有晶体眼后房型环曲面人工晶状体植入术矫正高度近视合并散光的临床观察

发布时间：2018-03-05 06:26

本文选题：散光　切入点：近视　出处：《浙江大学》2012年硕士论文　论文类型：学位论文

【摘要】：目的：评价有晶体眼后房型环曲面人工晶状体植入术矫正高度近视合并散光的有效性、安全性及稳定性。方法：观察2010年3月至2011年12月于浙江大学医学院附属第二医院眼科中心行有晶体眼后房型环曲面人工晶状体(Toric implantable collamer lens, TICL)植入术的高度近视合并散光患者8例(15只眼),术前平均近视度数为(-13.72±2.71)D,平均散光度数为(-3.15±1.08)D。术后1天、1周、1月、3月进行随访,随访内容包括裸眼视力、最佳矫正视力、球镜度数、散光度数、裂隙灯显微镜检查、眼底检查、眼压、角膜内皮细胞计数、中央角膜厚度、拱高、TICL轴向旋转情况。结果：全部8例(15只眼)TICL植入均一次成功。术后3月,术眼球镜度数由术前(-13.72±2.71)D降低至(-0.37±0.88)D(P0.01),散光度数由(-3.15±1.08)D矫正至(-0.57±0.45)D(P0.01),具有统计学意义。术眼裸眼视力由术前3.48±0.10(5-logMAR)提高到术后4.84±0.14(5-logMAR),最佳矫正视力由术前4.84±0.14(5-logMAR)提高到术后4.95±0.10(5-logMAR)(P0.05),有统计学意义。术后3月观察TICL散光轴向,平均旋转度数绝对值为(3.4±1.5)°。术后3个月随访眼压、角膜内皮细胞计数、中央角膜厚度与术前相比均无明显变化(P0.05)。1眼(6.7%)术后1天眼压一过性升高,2眼(13.3%)术后发生夜间眩光,1眼(6.7%)术后3月随访时见自身晶状体前囊下轻度混浊。所有术眼随访期间均未发现瞳孔阻滞、色素播散性青光眼、眼内炎等术后并发症。结论：有晶体眼后房型环曲面人工晶状体植入术矫正高度近视合并散光在随访期内具有有效性、安全性及稳定性。远期效果需进一步观察。
[Abstract]:Objective:. To evaluate the efficacy, safety and stability of posterior chamber curved intraocular lens implantation (IOL) for correction of high myopia with astigmatism. Methods:. To observe 8 patients with high myopia complicated with astigmatism treated with posterior chamber implantable collamer lens implantation from March 2010 to December 2011 in the ophthalmology center of the second affiliated Hospital of Zhejiang University Medical College. The mean preoperative myopia and astigmatism were -13.72 卤2.71d and -3.15 卤1.08d respectively. The follow-up included naked visual acuity, best corrected visual acuity, spherical degree, astigmatism, slit lamp microscopy, fundus examination, intraocular pressure, corneal endothelial cell count, central corneal thickness, arch height and axial rotation of TICL. Results:. TICL implantation was successful in all 8 cases with 15 eyes. On March, TICL was implanted successfully in all eyes. The degree of ophthalmoscopy decreased from -13.72 卤2.71D before operation to -0.37 卤0.88D, and astigmatism was corrected from -3.15 卤1.08D to -0.57 卤0.45g / g P 0.01.The naked visual acuity increased from 3.48 卤0.105logMARbefore operation to 4.84 卤0.145logMARL, and the best corrected visual acuity increased from 4.84 卤0.145logMARbefore operation to 4.95 卤0.105-MARP0.05L after operation. TICL astigmatism axis was observed on March, The mean degree of rotation was 3.4 卤1.5 掳. The intraocular pressure (IOP) and corneal endothelial cell count were observed 3 months after operation. There was no significant change in the thickness of central cornea between before and after operation (P 0.05% or 6.7%) IOP was temporarily elevated in 2 eyes (13.3%) 1 day after operation. (1 eye had nocturnal glare and 6.7%) on March, mild opacification under anterior lens capsule was observed. All eyes were treated with subcapsular opacification. No pupillary block was found during follow-up. Pigment disseminated glaucoma, endophthalmitis and other postoperative complications. Conclusion:. The correction of high myopia combined with astigmatism with posterior chamber curved intraocular lens implantation is effective, safe and stable during the follow-up period.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R779.6

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