白内障超声乳化吸除术后眼前节变化与屈光漂移的相关性分析

发布时间：2018-02-21 15:30

本文关键词： 白内障超声乳化吸除术屈光漂移眼前节　出处：《广西医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:应用Pentacam三维眼前节分析系统量化白内障超声乳化吸除术联合人工晶体植入术前后患者的角膜曲率(Km)、前房容积(ACV)、前房深度(ACD)、前房角度(ACA),分析它们的变化与术后屈光漂移的相关关系。方法:在术前,术后1天,术后1周,术后1月,应用Pentacam三维眼前节分析系统测量40例(42眼)白内障患者的Km、ACV、ACD、ACA等,同时进行验光记录屈光状态。使用重复测量资料的方差分析法、单样本t检验、Pearson线性相关分析,对所得数据进行统计学分析。结果:患者白内障超声乳化吸除术后1天的平均屈光度为(-0.43±0.50)D、术后1周为(-0.71±0.54)D、术后1月为(-0.50±0.46)D,术后1天时患者屈光度接近手术目标屈光度-0.5D,但术后1周时近视度比术后1天增加,于术后1月近视度数再次接近目标屈光度,与术后1天相比无明显差异(P〉0.05)。Pentacam三维眼前节分析系统检查显示患者ACD术后1天为(3.99±0.53)mm、术后1周为(3.81±0.50)mm、术后1月为(3.53±0.38)mm,ACV术后1天为(152.05±26.75)mm3、术后1周为(139.71±26.65)mm3、术后1月为(127.83±25.37)mm3,ACA术后1天为(45.44±6.45)°、术后1周为(43.83±5.81)°、术后1月为(43.82±4.58)°,术后1周、1月的ACD和ACV均比术后1天显著减少(均为P〈0.05),而术后1周、1月的ACA与术后1天相比无明显差异(P〉0.05)。患者术前Km为(42.74±1.06)、术后1天为(42.75±1.05)、术后1周为(42.73±1.00)、术后1月为(42.73±1.01),术前及术后各时间段的Km无明显差异(P〉0.05)。患者术后1周屈光度变化为(-0.28±0.60)D、术后1月屈光度变化为(-0.07±0.68)D,术后屈光度变化与ACD变化呈正相关(r1周=0.73,r1月=0.83,均为P〈0.05),术后1周屈光度变化与术后1周ACA变化呈弱相关(r1周=0.31,P〈0.05),而术后1月屈光度变化和ACA变化的相关性无统计学意义(P〉0.05)。屈光度变化与ACV变化无明显相关性(P〉0.05)。屈光度变化与Km变化无明显相关性(P〉0.05)。结论:白内障超声乳化吸除术后早期患者出现屈光漂移,手术后1天的屈光状态接近于手术目标屈光度,此后屈光度向近视漂移,术后1个月时近视漂移程度减轻。白内障术后早期的屈光漂移与ACD的变化密切相关。
[Abstract]:Objective: to quantify the corneal curvature of patients before and after phacoemulsification combined with intraocular lens implantation (IOL) with Pentacam three-dimensional anterior segment analysis system. The correlation of postrefractive drift. Methods: before operation, On 1 day, 1 week and January after operation, 40 patients with cataract were measured by Pentacam three-dimensional anterior segment analysis system. The refractive state of 40 patients with cataract were recorded by optometry and the variance analysis method of repeated measurements was used. Single sample t-test Pearson linear correlation analysis, Results: the average diopter after phacoemulsification was 0.43 卤0.50 d, 0.71 卤0.54 D at 1 week after phacoemulsification, and -0.50 卤0.46 Don on January. The diopter of the patient was close to the operation target at 1 day after phacoemulsification. -0.5D, but the myopia at 1 week after operation was higher than that on the first day after operation. On January, the myopia degree was close to the target diopter again, There was no significant difference (P > 0.05). Pentacam three-dimensional anterior segment analysis showed that ACD was 3.99 卤0.53 mm on day 1, 3.81 卤0.50 mm at 1 week after operation, 152.05 卤26.75 mm 3 on January, 139.71 卤26.65 mm 3 at 1 week after operation, 127.83 卤25.37 mm 3mm after operation on January, 152.05 卤26.75 mm 3 on 1 day after operation, 139.71 卤26.65 mm 3 at 1 week after operation, and 127.83 卤25.37 mm / 3mm on January after operation. At 1 week after operation, ACD and ACV in January were significantly lower than those in 1 day after operation (P < 0.05), but there was no significant difference in ACA between 1 week after operation and 1 day after operation (P > 0.05). The km before operation was 42.74 卤1.06m, and on the first day after operation, there was no significant difference (P > 0.05) between the first week after operation and the first day after operation (P > 0.05). The preoperative km of the patients was 42.74 卤1.06m, and that of postoperative day 1 was significantly lower than that of the first day after operation (P < 0.05), and there was no significant difference between ACA of January and postoperative day 1 (P > 0.05). There was no significant difference in km between before and after operation (P > 0.05). The diopter was -0.28 卤0.60D at 1 week after operation, and the diopter was -0.07 卤0.68D on January. There was a positive correlation between the change of diopter and the change of ACD. There was a weak correlation between the diopter change at 1 week after operation and the change of ACA at 1 week after operation (P < 0.05), but there was no significant correlation between diopter change and ACA change on January after operation (P > 0.05). There was no significant correlation between diopter change and ACV change. There was no significant correlation between the diopter change and km change (P > 0.05). Conclusion: the refractive drift was observed in early patients after phacoemulsification. One day after operation, the refractive state was close to the target diopter, then the diopter drifted to myopia, and the myopia drift reduced at 1 month after cataract. The early refractive drift was closely related to the change of ACD.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R779.66

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