有晶体眼后房型人工晶体植入术前术后瞳孔直径的评估

发布时间：2018-06-29 20:02

本文选题：ICL + 瞳孔直径　；参考：《浙江大学》2012年硕士论文

【摘要】：[目的]评估有晶体眼后房型人工晶体(ICL)植入术对明视和暗视下瞳孔直径的影响。 [方法]采集2011年12月至2012年2月在浙江大学医学院附属第二医院眼科中心进行ICL植入术的所有病例共7例14眼。分别于术前3天和术后1月进行随访,利用波前像差仪测量明视下瞳孔直径和暗视下瞳孔直径,利用超生生物显微镜(UBM)测量前房深度、ICL与角膜的距离、ICL拱高和瞳孔直径,并分析各瞳孔直径指标与ICL拱高、年龄及ICL矫正的等效球镜度的相关性。数据采用SPSS18.0软件进行统计分析,P0.05认为差异存在统计学意义。 [结果]波前像差仪测量ICL术眼暗视下瞳孔直径术前3天为5.54±1.17mm(3,83~7.16mm),术后1月为5.20±0.97mm(3.17~5.99mm),两者差异为-0.35±0.59mm(-1.26~0.70mm),差异有统计学意义(t=2.226,P0.05)。明视下瞳孔直径术前3天为3.92±0.67mm(3.02-4.84mm),术后1月为4.37±0.99mm(2.73~5.5mm),两者差异为0.44±0.54mm(-0.29~1.71mm),差异有统计学意义(t=-3.083,P0.01)。明暗视瞳孔直径差异为暗视下的瞳孔直径与明视下的瞳孔直径的差值,术前3天为1.62±0.72mm(0.74-3.19mm),术后1月为0.82±0.34mm(0.22~1.29mm),两者差异为-0.80±0.86mm(-2.82~0.30mm),差异有统计学意义(t=3.46I,P0.01)。UBM测量ICL术眼术前3天瞳孔直径为3.43±0.79mm(2.15~4.63mm),术后1月瞳孔直径为3.66±1.03mm(1.66~4.69mm),两者差异为0.22±0.45mm(-0.51~1.19mm),差异无统计学意义(t=-1.881,P0.05)。UBM测量ICL术眼前房深度术前3天为3.05±0.22mm(2.78~3.43mm),术后1月前房深度为3.03±0.22mm(2.77~3.48mm),两者差异为-0.02±0.11mm(-0.210.18mm),差异无统计学意义(t=0.577,P0.05)。术后1月ICL拱高为0.44±0.28mm(0.03~0.92mm),ICL与角膜的距离为2.32±0.22mm(1.79~2.60mm)。波前像差仪测量ICL术眼明视下瞳孔直径术前术后变化、UBM测量ICL术眼瞳孔直径术前术后变化,与ICL拱高的相关性均存在统计学意义(P0.05)。波前像差仪测量ICL术眼暗视下瞳孔直径术前术后变化、明暗视瞳孔直径差异术前术后变化,与ICL拱高的相关性均无统计学意义(P0.05)。波前像差仪测量ICL术眼明视下瞳孔直径术前术后变化,与年龄的相关性均存在统计学意义(P0.05)。波前像差仪测量ICL术眼暗视下瞳孔直径术前术后变化、明暗视瞳孔直径差异术前术后变化及UBM测量ICL术眼瞳孔直径术前术后变化,与年龄的相关性均无统计学意义(P0.05)。波前像差仪测量ICL术眼暗视下瞳孔直径术前术后变化、明暗视瞳孔直径差异术前术后变化,与ICL矫正的等效球镜度的相关性均存在统计学意义(P0.01)。波前像差仪测量ICL术眼明视下瞳孔直径术前术后变化、UBM测量ICL术眼瞳孔直径术前术后变化,与ICL矫正的等效球镜度的相关性均无统计学意义(P0.05)。 [结论]本研究表明高度近视眼ICL植入术后1月较术前3天暗视下瞳孔直径减小,明视下瞳孔直径增大,明暗视瞳孔直径差异减小,提示ICL植入术限制虹膜肌肉的活动,而影响瞳孔的自然收缩状态。本研究进一步提示ICL术眼瞳孔自然收缩状态的改变与ICL拱高、患者年龄及手术矫正度数可能相关。
[Abstract]:[Objective] to evaluate the effect of implantation of posterior chamber intraocular lens (ICL) on the pupil diameter of the patients with open vision and dark vision.
[Methods] 7 cases of 14 eyes were collected from December 2011 to February 2012 at the ophthalmology center of the Second Affiliated Hospital of Zhejiang University medical college. They were followed up at 3 days before and after operation in January. The diameter of the pupil and the pupil diameter of the pupil were measured by the wavefront aberration instrument, and the previsual microscopes (UBM) were used to measure the diameter of the pupil. The depth of the room, the distance between ICL and the cornea, the height of ICL arch and the diameter of the pupil, and the correlation between the pupil diameter index and the ICL arch height, the age and the equivalent spherical mirror degree corrected by ICL. The data were statistically analyzed with the SPSS18.0 software, and P0.05 thought the difference was statistically significant.
[results] the wavefront aberration measurement was 5.54 + 1.17mm (3,83~7.16mm) 3 days before the operation of ICL eye pupil diameter, and 5.20 + 0.97mm (3.17~5.99mm) after operation in January. The difference was -0.35 + 0.59mm (-1.26~0.70mm). The difference was statistically significant (t=2.226, P0.05). 3.92 + 0.67mm (3.02-4.84mm) was 3 days before the operation of the pupil diameter under the open vision, and 4.37 + after the operation. 0.99mm (2.73~5.5mm), the difference was 0.44 + 0.54mm (-0.29~1.71mm), the difference was statistically significant (t=-3.083, P0.01). The difference between pupil diameter and pupil diameter under dark vision was 1.62 + 0.72mm (0.74-3.19mm) at the 3 day before operation, and 0.82 + 0.34mm (0.22~1.29mm) in January after operation, and the difference was -0.80 + 0.86mm. (-2.82~0.30mm), the difference was statistically significant (t=3.46I, P0.01).UBM in the 3 days of ICL surgery, the pupil diameter was 3.43 + 0.79mm (2.15~4.63mm), and the pupil diameter was 3.66 + 1.03mm (1.66~4.69mm) in January, and the difference was 0.22 + 0.45mm (-0.51~1.19mm). The difference was not statistically significant for 3 days before the anterior chamber depth of the surgery. For 3.05 + 0.22mm (2.78~3.43mm), the anterior chamber depth was 3.03 + 0.22mm (2.77~3.48mm) before January, and the difference was -0.02 + 0.11mm (-0.210.18mm). The difference was not statistically significant (t=0.577, P0.05). The height of the ICL arch in January was 0.44 + 0.28mm (0.03~0.92mm), and the distance between the cornea and the cornea was 2.32 +. The changes of pupil diameter before and after operation, UBM measured the changes of pupil diameter before operation in ICL, and the correlation with the height of ICL arch (P0.05). The wavefront aberration meter measured the changes of pupil diameter before operation in ICL eyes, and the difference between the pupil diameter and the diameter of the pupil before and after the operation, and the correlation with the height of ICL arch had no statistical significance (P 0.05. The wavefront aberration was used to measure the preoperative and postoperative changes in the visual pupil diameter of ICL, and the correlation with age was statistically significant (P0.05). The wavefront aberration was used to measure the changes in the pupil diameter of the eyes under the ICL operation, the difference of the pupil diameter before and after the operation, and the changes of the pupil diameter before and after the ICL operation by UBM. The correlation of age was not statistically significant (P0.05). The wavefront aberration was used to measure the changes in the pupil diameter of the eyes under the ICL operation, and the difference between the pupil diameter before and after the operation was statistically significant (P0.01). The wavefront aberration instrument was used to measure the preoperative visual pupil diameter of ICL. There was no significant difference in the pupil diameter before and after ICL operation and the corrected spherical equivalent of ICL corrected by UBM (P0.05).
[Conclusion] this study showed that the pupil diameter of the pupil decreased in January 3 days after the implantation of high myopia, the diameter of the pupil in the lower eye pupil increased and the difference of the pupil diameter of the light and shade decreased. It suggested that the ICL implantation limit the activity of the iris muscles and influence the natural contraction of the pupil. This study further hints that the pupil of the ICL eye is naturally contracted. The change of state may be related to ICL arch height, patient age and surgical correction degree.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R779.6

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