暉,郭未艾,胡蓉;光學(xué)相干生物測(cè)量?jī)x測(cè)量人工晶體度數(shù)的初步研究[J];中國(guó)實(shí)用眼科雜志;2002年06期

，

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