影响犬白内障超声乳化手术效果的因素分析

发布时间：2019-01-27 22:12

【摘要】：白内障即晶状体囊或者晶状体出现混浊,是导致犬只视力丧失的主要原因之一。白内障患犬易碰撞障碍物,运动能力下降,甚至不能正常饮食,加重饲主的负担。目前,白内障最有效的治疗方法是超声乳化手术,将超声乳化探头通过小切口伸入眼球内,乳化探头发出超声波将晶状体击碎,再将其吸出。要得到好的超声乳化手术效果,术后光线需能够到达眼底,且视网膜功能正常。白内障成熟度、超声乳化参数和不同的术后并发症可导致光线进入眼底受阻或者破坏的视网膜功能,影响超声乳化手术的效果。本研究通过分析临床上进行超声乳化手术的白内障患犬的手术效果,明确以上因素对超声乳化手术效果的影响程度,以提出白内障手术的注意事项和降低不良效果的发生率。研究通过对患犬进行眼科学检查,包括泪液量测量、瞳孔对光反射、眼睑反射、威吓试验、炫光试验、荧光色素测试、眼压测量、裂隙灯检查、眼底镜检查、棉花球测试、迷宫测试和眼超声检查等,在术前对白内障成熟度进行分类并排除手术禁忌症,在术中对不同的犬设置高低两种不同超声乳化参数,在术后记录患犬的视力恢复情况和并发症情况,研究不同白内障成熟度、超声乳化参数和不同术后并发症对犬白内障超声乳化手术效果的影响。结果如下:1.确诊10例白内障患犬。其中贵宾犬占40%,西施犬占10%,混种犬占10%,古代牧羊占10%,雪纳瑞犬占10%,比熊犬占10%,博美犬占10%。60%为母犬,40%为公犬。小型犬占80%,中型犬占20%,大型犬占0%。幼犬占0%,成年犬占70%,老年犬占30%;2.11只眼睛其中未成熟期4只,成熟期4只,过熟期3只。术后未成熟期视力丧失率为0,成熟期视力丧失比例为25%,过熟期视力丧失比例达到33.3%;3.使用较高的超声乳化参数的白内障患犬术后有33.3%出现纤维蛋白渗出,而使用较低的超声乳化参数的患犬则为0。4.白内障并发症包括纤维蛋白渗出、虹膜粘连、后囊混浊、视网膜脱离、青光眼,其中视网膜脱离和青光眼导致视力丧失。综合以上试验结果表明:白内障多发于贵宾犬,小型犬发病率多于中大型犬,成年母犬的发病率较高。白内障成熟程度越高,术后并发症的发生率越高,手术后视力丧失的几率越大,手术效果越差。使用较高的超声乳化参数眼内炎症较重。不同的并发症会造成手术效果的降低甚至视力丧失,术后青光眼和视网膜脱离可导致动物失明,要特别注意预防。
[Abstract]:Cataract, which is the lens capsule or lens opacity, is one of the main causes of visual loss in dogs. Cataract dogs are prone to collision with obstacles, reduced motor ability, or even normal diet, increasing the burden on the owner. At present, the most effective treatment for cataract is phacoemulsification. The phacoemulsification probe is inserted into the eyeball through a small incision, and the phacoemulsification probe sends out ultrasonic wave to break the lens and suck it out. In order to obtain good phacoemulsification effect, the light should reach the fundus after operation and the retinal function should be normal. Cataract maturity, phacoemulsification parameters and different postoperative complications can result in light entering the fundus of the retina which is blocked or destroyed, which affects the effect of phacoemulsification. In this study, the effect of phacoemulsification on phacoemulsification was analyzed, and the influence of the above factors on phacoemulsification was determined, in order to put forward the points for attention and reduce the incidence of adverse effects. In this study, eye examination was carried out on dogs, including tear volume measurement, pupil light reflex, eyelid reflex, intimidation test, glare test, fluorescent pigment test, intraocular pressure measurement, slit lamp test, fundus examination, cotton ball test. Labyrinth test and ocular ultrasound examination were used to classify cataract maturity and eliminate contraindications before operation. Two different phacoemulsification parameters were set for different dogs during operation. The effects of different cataract maturity, phacoemulsification parameters and postoperative complications on phacoemulsification were studied. The results are as follows: 1. Ten canines with cataract were diagnosed. Among them, 40 poodles, 10 Xi Shi dogs, 10 mixed breed dogs, 10 ancient Shepherd dogs, 10 Shennari dogs, 10 bear dogs, 100.60% Beamey dogs and 40% male dogs. Small dogs account for 80 meters, medium dogs for 20 and large dogs for 0. Puppies accounted for 0, adult dogs 70 and aged dogs 302.11 eyes, of which 4 were immature, 4 were mature, and 3 were overmature. The loss rate of visual acuity was 0 in immature period, 25 in mature stage and 33.3in overmature period. Fibrin exudation was found in 33.3% of cataract dogs with higher phacoemulsification parameters, while 0.4 in dogs with lower phacoemulsification parameters. Cataract complications include fibrin exudation, iris adhesion, posterior capsule opacity, retinal detachment, and glaucoma, where retinal detachment and glaucoma lead to loss of vision. The results showed that cataract was more common in poodles, the incidence of cataract in small dogs was higher than that in medium and large dogs, and the incidence of adult female dogs was higher. The higher the maturation of cataract, the higher the incidence of postoperative complications, the greater the chance of loss of vision after surgery, and the worse the effect of surgery. Using higher phacoemulsification parameters, intraocular inflammation was more severe. Postoperative glaucoma and retinal detachment can lead to blindness in animals, and special care should be taken to prevent them.
【学位授予单位】：西北农林科技大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：S858.292

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