Phaco术后黄斑中心凹与视盘周围RNFL平均厚度变化的研究

发布时间：2018-04-27 01:05

本文选题：老年性白内障 + 白内障超声乳化吸除并人工晶体植入术　；参考：《大连医科大学》2012年硕士论文

【摘要】：目的：通过第四代光学相干断层扫描仪（Optical Coherence Tomography，OCT），对我院2011年1月至2011年7月间，，41例(41眼)行白内障超声乳化吸除术（Phacoemulsification，Phaco）的老年性白内障患者黄斑中心凹与视盘周围视网膜神经纤维层（Retinal erve fiber layer,RNFL）厚度进行测量，分析两者术后变化规律，探讨Phaco是否会引起眼底视神经损伤。方法：随机选取2011年1月至2011年7月间于大连医科大学附属二院眼科行白内障超声乳化吸除并人工晶体植入术的老年性白内障患者41例(41眼)。男21例(21眼)，女20例(20眼)。用OCT测量术前、术后1周、1个月、3个月、6个月的黄斑中心凹与视盘周围视网膜神经纤维层厚度的变化。结果：术后1个月的黄斑区平均厚度与术前相比增加有统计学意义；而术后1周、术后3个月、术后6个月，黄斑区平均厚度值分别与术前相比差异无统计学意义；术后1个月和3个月视盘周边部视网膜神经纤维层厚度增加有统计学意义；而术后1周、术后6个月视盘周边部视网膜神经纤维层厚度值与术前相比差异无统计学意义；术后1个月黄斑中心凹厚度均值最大，而术后3个月时视盘周围视网膜神经纤维层厚度最大。结论：老年性白内障患者行phaco术后1个月黄斑平均厚度增加，3个月后恢复至术前水平；术后1个月至3个月视盘周围平均RNFL厚度均增加，6个月后恢复至术前水平。说明phaco术后眼底视网膜虽有变化，但变化是短暂和可逆的。只要术前检查完善、操作手法熟练、术后治疗得当，phaco不会引起严重的眼底视网膜并发症。证实了phaco手术的安全性，为phaco手术的临床发展提供了理论依据。
[Abstract]:Objective: to perform phacoemulsification in 41 cases (41 eyes) of senile cataract patients with macular fovea and perioptic disc by the fourth generation optical coherence tomography (OCTT) in our hospital from January 2011 to July 2011. The thickness of Retinal erve fiber layerus was measured. To investigate whether Phaco can cause fundus optic nerve injury. Methods: 41 patients (41 eyes) with senile cataract underwent phacoemulsification and intraocular lens implantation from January 2011 to July 2011 in the second affiliated Hospital of Dalian Medical University. There were 21 eyes of male and 20 of female. The thickness of macular fovea and retinal nerve fiber layer around optic disc was measured by OCT before operation, 1 week, 1 month, 3 months and 6 months after operation. Results: the mean thickness of macular area increased significantly at 1 month after operation compared with that before operation, but there was no significant difference in mean thickness of macular area between 1 week, 3 months and 6 months after operation. The thickness of the retinal nerve fiber layer around the disc increased significantly 1 and 3 months after the operation, but there was no significant difference in the thickness of the retinal nerve fiber layer around the disc at 1 week and 6 months after the operation. The mean thickness of macular fovea was the highest at 1 month after operation, and the thickness of retinal nerve fiber layer around optic disc was the largest at 3 months after operation. Conclusion: the mean macular thickness increased 1 month after phaco and recovered to the preoperative level after 3 months, and the mean RNFL thickness around the optic disc increased from 1 month to 3 months after phaco, and recovered to the preoperative level after 6 months. The results showed that the changes of retinal fundus after phaco were transient and reversible. So long as the preoperative examination is perfect and the operation is skillful, the proper treatment of phaco after operation will not cause serious retinal complications. The safety of phaco surgery is confirmed, which provides a theoretical basis for the clinical development of phaco surgery.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R779.6

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