【摘要】： 目的:利用光學(xué)相干斷層成像(OCT)對接受白內(nèi)障超聲乳化吸出術(shù)后的患眼黃斑部進(jìn)行掃描,分析白內(nèi)障超聲乳化吸出手術(shù)對黃斑中心小凹厚度的影響,及其與黃斑囊樣水腫發(fā)生率之間的關(guān)系。 方法:選取64例老年性白內(nèi)障患者96眼,其中女性患者33例(51眼),男性患者31例(45眼),年齡46～75歲,平均年齡65.23±3.78歲,所有患眼均無其他眼部疾病,且排除高度近視眼,患者無高血壓、糖尿病等全身疾病,對于上述患眼行常規(guī)白內(nèi)障超聲乳化吸出+人工晶體植入術(shù),于術(shù)前、術(shù)后1d、1W、2W四個(gè)時(shí)間段分別應(yīng)用OCT黃斑部掃描程序?qū)πg(shù)眼行黃斑中心小凹厚度測量,通過配對t檢驗(yàn)進(jìn)行統(tǒng)計(jì)學(xué)處理,分析術(shù)眼術(shù)前及術(shù)后各時(shí)段黃斑部厚度數(shù)值的變化,借此評價(jià)白內(nèi)障超聲乳化吸出術(shù)對黃斑中心小凹厚度的影響,并將黃斑中心小凹厚度與術(shù)后最佳矯正視力、術(shù)后屈光度進(jìn)行相關(guān)分析 結(jié)果: 96例術(shù)眼術(shù)后最佳矯正視力均達(dá)0.5以上,平均術(shù)后最佳矯正視力為0.8±0.23,術(shù)后2W內(nèi)術(shù)眼術(shù)后最佳矯正視力無變化,術(shù)后屈光度檢查發(fā)現(xiàn)術(shù)眼術(shù)后2W內(nèi)伴有-0.5DS～-0.75DS近視漂移,平均漂移度為-0.62±0.18DS。OCT掃描顯示,術(shù)后無一例術(shù)眼發(fā)生黃斑囊樣水腫,測得96例術(shù)眼黃斑中心小凹厚度四個(gè)時(shí)段均值為:術(shù)前為176.101μm,術(shù)后1d為176.554μm,術(shù)后1W為176.502μm,術(shù)后2W為179.456μm,將術(shù)前、術(shù)后1d、術(shù)后1W、術(shù)后2W四組黃斑中心小凹厚度值予以配對t檢驗(yàn),p值均0.05,即差異無統(tǒng)計(jì)學(xué)意義,提示術(shù)眼黃斑中心小凹厚度在術(shù)前與術(shù)后無變化。將術(shù)后1d、1w、2w,最佳矯正視力與黃斑中心凹厚度相關(guān)系數(shù)分別為:-0.76、-0.78、-0.72,p0.05,差異有統(tǒng)計(jì)學(xué)意義。即術(shù)后最佳矯正視力與黃斑中心小凹厚度成反比。術(shù)后術(shù)眼屈光度與黃斑中心小凹厚度相關(guān)系數(shù)為-0.075,p0.05,即術(shù)后屈光度與黃斑中心小凹厚度無相關(guān)性。 結(jié)論:OCT是檢測黃斑厚度的有力工具之一,常規(guī)白內(nèi)障超聲乳化術(shù)后,患眼術(shù)后1d、1w、2w黃斑中心小凹厚度與術(shù)前相比差異無統(tǒng)計(jì)學(xué)意義;黃斑中央小凹厚度與超聲乳化白內(nèi)障吸出術(shù)后最佳矯正視力相關(guān)分析顯示在單純性老年性白內(nèi)障患者中,最佳矯正視力同黃斑中心小凹厚度呈負(fù)相關(guān)。術(shù)后屈光度與黃斑中心小凹厚度無相關(guān)性。目前無臨床證據(jù)表明,該手術(shù)方式可提高黃斑囊樣水腫發(fā)生的發(fā)生率。
[Abstract]:Objective: to study the effect of phacoemulsification on macular fovea thickness after phacoemulsification (phacoemulsification) with optical coherence tomography (OCT). And its relationship with the incidence of macular cystic edema. Methods: 96 eyes of 64 patients with senile cataract were selected, including 33 female patients (51 eyes) and 31 male patients (45 eyes), aged 46 to 75 years, with an average age of 65.23 鹵3.78 years. There were no other ocular diseases in all eyes, and high myopia was excluded. Patients without hypertension, diabetes and other systemic diseases, for the above-mentioned eyes phacoemulsification routine phacoemulsification intraocular lens implantation, before the surgery, The macular fovea thickness was measured by OCT scanning program 1 day after operation, and the change of macular thickness before and after operation was analyzed by paired t test. To evaluate the effect of phacoemulsification and phacoemulsification on the thickness of macular central fovea, the thickness of macular central fovea and the best corrected visual acuity were evaluated. The results of correlation analysis of postoperative diopter showed that the postoperative best corrected visual acuity (BCVA) of 96 eyes was above 0.5, the average postoperative BCVA was 0.8 鹵0.23.There was no change of BCVA within 2 weeks after operation. The postoperative diopter examination showed that the myopia drift was -0.5DS + -0.75DS within 2 weeks after operation, and the mean drift degree was -0.62 鹵0.18DS.OCT scan. There was no postoperative macular cystic edema in any of the eyes. The mean value of macular fovea thickness in 96 eyes was 176.101 渭 m before operation, 176.554 渭 m at 1 day after operation, 176.502 渭 m at 1W and 179.456 渭 m at 2W. The thickness of fovea of macular center in the four groups was matched with t test (0.05) on the 1st day, 1W and 2W after operation, which indicated that the thickness of fovea macula had no change before and after operation, which indicated that there was no significant difference in the thickness of macular central fovea before and after operation. The correlation coefficients between the best corrected visual acuity and the foveal thickness of the macular fovea were: 1: -0.76- -0.78- 0.72p0.05, respectively, and the difference was statistically significant. The best corrected visual acuity was inversely proportional to the fovea thickness. The correlation coefficient between postoperative diopter and macular fovea thickness was -0.075 (p 0.05), that is, there was no correlation between postoperative diopter and macular fovea thickness. Conclusion 1% Oct is a powerful tool for detecting macular thickness. After conventional phacoemulsification, there was no significant difference in macular fovea thickness between 1 day and 2 weeks after cataract phacoemulsification. The correlation analysis between the thickness of central fovea of macular and the best corrected visual acuity after phacoemulsification cataract extraction showed that the best corrected visual acuity was negatively correlated with the thickness of fovea of macular center in patients with simple senile cataract. There was no correlation between postoperative diopter and macular fovea thickness. There is no clinical evidence that this procedure can increase the incidence of macular cystic edema.
【學(xué)位授予單位】：汕頭大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2010
【分類號(hào)】：R779.66

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