高度近视白内障患者预留-3D术后早期视力及屈光状态的临床观察

发布时间：2018-04-11 03:24

本文选题：高度近视 + 白内障手术　；参考：《天津医科大学》2017年硕士论文

【摘要】：目的探讨高度近视白内障患者行超声乳化吸除联合人工晶状体(Intraocular lens,IOL)植入术预留-3D术后早期视力及屈光状态的变化。方法本研究为前瞻性病例对照研究,连续收集2016年10月至2017年1月期间在天津市眼科医院接受白内障超声乳化吸除联合IOL植入术的高度近视白内障患者21例(31只眼),除外合并有角膜病、青光眼、视网膜脱离、糖尿病性视网膜病变等疾病者。术后随访1月,对比术前与术后1天,术后1天、1周、1个月的裸眼视力(Uncorrected Visual Acuity,UCVA)、最佳矫正视力(Best Corrected Visual Acuity,BCVA)、最佳阅读近视力(Best Reading Near Visual Acuity,BRNVA)、眼轴(Axial Length,AL)、平均角膜曲率(Average Corneal Curvature,K)、角膜散光(Corneal Astigmatism,CA)、前房深度(Anterior Chamber Depth,ACD)、等效球镜屈光度数(Spherical Equivalent,SE)、球镜及柱镜度数的变化。1.术后基本情况:所有患者术眼术后IOL均位于囊袋内,无偏心及移位,连续环形撕囊口居中,无青光眼、后发性白内障(Posterior capsular opacification,PCO)、角膜失代偿、视网膜脱离等并发症发生。2.UCVA:患者术后1天较术前提高,差异有统计学意义(Z=-4.379,P0.01);术后1天、1周和1个月UCVA保持稳定状态,无明显差异(Z1=-0.458,P10.05;Z2=-0.142,P20.05;Z3=-0.975,P30.05)。3.BCVA:术后1月较术前明显提高,差异有统计学意义(Z=-3.829,P0.01),在术后随访1周和1个月的BCVA均保持稳定状态,无明显变化(Z=-0.53,P0.05)。4.BRNVA:术后1周和1个月的BRNVA较术后1天提高,差异有明显统计学意义(Z1=-2.670,Pl0.01;Z2=-2.694,P20.01),术后1周和1个月的BRNVA保持稳定状态,无明显差异(Z=-1.558,P0.05)。5.AL:患者术后1天AL与术前比较,无显著性差异(t=-0.352,P0.05);术后1天、1周和1个月AL保持稳定状态,无明显差异(t1=-1.196,P10.05;t2=-0.212,P20.05;t3=0.645,P30.05)。6.K:患者术后1天与术前比较,无显著性差异(t=2.19,P0.05);术后1天、1周和1个月的K值保持稳定状态,无明显差异(t1=0.88,P10.05;t2=0.995,P20.05;t3=0.484,P30.05)。7.CA:患者术后1天与术前比较无显著性差异(Z=-0.889,P0.05);术后1天、1周和1个月CA维持稳定状态,无明显差异(Z1=-0.7,P10.05;Z2=-1.156,P20.05;Z3=-0.065,P30.05)。8.ACD:患者术后1天、1周和1个月ACD无显著差异(t1=0.143,P10.05;t2=1.329,P20.05;t3=1.651,P30.05)。9.SE:患者术后1天、1周和1个月SE无显著差异(t1=1.582,P10.05;t2=1.503,P20.05;t3=0,P30.05)。10.球镜度数:患者术后1天、1周和1个月球镜度数无显著差异(t1=0.526,P10.05;t2=0.157,P20.05;t3=-0.629,P30.05)。11.柱镜度数:患者术后1天与术前比较,无显著差异(Z=-0.271,P0.05);患者术后1天、1周和1个月柱镜度数无显著差异(Z1=-0.933,P10.05;Z2=-1.273,P20.05;Z3=-1.243,P30.05)。结论1.高度近视白内障患者手术预留-3D术后早期屈光状态基本稳定;2.高度近视白内障患者手术预留-3D术后早期UCVA基本稳定;3.高度近视白内障患者手术预留-3D术后BRNVA有提高趋势。
[Abstract]:Objective to investigate the changes of early visual acuity and refractive state in patients with high myopia cataract after phacoemulsification combined with intraocular lens implantation (IOL).Methods this study was a prospective case-control study.From October 2016 to January 2017, 21 patients with high myopia cataract underwent phacoemulsification combined with IOL implantation in Tianjin Eye Hospital, with the exception of corneal diseases, glaucoma and retinal detachment.Diabetic retinopathy and other diseases.All patients were followed up for 1 month, compared with 1 day before and 1 day after operation.The changes of spherical Evalentate, spherical and Cylindrical degrees.After operation, IOL was located in the pouch without eccentricity and displacement, continuous circular capsulorhexis in the middle, no glaucoma, posterior capsular opacification, corneal decompensation.The difference was statistically significant (P 0.01). The BCVA remained stable at 1 week and 1 month after operation, and there was no significant change in BRNVA. The BRNVA of 1 week and 1 month after operation was higher than that of 1 day after operation.There was no significant difference between the two groups. There was no significant difference between the two groups. The K values of the patients remained stable at 1 week and 1 month after operation, and there was no significant difference between the two groups on the first day after operation, and the K values at 1 week and 1 month after operation remained stable, and there was no significant difference between the patients and the patients before operation on the first day after the operation, and there was no significant difference between the patients and the patients before the operation on the first day after the operation, and the K values remained stable at 1 week and 1 month after the operation.The degree of spherical endoscopy: there was no significant difference in the degree between 1 week after operation and 1 day after operation. There was no significant difference in the degree between the first week and the first day after operation. There was no significant difference in the degree between the two groups (P 10.05 t _ (2)) 0.157 (P 20.05) t _ (3) ~ (-0.629) (P _ 30.05) 路11.Conclusion 1.The early refractive state of patients with high myopia cataract after operation reservation-3 D operation is basically stable.Early UCVA was stable in patients with high myopia cataract.The BRNVA of high myopia cataract patients after-3 D operation has a tendency to increase.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R779.66

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