两种非球面人工晶体有效晶体位置变化的临床观察研究

发布时间：2018-06-12 21:24

  本文选题：人工晶状体 + 屈光度　； 参考：《昆明医科大学》2017年硕士论文

【摘要】：[目的]通过白内障超声乳化吸除术联合人工晶体(Intraocular lens,IOL)植入术,观察术前术后患者前房深度(Anterior chamber depth,ACD)变化间接了解Zeiss603P和AMOZA90003非球面人工晶状体在眼内有效人工晶体位置(effective lens position,ELP)的变化规律,为临床个性化选择两种IOL屈光度提供参考。[方法]选取就诊于我科的年龄相关性白内障患者60例(75眼),随机分为两组:A组40例(54眼)植入一片式三襻型ZEISS 603P非球面IOL;B组20例(21眼)植入三片式AMOZA9003非球面IOL。术前使用IOL master测量眼轴长度(axial length,AL)、角膜曲率及前房深度,所有患者均使用SRK-T公式、Haigis公式计算预测的IOL度数,术后1天、7天、1月、3月验光测量最佳矫正视力(best corrected visual acuity,BCVA)、屈光度,使用前节光学相干断层扫描技术(optical coherence tomography,OCT)测量 ACD,比较两种 IOL 术前、术后1天、7天、1月、3月ACD的差异,比较SRK-T公式及Haigis公式预测屈光度与术后实际屈光度的差异,分析两种不同类型IOL在不同AL长度和不同IOL度数时ACD的变化规律。[结果]1.术后ACD的变化:Zeiss603P植入术后ACD深度在第1周内随时间的推移有逐渐加深的趋势(p0.05),1周后至3个月ACD基本处于稳定状态(p0.05);AMOZA9003植入术后ACD深度在三个月内处于稳定状态(p0.05)。2.屈光误差:Zeiss603P及AMOZA9003两组术前预测屈光度与术后屈光度结果显示两者预测屈光度与实际值符合(p0.05)。3.晶体度数与ACD的关系:实验通过分析IOL度数和相应ACD变化观察到,Zeiss603P 组中,当 IOL 为 18≤P21D、21 ≤P24D 及 P≥24D 时,ACD 随时间加深(p0.05);术后3月时P≥24D组较其他三组ACD值更大,与其余三组差异有统计学意义(P0.05);植入AMOZA9003时术后四个时间点的ACD无变化(p0.05)。4.眼轴与ACD的关系:Zeiss603P组,当22≤AL24mm,ACD随时间加深(P0.05),术后3月时,22≤AL23mm组ACD变化明显大于23≤AL24mm组,差异有统计学意义(P0.05)。AMOZA9003组术后四个时间点的ACD处于稳定状态(p0.05)。5.公式预测屈光度的准确性:术后3月实际屈光状态与Haigis公式和SRK-T公式预测的屈光结果相符合(p0.05)。[结论]1.ZEISS603P和AMOZA9003植入术后三个月ACD稳定,术后屈光度与预测值一致。2.术眼屈光度受ACD变化的影响,ZEISS603P组在术后一周内IOL后移,光学面贴向后囊膜,伴随近视漂移,一周后ACD变化稳定。3.ZEISS603P使用的IOL度数越大越容易产生后移,度数越小ACD变化越小。4.ZEISS603P在短眼轴时较正常眼轴更易产生后移。5.AMOZA9003术后ACD变化不受IOL度数大小及眼轴长短的影响。6.Haigis公式和SRK-T公式在预测IOL度数方面未体现出差异,均能准确预测术后屈光度。
[Abstract]:[objective] to investigate the application of phacoemulsification combined with intraocular lens implantation (IOL). To observe the changes of anterior chamber depth (chamber) in patients with intraocular lens (IOL) before and after operation, and to understand indirectly the change rule of Zeiss603P and AMOZA90003 aspherical intraocular lens (AMOZA90003) in the position of effective intraocular lens (IOL) and to provide reference for clinical individualized selection of two IOLs. [methods] Sixty patients (75 eyes) with age-related cataract in our department were randomly divided into two groups: group A (n = 40, n = 54) and group B (n = 20, n = 20) with AMOZA9003 aspheric IOL. The axial length, corneal curvature and anterior chamber depth were measured by master before operation. All patients were calculated with SRK-T formula and Haigis formula. The best corrected visual acuity (BCV) was measured in 1 day, 7 days, 1 month and 3 months after operation, and the diopter was used to measure the best corrected visual acuity. The optical coherence tomography (Oct) technique was used to measure ACD. The difference of ACD between the two kinds of IOLs was compared before operation, 1 day, 1 day and 3 months after operation. The difference between the predicted diopter of SRK-T formula and Haigis formula was compared with the actual diopter after operation. The changes of ACD in two different types of IOLs with different AL lengths and degrees of IOL were analyzed. [result] 1. The changes of ACD after the implantation of: Zeiss603P showed that the depth of ACD gradually deepened with the passage of time in the first week. After 1 week to 3 months, the ACD was in a stable state (p0.05 / AMOZA9003) and the depth of ACD was in a stable state within three months. Refractive error: Zeiss603P and AMOZA9003. The results of preoperative and postoperative diopter showed that the predicted diopter and the actual value were in agreement with that of P0.05. 3. The relationship between crystal degree and ACD: in the Zeiss603P group, when the IOL was 18 鈮，

本文编号：2011136