Bigbag与209M人工晶体植入高度近视白内障眼的比较观察

发布时间：2018-06-27 16:07

本文选题：Bigbag人工晶状体 + 高度近视　；参考：《皖南医学院》2017年硕士论文

【摘要】：目的:高度近视白内障患者行超声乳化联合人工晶状体植入手术,对比观察术眼植入高度近视专用蔡司Bigbag人工晶状体及常规蔡司209M折叠人工晶状体后,手术前后的视力中轴区后囊膜到视网膜的距离以及术后晶状体后囊膜混浊视网膜脱离黄斑囊样水肿等术后并发症发生情况。研究探讨应用蔡司Bigbag人工晶状体对高度近视白内障患者是否安全有效,及其在同类常规人工晶状体中的优越性。方法:本文选取2014年1月至2016年1月,于医院眼科接受超声乳化联合人工晶状体植入手术治疗的高度近视白内障患者,年龄47岁~65岁,共20例(26眼),每组10例13眼,患眼眼轴长度均≥27mm,A组植入蔡司Bigbag人工晶状体;B组植入蔡司209M折叠人工晶状体。回顾性分析两组术后6个月的随访资料。比较分析两组术前和随访时视力、中轴区后囊膜到视网膜的距离,观察术后并发症(包括晶状体后囊膜混浊、视网膜脱离黄斑囊样水肿)的发生情况,对两组患者进行术后满意度调查。对检查结果用SPSS19.0统计软件进行分析。结果:1.术后视力:两组20例26眼患眼均成功植入人工晶状体,术后视力均提高≥2行。2.并发症:术后早期部分患者出现不同程度的角膜水肿,术后一周均恢复透明;术后晚期(随访6个月时),○1视网膜脱离发生情况比较:两组术眼均无视网膜脱离发生;○2后囊膜混浊比较:A组术眼发生后囊膜混浊0眼,B组术眼发生后囊膜混浊数为2眼。两组术后后囊膜混浊发生率无明显差异(P=0.48,P0.05)。3.中轴区晶状体后囊膜与视网膜距离变化:A组:术前为22.5585±1.97742,术后为24.0808±1.92194,手术前后差值为1.5223±0.16192;B组:术前为20.0438±0.98495,术后为21.7631±0.98577,手术前后差值为1.7192±0.03451。两组手术前后中轴区晶状体后囊膜与视网膜距离差变化有明显差异(P=0.001,P0.05)。4.满意度调查:两组植入人工晶状体的患者在视力提高术后舒适感等方面无明显差异,但A组植入Bigbag人工晶状体对预防患者夜间发生眩光现象明显优于B组(P=0.039,P0.05)。结论:与209M折叠人工晶状体相比,Bigbag人工晶状体进一步缩短了手术前后中轴区晶状体后囊膜与视网膜距离差,更加接近生理性晶状体位置,对眼内环境改变更小,更好地防止后方玻璃体前涌,减少玻璃体后运动的幅度,从而能更好地预防高度近视患者术后视网膜脱离等眼底病的发生;能更好地降低超声乳化摘除白内障摘除术后晶状体后囊膜皱褶的发生率;此外,Bigbag人工晶状体术后眩光的发生率明显减小。同时,因其负屈光度拥有更广的范围,也能较好地降低术后高度近视患者的近视屈光度残留问题,对患者术后视力的提高有较为明显的疗效。因此,Bigbag人工晶状体较常规209M人工晶状体更适合高度近视白内障患者使用。总之,Bigbag人工晶状体及209M折叠人工晶状体在治疗高度近视白内障患者的临床应用中都是安全有效的。与常规蔡司209M折叠人工晶状体相比,患者对植入Bigbag人工晶状体的术后疗效更为满意。
[Abstract]:Objective: phacoemulsification combined with intraocular lens implantation for high myopia cataract patients, the visual acuity before and after the operation of high myopia special Bigbag intraocular lens and conventional Zeiss 209M foldable intraocular lens, the distance between the posterior capsule to the optic membrane and the posterior capsular opacification of the lens and the posterior capsular opacification of the lens after operation are compared. Postoperative complications such as retinal detachment? Macular cystoid edema and other postoperative complications. The study and discussion of the safety of the use of Zeiss Bigbag intraocular lens for high myopia cataract patients and their advantages in similar conventional intraocular lenses. Methods: This article was selected from January 2014 to January 2016 in the Department of ophthalmology to receive phacoemulsification. The patients with high myopia and cataract were treated with lens implantation, 47 years old ~65 years old, 20 cases (26 eyes), 10 cases in each group, 13 eyes, the axial length of the eyes were more than 27mm, group A was implanted with Zeiss Bigbag intraocular lens, and group B was implanted with Zeiss 209M foldable intraocular lens. The follow-up data of the two groups after 6 months were analyzed retrospectively. Comparison and analysis of the two groups before and after the operation were compared and analyzed. Visual acuity, the distance from the posterior capsule to the retina in the middle axis, the postoperative complications (including posterior capsule opacification, retinal detachment and macular edema) were observed, and the postoperative satisfaction of the two groups was investigated. The results were analyzed with SPSS19.0 software. Results: 1. postoperative visual acuity: two groups and 26 eyes in 20 eyes. After implantation of intraocular lens successfully, the postoperative visual acuity improved more than 2 lines of.2. complications: the early part of the patients had different degrees of corneal edema after the operation, and the postoperative recovery was transparent. After the operation (6 months of follow-up), the retinal detachment occurred in the two groups, no retinal detachment occurred, and the posterior capsule opacification was compared in the two group: group A surgery. Posterior capsular opacity in 0 eyes, in group B, the number of posterior capsule opacities was 2 eyes. There was no significant difference in the incidence of posterior capsule opacities in the two groups (P=0.48, P0.05) of posterior capsule and retinal distance in the axial region of.3.: group A: 22.5585 + 1.97742 before operation, 24.0808 + 1.92194 after operation, and 1.5223 + 0.16192 before and after operation; group B: preoperative 20.0438 + 0.98495, after operation was 21.7631 + 0.98577. The difference between the posterior capsule of the middle axis and the retinal distance difference before and after operation before and after operation was 1.7192 + 0.03451. two (P=0.001, P0.05).4. satisfaction survey: the two groups of intraocular lenses were improved in visual strength and there was no significant difference in postoperative comfort, but A Group implantation of Bigbag intraocular lens was better than group B (P=0.039, P0.05) in the prevention of nocturnal glare. Conclusion: compared with 209M foldable intraocular lens, Bigbag intraocular lens can further shorten the distance between the posterior capsule and the retina in the middle axis of the middle axis before and after the operation, which is closer to the position of the physiological lens, and changes the intraocular environment to the intraocular environment. Small changes, better prevention of anterior vitreous surges, reducing the amplitude of posterior vitreous movement, so as to better prevent retinal detachment in patients with high myopia, and to better reduce the incidence of posterior capsule folds after phacoemulsification and cataract extraction; in addition, after the Bigbag intraocular lens (IOL) surgery vertigo. The incidence of light is obviously reduced. At the same time, because of the wider range of the negative refraction, it can also reduce the myopia diopter residue in the patients with high myopia after operation, and it has a more obvious effect on the improvement of visual acuity after the operation. Therefore, Bigbag IOL is more suitable for the patients with high myopia and cataract than the conventional 209M IOL In conclusion, the Bigbag and 209M foldable intraocular lenses are safe and effective in the treatment of patients with high myopia and cataract. Compared with the conventional Zeiss 209M foldable intraocular lens, the patients are more satisfied with the postoperative effect of the implantation of the Bigbag intraocular lens.
【学位授予单位】：皖南医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R779.66

【参考文献】