iTrace像差仪在Toric人工晶状体植入术中的应用

发布时间：2018-06-22 19:59

本文选题：iTrace像差仪 + Toric人工晶状体　；参考：《天津医科大学》2017年硕士论文

【摘要】：目的研究和评价:1、iTrace像差仪在白内障患者角膜曲率测量的重复稳定性及其与Lenstar900、IOL-Master测量结果的差异2、iTrace像差仪内置Toric计算器的准确性和设计理念。3、iTrace像差仪在Toric人工晶状体植入术后晶状体轴位测量中的应用价值。方法选择在2015年6月至2016年2月在我院接受超声乳化白内障吸出术联合Toric人工晶状体植入的白内障患者35例(45只眼)。1、所有患者在术前均进行iTrace像差仪、IOL-Master、Lenstar900角膜曲率(Ks、Kf、Km)的测量。分析iTrace像差仪在测量角膜曲率的重复稳定性并将结果和IOL-Master、Lenstar900所测结果分别进行配对t检验。2、将iTrace像差仪所测量的角膜曲率数据(瞳孔直径为3.0mm)分别代入iTrace计算器与Acry Sof Toric计算器进行计算,分析两者计算结果中角膜平面所需矫正散光值和角膜平面预期残余散光值的差异以及推荐Toric人工晶状体型号和植入轴位的差异。3、所有患者均在术后1周进行随访并进行iTrace像差仪的检查。用iTrace像差仪所测出的眼内像差散光轴位进行换算,计算出术后Toric人工晶状体轴位。将计算结果与传统裂隙灯法测得的Toric人工晶状体轴位做比较,分析两者的统计学差异及相关性。结果1、iTrace像差仪所测量的Ks、Kf、Km参数的组内相关系数(intraclass correlation coefficient,ICC)均大于0.9。iTrace像差仪所测量的Ks、Kf、Km分别为(44.82±1.43)、(43.97±1.31)、(44.41±1.30),分别与Lenstar 900、IOL-Master所测结果进行配对T检验,结果之间差异没有统计学意义。2.、Acry Sof Toric计算器与iTrace计算器计算得出角膜平面所需矫正的散光值分别为(2.03±0.63)D、(2.03±0.63)D,结果之间差异没有统计学意义(t=-1.431,P=0.160);术后角膜平面预期残留散光值为(0.24±0.11)D、(0.16±0.06)D,结果之间差异有统计学意义(t=4.14,P0.001)。Toric人工晶状体植入轴位分别为(87.89°±69.56°)、(87.93°±69.50°),结果之间差异没有统计学意义(t=-1.431,P=0.160)。17眼(38%)在两种Toric计算器所得出的推荐Toric人工晶状体型号之间存在差异。3、患者在术后1周时,裸眼视力与术后最佳矫正视力分别为(0.19±0.12)Log MAR和(0.10±0.09)Log MAR。42眼(93.3%)的裸眼视力≥20/40。iTrace法传统与裂隙灯法测得的晶状体轴位旋转分别为(4.44°±3.42°)、(3.13°±2.86°);两者比较有统计学差异(t=2.321,P=0.025)。两种方法测得的Toric人工晶状体轴位差值的绝对值为3.67°±3.59°(0~14°),其中32眼(71.1%)5°,9眼(20%)位于5至10°,4眼(8.9%)10°。两种方法测得的人工晶状体轴位直线相关性分析成线性正相关(r=0.926,P0.01)。结论1、iTrace像差仪在测量角膜曲率(Ks、Kf、Km)时,其测量重复稳定性较好,与临床常用的Lenstar900、IOL-Master相比较结果差异没有统计学意义。数值可以用于代入Toric人工晶状体型号和植入轴位的计算。2、iTrace像差仪内置的Toric计算器计算准确,与Acry Sof Toric计算器相比偏好于患者术后获得最小预期残留散光值,不考虑术前术后散光类型的变化。3、运用iTrace像差仪可以在不散瞳的情况下准确测量Toric人工晶状体的轴位,其结果具有一定的参考价值及临床应用价值。
[Abstract]:Objective study and evaluation: 1, the repeatability of corneal curvature measurement in cataract patients and the difference between iTrace and Lenstar900, IOL-Master measurement results 2, the accuracy and design concept of Toric calculator built in iTrace aberration instrument,.3, the application price of iTrace aberration instrument in the axial measurement of lens after Toric artificial crystal implantation Methods 35 cases (45 eyes) of.1 were selected from June 2015 to February 2016 in our hospital with phacoemulsification combined with Toric intraocular lens implantation. All patients were measured by iTrace aberration, IOL-Master, Lenstar900 corneal curvature (Ks, Kf, Km) before operation. Analysis of the corneal curvature by the iTrace aberration meter. The results were paired with the results of the paired t test and the results measured by IOL-Master and Lenstar900 respectively. The corneal curvature data (the pupil diameter of the pupil) measured by the iTrace aberration meter was replaced by the iTrace calculator and the Acry Sof Toric calculator respectively. The corrected astigmatism and cornea needed for the corneal plane were analyzed. The difference in plane expected residual astigmatism and the difference between the recommended Toric IOL model and the difference in the axial position of the implant were.3. All patients were followed up at 1 weeks after the operation and examined by the iTrace aberration instrument. The axial position of the intraocular aberration of the intraocular aberration measured by the iTrace aberration instrument was converted to calculate the axial position of the Toric intraocular lens after the operation. The results were calculated. The statistical difference and correlation between the two Toric IOL axes measured by the traditional slit lamp method were compared. Results 1, the intra group correlation coefficient (intraclass correlation coefficient, ICC) measured by the iTrace aberration meter (intraclass correlation coefficient, ICC) was greater than the Ks of the 0.9.iTrace aberration meter, and (44.82 + 1.43), respectively, (43.97 + 1). .31), (44.41 + 1.30), paired T test with Lenstar 900 and IOL-Master respectively, the difference between the results was not statistically significant.2., Acry Sof Toric calculator and iTrace calculator calculated that the corrected astigmatism required by the corneal plane was (2.03 + 0.63) D, (2.03 + 0.63) D, and there was no significant difference between the results (t=-1.431). The expected residual astigmatism of corneal plane after operation was (0.24 + 0.11) D, (0.16 + 0.06) D, and the difference between the results was statistically significant (t=4.14, P0.001).Toric IOL implantation axis was (87.89 + 69.56 degrees) and (87.93 [87.93] 69.50 degrees), and there was no statistical significance (t=-1.431, P=0.160).17 eye (38%) in two Toric calculations. There was a difference between the recommended Toric IOL models and.3. At 1 weeks after the operation, the patients' visual acuity and the best corrected visual acuity were (0.19 + 0.12) Log MAR and (0.10 + 0.09) Log MAR.42 eyes (93.3%) of the naked eye vision > 20/40.iTrace method and the gap light method, respectively (4.44? 3.42). There was a statistical difference (t=2.321, P=0.025). The absolute value of the axial difference of the Toric intraocular lens measured by the two methods was 3.67 [3.67] 3.59 degrees (0~14 degrees), of which 32 eyes (71.1%) 5, 9 eyes (20%) located in 5 to 10 degrees and 4 eyes (8.9%). Conclusion (r=0.926, P0.01). Conclusion 1, when measuring the corneal curvature (Ks, Kf, Km), the measurement repeatability of the iTrace aberration meter is better. There is no statistical difference compared with the commonly used Lenstar900, IOL-Master. The numerical value can be used to replace the Toric artificial crystal model and the calculation.2 for the implantation axis, and the Toric meter built in the iTrace aberration meter. The calculator is accurate. Compared with the Acry Sof Toric calculator, the minimum expected residual astigmatism is obtained after the operation, and the change of astigmatism is not considered before the operation. The iTrace aberration meter can be used to accurately measure the axis of the Toric IOL in the absence of mydriasis. The results have a certain reference value and clinical application price. Value.
【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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