非球面人工晶狀體囊袋內(nèi)植入后的傾斜和偏心及視覺(jué)質(zhì)量的研究
發(fā)布時(shí)間：2018-10-24 22:42
【摘要】：目的： 用Pentacam三維眼前節(jié)分析系統(tǒng)測(cè)量非球面人工晶狀體(intraocular lens,IOL)囊袋內(nèi)植入后的傾斜和偏心及其對(duì)高階像差(higher-order aberration, HOA)和視覺(jué)質(zhì)量的影響。 方法： 1、選擇年齡相關(guān)性白內(nèi)障患者90例(120眼),行超聲乳化白內(nèi)障吸除術(shù),隨機(jī)植入非球面IOL Tecnis ZA9003(30只眼)、Acrysoft IQ(30只眼)以及Akreos AO(30只眼)；球面IOL AR40e(30只眼)。用Pentacam三維眼前節(jié)分析系統(tǒng)測(cè)量四組術(shù)后1周、1月和3月IOL的傾斜和偏心。 2、取50例單純性老年性白內(nèi)障患者60只眼,30只眼隨機(jī)植入AMO公司的球面IOL SensarAR40e,30只眼植入非球面IOL Tecnis ZA9003。術(shù)后3到4個(gè)月,檢測(cè)患者在5.0mm瞳孔下的HOA以及5、10、15、20、25、30周每度(cycles per degree, cpd)空間頻率下的調(diào)制傳遞函數(shù)(modulation transfer function, MTF)。通過(guò)Scheimpflug像,測(cè)量IOL的傾斜與偏心。比較兩組間傾斜度和偏心值、HOA及各空間頻率下去除低階像差的MTF (MTF(HOA))值。使用多元回歸分析來(lái)確定傾斜和偏心對(duì)HOA和視覺(jué)質(zhì)量的影響。 結(jié)果： 1、ZA9003組、IQ組、AO組和AR40e組,四組組內(nèi)在術(shù)后1周、1月、3月不同隨訪時(shí)間的傾斜度,差異都無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。四組組間在不同隨訪時(shí)間的傾斜度,差異也都無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)；四組組內(nèi)在不同隨訪時(shí)間的偏心量,差異都無(wú)統(tǒng)計(jì)學(xué)意義(P＞0.05)。四組組間在不同隨訪時(shí)間的偏心量,均表現(xiàn)出AO組和ZA9003組、IQ組、AR40e組差異有統(tǒng)計(jì)學(xué)差異(F=6.391,4.265,7.692; P=0.021,0.030,0.011). ZA9003組、IQ組、AR40e組兩兩之間無(wú)統(tǒng)計(jì)學(xué)差異(P0.05)； 2、光學(xué)部?jī)A斜AR40e組(2.99+0.94)°, ZA9003組(2.98+1.15)°。光學(xué)部偏心AR40e組(0.30±0.13)mm, ZA9003組(0.31±0.14)mm。組間傾斜和偏心差異無(wú)統(tǒng)計(jì)學(xué)意義(t=-0.044,-0.525, P=0.965,0.600);總球差,AR40e組(0.366±0.163)μm大于ZA9003組(0.027±0.032)μm,差異有統(tǒng)計(jì)學(xué)意義(t=-10.386, P=0.000); ZA9003組在5mm瞳孔直徑下各頻段的MTF(HOA)值均高于AR40e組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)；兩組IOL傾斜和偏心對(duì)各自的HOA及各頻段的MTF(HOA)值均無(wú)明顯影響。 結(jié)論： 1、Pentacam三維眼前節(jié)分析系統(tǒng)可以動(dòng)態(tài)觀察并評(píng)價(jià)IOL在眼內(nèi)的位置；一片式軟袢IQ非球面IOL具有與三片式硬袢ZA9003非球面IOL相似的良好囊袋穩(wěn)定性；四襻式非球面IOL AO的眼內(nèi)偏心穩(wěn)定性可能好于兩袢式非球面IOL ZA9003、IQ; 2、在正常條件下,白內(nèi)障超聲乳化聯(lián)合IOL植入術(shù)后球面IOL AR40e和非球面IOL ZA9003的傾斜度和偏心量是很小的；當(dāng)IOL的傾斜和偏心在正常限度內(nèi)時(shí),不會(huì)危害非球面IOL對(duì)球差的補(bǔ)償作用,不足以導(dǎo)致視覺(jué)質(zhì)量的下降。
[Abstract]:Aim: to measure the inclination and eccentricity of aspherical intraocular lens (intraocular lens,IOL) after implantation into the capsular bag and its effect on higher order aberration (higher-order aberration, HOA) and visual quality by using Pentacam three-dimensional anterior segment analysis system. Methods: 1. 90 patients (120 eyes) with age-related cataract underwent phacoemulsification cataract extraction, and 30 eyes of aspherical IOL Tecnis ZA9003 (30 eyes of), Acrysoft IQ (and 30 eyes of Akreos AO () and 30 eyes of spherical IOL AR40e (30 eyes) were randomly implanted with aspherical IOL Tecnis ZA9003 (30 eyes) and Akreos AO (30 eyes). The tilt and eccentricity of IOL in four groups were measured by Pentacam three-dimensional anterior segment analysis system at 1 week, 1 month and 3 months after operation. 60 eyes of 50 patients with simple senile cataract and 30 eyes were randomly implanted with spherical IOL SensarAR40e,30 of AMO Company. Ocular aspherical IOL Tecnis ZA9003. implantation From 3 to 4 months after operation, the modulation transfer function (modulation transfer function, MTF).) was measured under the pupil of 5.0mm and at the spatial frequency of (cycles per degree, cpd) at the spatial frequency of 510101520 / 2530 weeks. The tilt and eccentricity of IOL are measured by Scheimpflug images. The slope, eccentricity, HOA and the MTF (HOA) value of removing low order aberration at different spatial frequencies were compared between the two groups. Multiple regression analysis was used to determine the effects of tilt and eccentricity on HOA and visual quality. Results: 1 the inclination of ZA9003 group, IQ group, AO group and AR40e group were not significantly different between the four groups in 1 week, 1 month and 3 months after operation (P0.05). The inclination of the four groups in different follow-up time, the difference was not statistically significant (P0.05); in the four groups in different follow-up time eccentric, there was no significant difference (P > 0.05). The eccentricity of the four groups at different follow-up time showed significant difference between AO group, ZA9003 group, IQ group and AR40e group (F _ (6.391) 4.265 ~ 7.692; P _ (0.021) 0.030 ~ 0.011). There was no significant difference between the ZA9003 group, IQ group and AR40e group (P0.05), 2, the optical partial tilting AR40e group (2.99 0.94) 擄, the ZA9003 group (2.98 1.15) 擄. Optical eccentric AR40e group (0.30 鹵0.13) mm, ZA9003 group (0.31 鹵0.14) mm. There was no significant difference in tilting and eccentricity between groups (t0. 04 ~ 0. 525, P = 0. 965 ~ 0. 600), total spherical aberration in AR40e group (0.366 鹵0.163) 渭 m was significantly higher than that in ZA9003 group (0.027 鹵0.032) 渭 m (t = 10. 386, P < 0. 000), MTF (HOA) value in 5mm pupil diameter in ZA9003 group was higher than that in AR40e group (P0.05). IOL tilt and eccentricity had no significant effect on HOA and MTF (HOA) values of each frequency band. Conclusion: 1 Pentacam three-dimensional anterior segment analysis system can dynamically observe and evaluate the position of IOL in the eye, one piece of soft loop IQ aspherical IOL has good bag stability similar to that of ZA9003 aspheric IOL. The intraocular eccentricity stability of four-loop aspheric IOL AO may be better than that of two-loop aspherical IOL ZA9003,IQ; _ 2. Under normal conditions, the inclination and eccentricity of spherical IOL AR40e and aspheric IOL ZA9003 after phacoemulsification combined with IOL implantation are very small. When the tilt and eccentricity of IOL are within the normal limit, it will not harm the compensation effect of aspheric IOL to spherical aberration, which is not enough to cause the decline of visual quality.
【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
【分類號(hào)】：R779.6
本文編號(hào)：2292784
[Abstract]:Aim: to measure the inclination and eccentricity of aspherical intraocular lens (intraocular lens,IOL) after implantation into the capsular bag and its effect on higher order aberration (higher-order aberration, HOA) and visual quality by using Pentacam three-dimensional anterior segment analysis system. Methods: 1. 90 patients (120 eyes) with age-related cataract underwent phacoemulsification cataract extraction, and 30 eyes of aspherical IOL Tecnis ZA9003 (30 eyes of), Acrysoft IQ (and 30 eyes of Akreos AO () and 30 eyes of spherical IOL AR40e (30 eyes) were randomly implanted with aspherical IOL Tecnis ZA9003 (30 eyes) and Akreos AO (30 eyes). The tilt and eccentricity of IOL in four groups were measured by Pentacam three-dimensional anterior segment analysis system at 1 week, 1 month and 3 months after operation. 60 eyes of 50 patients with simple senile cataract and 30 eyes were randomly implanted with spherical IOL SensarAR40e,30 of AMO Company. Ocular aspherical IOL Tecnis ZA9003. implantation From 3 to 4 months after operation, the modulation transfer function (modulation transfer function, MTF).) was measured under the pupil of 5.0mm and at the spatial frequency of (cycles per degree, cpd) at the spatial frequency of 510101520 / 2530 weeks. The tilt and eccentricity of IOL are measured by Scheimpflug images. The slope, eccentricity, HOA and the MTF (HOA) value of removing low order aberration at different spatial frequencies were compared between the two groups. Multiple regression analysis was used to determine the effects of tilt and eccentricity on HOA and visual quality. Results: 1 the inclination of ZA9003 group, IQ group, AO group and AR40e group were not significantly different between the four groups in 1 week, 1 month and 3 months after operation (P0.05). The inclination of the four groups in different follow-up time, the difference was not statistically significant (P0.05); in the four groups in different follow-up time eccentric, there was no significant difference (P > 0.05). The eccentricity of the four groups at different follow-up time showed significant difference between AO group, ZA9003 group, IQ group and AR40e group (F _ (6.391) 4.265 ~ 7.692; P _ (0.021) 0.030 ~ 0.011). There was no significant difference between the ZA9003 group, IQ group and AR40e group (P0.05), 2, the optical partial tilting AR40e group (2.99 0.94) 擄, the ZA9003 group (2.98 1.15) 擄. Optical eccentric AR40e group (0.30 鹵0.13) mm, ZA9003 group (0.31 鹵0.14) mm. There was no significant difference in tilting and eccentricity between groups (t0. 04 ~ 0. 525, P = 0. 965 ~ 0. 600), total spherical aberration in AR40e group (0.366 鹵0.163) 渭 m was significantly higher than that in ZA9003 group (0.027 鹵0.032) 渭 m (t = 10. 386, P < 0. 000), MTF (HOA) value in 5mm pupil diameter in ZA9003 group was higher than that in AR40e group (P0.05). IOL tilt and eccentricity had no significant effect on HOA and MTF (HOA) values of each frequency band. Conclusion: 1 Pentacam three-dimensional anterior segment analysis system can dynamically observe and evaluate the position of IOL in the eye, one piece of soft loop IQ aspherical IOL has good bag stability similar to that of ZA9003 aspheric IOL. The intraocular eccentricity stability of four-loop aspheric IOL AO may be better than that of two-loop aspherical IOL ZA9003,IQ; _ 2. Under normal conditions, the inclination and eccentricity of spherical IOL AR40e and aspheric IOL ZA9003 after phacoemulsification combined with IOL implantation are very small. When the tilt and eccentricity of IOL are within the normal limit, it will not harm the compensation effect of aspheric IOL to spherical aberration, which is not enough to cause the decline of visual quality.
【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
【分類號(hào)】：R779.6
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相關(guān)期刊論文 前3條
1 宋黎;朱思泉;;非球面人工晶狀體的臨床研究進(jìn)展[J];國(guó)際眼科縱覽;2006年01期
2 宋旭東;郭佳;;如何理解和選擇非球面人工晶狀體[J];眼科;2007年02期
3 呂秀芳;楊浩江;樓定華;;晶狀體乳化吸出非球面人工晶狀體植入術(shù)后視覺(jué)質(zhì)量的臨床研究[J];眼外傷職業(yè)眼病雜志(附眼科手術(shù));2007年05期
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