不同設(shè)計(jì)的人工晶狀體的傾斜與偏心及其對(duì)調(diào)制解調(diào)函數(shù)的影響
發(fā)布時(shí)間：2018-09-07 10:37
【摘要】：目的：比較白內(nèi)障超聲乳化聯(lián)合后房型人工晶狀體(IOL)囊袋內(nèi)植入后,不同IOL的傾斜度對(duì)調(diào)制解調(diào)函數(shù)(MTF)的影響。并比較一體式與三片式人工晶體的穩(wěn)定性。 方法：回顧性系列病例研究。對(duì)單純性白內(nèi)障患者112例(112眼),年齡50-75歲。按照IOL類(lèi)別分組分為負(fù)球差的ZA9003組、0球差的ADAPT-AO組和正球差的AR40E組,其中ZA9003組42例、ADAPT_AO組37例和AR40E組35例。術(shù)后2個(gè)月進(jìn)行隨訪,散瞳至8mm后,用Pentcam眼前節(jié)成像系統(tǒng)采集Scheimpflug圖像,分析IOL的傾斜度與偏心值,itrace采集5mm瞳孔下的各空間頻率(5、10、15、20、25、30 c/d)MTF值。三組再根據(jù)傾斜度大小以0.5。為組距分為傾斜小、傾斜中和傾斜大3組,對(duì)傾斜度與偏心值進(jìn)行Peason相關(guān)分析,3種IOL組間的傾斜度與偏心值之間、多個(gè)傾斜度組間及其所對(duì)應(yīng)的空間頻率為(5、10、15、20、25、30c/d)下的MTF采用單因素方差分析,3組1OL的傾斜對(duì)MTF影響用中心調(diào)整后的數(shù)值進(jìn)行kolmogorov-smirnovz檢驗(yàn)。3組不同球差的IOL在5mm瞳孔下不同空間頻率的MTF值進(jìn)行單因素方差分析。 對(duì)82例82眼單純性白內(nèi)障患者進(jìn)行術(shù)后2月的隨訪。這些患者分別植入一體式IOL(PY-60AD,HOYA,)和三片式IOL(ZA9003,AMO).散瞳后,用眼前節(jié)成像系統(tǒng)Pentcam(oculus)采集各眼的Scheimpflug圖像,用圖像分析的方法得出IOL的傾斜度與偏心值。采用t檢驗(yàn)對(duì)獲得的數(shù)據(jù)進(jìn)行統(tǒng)計(jì)學(xué)分析。 結(jié)果：所有IOL的傾斜與偏心無(wú)顯著相關(guān)(r=0.183,,p=0.051).ZA9003、AR40組和ADAPT-AO組患者IOL的平均傾斜度分別為(0.93±0.71)。、(1.12±0.73)。(0.76±0.51)。；平均偏心值為(0.13±0.10)mm、(0.18±0.12)mm、(0.13±0.08)mm,3組差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。ZA9003組小、中、大傾斜度組的平均傾斜度分別為(0.28±0.15)。、(0.78±0.12)。、(1.67±0.60)AR40E組內(nèi)平均傾斜度(0.38±0.20)。、(0.71±0.12)。、(1.77±0.56)。；ADAPT-AO組內(nèi)平均傾斜度(0.31±0.16)。、(0.66±0.17)。、(1.40±0.39)。,差異有統(tǒng)計(jì)學(xué)意義(p0.05)。ZA9003組小、中、大傾斜度組的平均偏心值為(0.09±0.05)mm、(0.11±0.08)mm、(0.16±0.12)mm:AR40E組平均值為(0.15±0.06)mm、(0.13±0.15)mm、(0.16±0.08)mm；ADAPT-AO組平均值為(0.13±0.06)mm、(0.14±0.15)mm、(0.13±0.08)mm,差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)；在5mm瞳孔下,ZA9003組、AR40E組及ADAPT-AO組各傾斜度組在在各空間頻率下的MTF值差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。ZA9003、AR40E與ADAPT-AO (?)頃斜大中小下的各空間頻率的MTF值調(diào)整后比較,在小傾斜值組和中傾斜值組之間三組之間在各空間頻率下差異均無(wú)統(tǒng)計(jì)學(xué)差異(P0.05),在大傾斜值組只有在空間頻率為20、25(c/d)時(shí)3種IOL之間差異有統(tǒng)計(jì)學(xué)意義(P0.05),其他空間頻率下差異均無(wú)統(tǒng)計(jì)學(xué)差異(P0.05)；其中,ZA9003組與AR40E和ADAPT-AO之間差異均有統(tǒng)計(jì)學(xué)意義(P0.05),而AR40AE組與ADAPT-AO組之間差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。ZA9003、AR40E與ADAPT-AO在5mm瞳孔下各空間頻率下的MTF差異均有統(tǒng)計(jì)學(xué)意義；其中ZA9003與AR40E和ADAPT-AO之間均有統(tǒng)計(jì)學(xué)差異,AR40E與ADAPT-AO之間均無(wú)統(tǒng)計(jì)學(xué)差異。 大瞳孔下PY-60AD與ZA90032組患者IOL的平均傾斜值分別為(0.81±0.62)、(0.93±0.71),其差異無(wú)統(tǒng)計(jì)學(xué)意義(P=0.478),平均偏心值為(0.11±0.09)、(0.13±0.10).其差異無(wú)統(tǒng)計(jì)學(xué)意義(P=0.637)。 結(jié)論：在現(xiàn)在的手術(shù)技術(shù)條件下,對(duì)大傾斜度所造成的視覺(jué)質(zhì)量改變?cè)谝恍┛臻g頻率下負(fù)球差I(lǐng)OL比球差和O球差的IOL敏感,0球差與正球差之間具有相似的敏感性。但是,無(wú)論是球面還是非球面的IOL的傾斜不足以引起人眼視覺(jué)質(zhì)量的明顯改變。一體式與三片式IOL囊袋內(nèi)植入術(shù)后在大瞳孔下均具有相似的穩(wěn)定性。
[Abstract]:Objective: To compare the effects of different IOL inclination on the modulation-demodulation function (MTF) after cataract phacoemulsification combined with posterior chamber intraocular lens (IOL) implantation in capsular bag, and to compare the stability of monolithic and Trilithic IOL.
Methods: A retrospective series of case studies was conducted in 112 patients (112 eyes) with simple cataract aged 50-75 years. They were divided into ZA9003 group with negative spherical aberration, ADAPT-AO group with zero spherical aberration and AR40E group with positive spherical aberration, including 42 cases in ZA9003 group, 37 cases in ADAPT-AO group and 35 cases in AR40E group. Scheimpflug images were collected by anterior segment imaging system, and the inclination and eccentricity of IOL were analyzed. The MTF values of spatial frequencies (5,10,15,20,25,30 c/d) under 5 mm pupil were collected by itrace. The three groups were divided into three groups according to the inclination of 0.5. The MTF values between tilt and eccentricity were analyzed by one-way ANOVA, and the effects of tilt on MTF were examined by Kolmogorov-smirnovz test with center-adjusted values. The MTF values of three groups of IOLs with different spherical aberrations at different spatial frequencies were entered at 5 mm pupils. One way ANOVA was used.
Eighty-two eyes of 82 patients with simple cataract were followed up for 2 months after operation. All patients were implanted with integrated IOL (PY-60AD, HOYA,) and three-slice IOL (ZA9003, AMO). After mydriasis, Scheimpflug images of each eye were collected by Pentcam (oculus) imaging system. The tilt and eccentricity of IOL were obtained by image analysis. The data obtained were statistically analyzed.
Results: There was no significant correlation between IOL tilt and eccentricity (r = 0.183, P = 0.051). ZA9003, AR40 and ADAPT-AO groups had no significant difference (P 0.05). The mean inclination of the ADAPT-AO group was (0.28.15), (0.78.12), (1.67.60) the mean inclination of the AR40E group was (0.38.20), (0.71.12), (1.77.56)., and (0.31.16), (0.66.17, (1.40.39). The difference was statistically significant (p0.05). The mean inclination of the ADAPT-AO group was (0.40.39). The The mean values of AR40E group were (0.15 + 0.06) mm, (0.15 + 0.06) mm, (0.13 + 0.15) mm, (0.16 + 0.15) mm, (0.16 + 0.08) mm, (0.16 + 0.08) mm, (0.16 + 0.08) mm, (0.09 + 0.05) mm, (0.11 + 0.08) mm, (0.11 + 0.08) mm, (0.16 + 0.12) mm: AR40E group was (0.15 + 0.06) mm, (0.15 + 0.06) mm, (0.16 + 0.08) mm, (0.14 + 0.15 mm, (0.13 + 0.15) mm, (0.13 + 0.08) mm, Groups of inclination groups in each space There was no significant difference in MTF values among different frequencies (P 0.05). ZA9003, AR40E and ADAPT-AO (?) were used to adjust the MTF values of different spatial frequencies. There was no significant difference among the three groups at different spatial frequencies (P 0.05). At 25 (c/d), there were significant differences among the three IOLs (P 0.05), and no significant differences in other spatial frequencies (P 0.05); among them, there were significant differences between ZA9003 group and AR40E and ADAPT-AO group (P 0.05), but there was no significant difference between AR40AE group and ADAPT-AO group (P 0.05). ZA9003, AR40E and ADAPT-AO were all empty under 5 mm pupil. The MTF of ZA9003 and AR40E were significantly different from that of ADAPT-AO, and there was no significant difference between AR40E and ADAPT-AO.
The mean IOL tilt values of PY-60AD and ZA90032 groups were (0.81.62), (0.93.71), respectively, with no significant difference (P = 0.478), and the mean eccentricity was (0.11.09), (0.13.10). There was no significant difference (P = 0.637).
CONCLUSIONS: Under current surgical conditions, the visual quality changes caused by high tilt are more sensitive to negative IOL than to spherical IOL and O spherical IOL at some spatial frequencies, and there is a similar sensitivity between zero spherical IOL and positive spherical IOL. Obvious changes. The integration and three slice IOL bag implantation have similar stability in the large pupil.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2011
【分類(lèi)號(hào)】：R779.6
本文編號(hào)：2228020
[Abstract]:Objective: To compare the effects of different IOL inclination on the modulation-demodulation function (MTF) after cataract phacoemulsification combined with posterior chamber intraocular lens (IOL) implantation in capsular bag, and to compare the stability of monolithic and Trilithic IOL.
Methods: A retrospective series of case studies was conducted in 112 patients (112 eyes) with simple cataract aged 50-75 years. They were divided into ZA9003 group with negative spherical aberration, ADAPT-AO group with zero spherical aberration and AR40E group with positive spherical aberration, including 42 cases in ZA9003 group, 37 cases in ADAPT-AO group and 35 cases in AR40E group. Scheimpflug images were collected by anterior segment imaging system, and the inclination and eccentricity of IOL were analyzed. The MTF values of spatial frequencies (5,10,15,20,25,30 c/d) under 5 mm pupil were collected by itrace. The three groups were divided into three groups according to the inclination of 0.5. The MTF values between tilt and eccentricity were analyzed by one-way ANOVA, and the effects of tilt on MTF were examined by Kolmogorov-smirnovz test with center-adjusted values. The MTF values of three groups of IOLs with different spherical aberrations at different spatial frequencies were entered at 5 mm pupils. One way ANOVA was used.
Eighty-two eyes of 82 patients with simple cataract were followed up for 2 months after operation. All patients were implanted with integrated IOL (PY-60AD, HOYA,) and three-slice IOL (ZA9003, AMO). After mydriasis, Scheimpflug images of each eye were collected by Pentcam (oculus) imaging system. The tilt and eccentricity of IOL were obtained by image analysis. The data obtained were statistically analyzed.
Results: There was no significant correlation between IOL tilt and eccentricity (r = 0.183, P = 0.051). ZA9003, AR40 and ADAPT-AO groups had no significant difference (P 0.05). The mean inclination of the ADAPT-AO group was (0.28.15), (0.78.12), (1.67.60) the mean inclination of the AR40E group was (0.38.20), (0.71.12), (1.77.56)., and (0.31.16), (0.66.17, (1.40.39). The difference was statistically significant (p0.05). The mean inclination of the ADAPT-AO group was (0.40.39). The The mean values of AR40E group were (0.15 + 0.06) mm, (0.15 + 0.06) mm, (0.13 + 0.15) mm, (0.16 + 0.15) mm, (0.16 + 0.08) mm, (0.16 + 0.08) mm, (0.16 + 0.08) mm, (0.09 + 0.05) mm, (0.11 + 0.08) mm, (0.11 + 0.08) mm, (0.16 + 0.12) mm: AR40E group was (0.15 + 0.06) mm, (0.15 + 0.06) mm, (0.16 + 0.08) mm, (0.14 + 0.15 mm, (0.13 + 0.15) mm, (0.13 + 0.08) mm, Groups of inclination groups in each space There was no significant difference in MTF values among different frequencies (P 0.05). ZA9003, AR40E and ADAPT-AO (?) were used to adjust the MTF values of different spatial frequencies. There was no significant difference among the three groups at different spatial frequencies (P 0.05). At 25 (c/d), there were significant differences among the three IOLs (P 0.05), and no significant differences in other spatial frequencies (P 0.05); among them, there were significant differences between ZA9003 group and AR40E and ADAPT-AO group (P 0.05), but there was no significant difference between AR40AE group and ADAPT-AO group (P 0.05). ZA9003, AR40E and ADAPT-AO were all empty under 5 mm pupil. The MTF of ZA9003 and AR40E were significantly different from that of ADAPT-AO, and there was no significant difference between AR40E and ADAPT-AO.
The mean IOL tilt values of PY-60AD and ZA90032 groups were (0.81.62), (0.93.71), respectively, with no significant difference (P = 0.478), and the mean eccentricity was (0.11.09), (0.13.10). There was no significant difference (P = 0.637).
CONCLUSIONS: Under current surgical conditions, the visual quality changes caused by high tilt are more sensitive to negative IOL than to spherical IOL and O spherical IOL at some spatial frequencies, and there is a similar sensitivity between zero spherical IOL and positive spherical IOL. Obvious changes. The integration and three slice IOL bag implantation have similar stability in the large pupil.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2011
【分類(lèi)號(hào)】：R779.6
【參考文獻(xiàn)】
相關(guān)期刊論文 前3條
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2 張鈺,郝燕生,王薇;超聲乳化白內(nèi)障吸除聯(lián)合人工晶狀體植入術(shù)后波陣面像差變化的研究[J];眼科;2005年01期
3 方艷文;盧奕;汪琳;;折疊式人工晶狀體囊袋內(nèi)植入后偏心與傾斜的臨床研究[J];眼視光學(xué)雜志;2008年04期
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