發(fā)布時(shí)間：2018-11-17 09:34

【摘要】： 目的： 1.對(duì)比分析IOLMaster和接觸式A超兩種生物測(cè)量方法測(cè)算伴后鞏膜葡萄腫的高度近視白內(nèi)障患者IOL度數(shù)的精確性,比較不同IOL計(jì)算公式的準(zhǔn)確性。 2.對(duì)比分析IOLMaster和接觸式A超測(cè)得的黃斑水腫患者的眼軸長(zhǎng)度(axial length,AL),探討眼軸測(cè)量差值與黃斑中心凹厚度的相關(guān)性。 3.評(píng)價(jià)IOLMaster測(cè)量硅油眼AL的精確性。 方法： 1.本研究為前瞻性病例對(duì)照臨床研究。 2.收集伴后鞏膜葡萄腫的高度近視白內(nèi)障患者28例(41眼),所有患者均行白內(nèi)障超聲乳化聯(lián)合IOL植入術(shù),術(shù)前分別用IOLMaster和接觸式A超聯(lián)合手動(dòng)角膜曲率計(jì)(manual keratometer,MK)測(cè)量生物參數(shù)；并根據(jù)SRK-II,SRK-T,Haigis,Hoffer Q,Holladay 1公式計(jì)算IOL度數(shù)；術(shù)后3個(gè)月檢查患者屈光狀態(tài)。 3.收集確診為黃斑水腫的患者42例(67眼),正常對(duì)照組30例(40眼)。應(yīng)用TOPCON 3D OCT-1000測(cè)得病例組及對(duì)照組黃斑中心凹厚度,并應(yīng)用IOLMaster和接觸式A超測(cè)量患者的AL。 4.收集在本院行玻璃體切割聯(lián)合硅油填充術(shù)的患者26例(30眼),分別于術(shù)前1天和術(shù)后1個(gè)月應(yīng)用IOLMaster測(cè)量AL,觀察前后有無(wú)差異。 5.統(tǒng)計(jì)學(xué)方法：本研究使用SPSS16.0統(tǒng)計(jì)學(xué)軟件,兩種方法的比較應(yīng)用配對(duì)設(shè)計(jì)資料的t檢驗(yàn)、單因素方差分析；不同IOL計(jì)算公式間率的比較應(yīng)用配對(duì)設(shè)計(jì)下兩組頻數(shù)分布χ2檢驗(yàn)(又稱(chēng)McNemar檢驗(yàn))；應(yīng)用Pearson相關(guān)系數(shù)進(jìn)行相關(guān)性分析。 結(jié)果： 1.IOLMaster和接觸式A超測(cè)得的AL和前房深度差異均有統(tǒng)計(jì)學(xué)意義(P=0.005,0.000);IOLMaster與MK測(cè)得的角膜曲率差異無(wú)統(tǒng)計(jì)學(xué)意義(P=0.398)。MAE以±1.00D為界做χ2檢驗(yàn),只有應(yīng)用Haigis公式時(shí)IOLMaster與接觸式A超差異有統(tǒng)計(jì)學(xué)意義(χ2=3.953,P=0.047)。應(yīng)用IOLMaster生物測(cè)量方法,SRK/T,Haigis公式最精確,應(yīng)用接觸式A超聯(lián)合MK生物測(cè)量方法Holladay 1,Hoffer Q,Haigis公式最精確,平均絕對(duì)屈光誤差(mean absolute refractive error,MAE)較為接近。 2.黃斑水腫患者的平均黃斑中心凹厚度為(377.85±119.84)μm;IOLMaster和接觸式A超測(cè)得的AL分別為(22.95±0.97)mm和(22.82±1.04)mm,差異有統(tǒng)計(jì)學(xué)意義(P=0.003)；但AL差值與OCT測(cè)得的黃斑中心凹厚度無(wú)相關(guān)性(r=-0.097：P=0.447)。 3.應(yīng)用IOLMaster在有、無(wú)硅油填充時(shí)測(cè)得的AL分別是(24.38±3.18)mm和(24.23±2.91)mm,非參數(shù)檢驗(yàn)差異無(wú)統(tǒng)計(jì)學(xué)意義(P=0.261)。 結(jié)論： 1.對(duì)于伴后鞏膜葡萄腫的高度近視白內(nèi)障患者,只有應(yīng)用Haigis公式時(shí)IOLMaster測(cè)算的IOL度數(shù)較接觸式A超精確；應(yīng)用IOLMaster生物測(cè)量方法推薦使用SRK/T,Haigis公式；應(yīng)用接觸式A超聯(lián)合MK生物測(cè)量方法推薦使用Holladay 1,Hoffer Q,Haigis公式。 2.IOLMaster接觸式A超所測(cè)得的黃斑水腫患者的AL差異有統(tǒng)計(jì)學(xué)意義,但是其差值與黃斑中心凹厚度無(wú)相關(guān)性。 3.有、無(wú)硅油填充對(duì)IOLMaster測(cè)量眼軸沒(méi)有影響。
[Abstract]:Objective: 1. To compare and analyze the accuracy of IOLMaster and contact A-ultrasound in estimating the IOL degree of high myopic cataract patients with posterior scleral grape swelling, and to compare the accuracy of different IOL calculation formulas. 2. The eye axis length (axial length,AL) of patients with macular edema measured by IOLMaster and contact A ultrasound was compared and analyzed to explore the correlation between the difference of eye axis and the thickness of macular fovea. 3. To evaluate the accuracy of IOLMaster in measuring AL of silicone eye. Methods: 1. This study is a prospective case-control clinical study. 2. Twenty-eight cases (41 eyes) of high myopia cataract with posterior scleral grape swelling were collected. All patients were treated with phacoemulsification combined with IOL implantation. IOLMaster and contact A ultrasound combined with manual keratometer (manual keratometer, were used before operation. MK) was used to measure biological parameters. The degree of IOL was calculated according to the formula of SRK-II,SRK-T,Haigis,Hoffer QG Holladay 1, and the refractive state of the patients was examined 3 months after operation. 3. 42 cases (67 eyes) of macular edema and 30 cases (40 eyes) of normal control group were collected. The thickness of macular fovea was measured by TOPCON 3D OCT-1000 in case group and control group. IOLMaster and contact A ultrasound were used to measure AL. in patients. 4. A total of 26 patients (30 eyes) who underwent vitrectomy combined with silicone oil implantation in our hospital were collected. IOLMaster was used to measure AL, 1 day before operation and 1 month after operation. 5. Statistical methods: SPSS16.0 software was used to compare the two methods with t-test of paired design data, and single factor analysis of variance (ANOVA). Comparison of the rates of different IOL formulas two groups of frequency distribution 蠂 2 test (also called McNemar test) and Pearson correlation coefficient were used to analyze the correlation between the two groups. Results: there was significant difference between AL and anterior chamber depth measured by 1.IOLMaster and contact A ultrasound (P0. 005U 0. 000). There was no significant difference in corneal curvature between IOLMaster and MK (P < 0. 398). MAE 鹵1. 00D was used as 蠂 2 test). Only when the Haigis formula was used, there was a significant difference between IOLMaster and contact A ultrasound (蠂 2 + 3. 953% P 0. 047). Using IOLMaster biometric method, SRK/T,Haigis formula is the most accurate, and contact A-super combined with MK biometric method Holladay 1Hoffer QI Haigis formula is the most accurate, and the average absolute refractive error (mean absolute refractive error,MAE) is close. 2. The mean foveal thickness of macular fovea in patients with macular edema was (377.85 鹵119.84) 渭 m IOLMaster and (22.95 鹵0.97) mm and (22.82 鹵1.04) mm, respectively (P0. 003). However, there was no correlation between AL difference and macular foveal thickness measured by OCT (r=-0.097:P=0.447). 3. The AL measured by IOLMaster was (24.38 鹵3.18) mm and (24.23 鹵2.91) mm, respectively. Conclusion: 1. For high myopic cataract patients with posterior scleral grape swelling, the IOL degree calculated by IOLMaster with Haigis formula is more accurate than that of contact A, and SRK/T,Haigis formula is recommended by IOLMaster biometrics. In this paper, we recommend the use of Holladay 1 / Hoffer QS Haigis formula by means of contact A ultrasound combined with MK biometrics. There was significant difference in AL between the patients with macular edema measured by 2.IOLMaster contact A ultrasound, but there was no correlation between the difference and the foveal thickness of macular. 3. Yes, no silicone oil filling has no effect on the IOLMaster measurement eye shaft.
【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】：2010
【分類(lèi)號(hào)】：R77

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