非球面与球面人工晶体的临床应用研究
发布时间：2018-07-16 19:31
【摘要】：目的 对比研究白内障超声乳化吸出分别植入德国人类光学MCX11ASP非球面人工晶体与AS球面人工晶体术后裸眼视力、最佳矫正视力、对比敏感度与像差的差异。 方法 1、采用前瞻性临床对照研究。连续选取2011年6月——2011年12月在我院确诊的年龄相关性白内障患者并进行常规白内障术前检查(例如裂隙灯显微镜眼前节检查、眼底检查、(A、B)超、角膜曲率、眼压、电生理等),术前排除角膜病变、青光眼、葡萄膜炎、晶状体半脱位、视网膜疾病、中高度近视。术前按照患者意愿分成两组。A组植入德国人类光学MCX11ASP非球面人工晶体；B组植入AS球面人工晶体。 2、术后筛选标准：术后门诊随访患者,进行眼科常规检查,无裂隙灯显微镜下可见的角膜病理改变,虹膜无萎缩、无色素脱落,瞳孔直接、间接对光反射正常,人工晶体位于囊袋内,居中,无明显倾斜,人工晶体表面无明显色素沉着,无混浊,无表面损伤裂隙,后囊膜无混浊,玻璃体及视网膜无病理性改变。 3、A、B两组分别用普通视力表测量裸眼视力、最佳矫正视力。术后三个月Talcagi-CGT-1000自动眩光对比敏感度检查仪进行非眩光及眩光对比敏感度检查,Nidek验光仪检查屈光状态,用OPD-Scan波前像差仪检查两组术后三个月的像差。 4、统计学方法采用SPSS13.0软件包,对两组测量结果行T检验与X2检验。 结果 1、术后一周所有研究对象进行各项检查。术后随访一月时3例患者(4眼)因外出失访,其中A组2例(3眼),B组1例(1眼)。术后随访三个月时5例患者(7眼)因外出失访,其中A组2例(3眼),B组3例(4眼)。共入选78例(96眼),A组30例(36眼),B组48例(60眼)。 2、两组患者术中植入人工晶体平均度数分别为A组21.23±2.16(D)；B组21.97±2.24(D),两组差异无统计学意义(t=1.692,P＝0.0936)。其中6例患者(6眼)人工晶体轻度偏位,偏中心≤0.25mm,A组2例(2眼),B组4例(4眼)。术后三个月两组离焦度数A组-0.1875±0.5806D(-1.25D～0.75D),B组-0.1258±0.6159D(-1.25D～1.25D),两组差异无统计学意义(t＝0.000,P=1.000)。散光度数A组0.5486±0.3526D(0～1.25D),B组0.5333±0.3459D(1～1.25D),两组差异无统计学意义(t＝0.2083,P＝0.8354)。 3、术后一周两组患者裸眼视力分别为A组0.35±0.16；B组0.31±0.18,两组差异无统计学意义(t＝1.1715,P＝0.2440)。术后一个月两组患者裸眼视力分别为A组0.43±0.20；B组0.38±0.25,两组差异无统计学意义(t=1.0589,P＝0.2922)术后三个月两组患者裸眼视力分别为A组0.58±0.18；B组为0.54±0.17,两组差异无统计学意义(t=1.0918,P=0.2777)。术后三个月最佳矫正视力A组为0.91±0.12；B组为0.88±0.11,两组差异无统计学意义(t=1.2502,P=0.2143)。测得瞳孔大小A组3.49±0.53(mm)；B组3.48±0.53(mm),两组差异无统计学意义(t=0.0895,P=0.9289)。 4、术后三个月两组分别在非眩光与眩光条件下,在6.3°、4°、2.5°、1.6°、1°、0.7°视角测量对比敏感度。两组比较在6.3°视角(低频段)有显著性差异(P0.01),A组优于B组。 5、术后三个月测量瞳孔3～4mm时A组球差为0.003±0.015μm,慧差为0.032±0.038μm。B组球差为0.004±0.01μm,慧差为0.040±0.025μm。两组之间的差异无统计学意义(t1=0.3554,P1=0.6961；t2=1.1254,P2=0.2165)。瞳孔5.0mm时测得A组球差为0.050±0.046μm,慧差为0.150±0.09μm。B组球差为0.120±0.095μm,慧差为0.202±0.129μm。两组之间的差异有统计学意义(t1=4.8398,P1=0.001：t2=2.0993,P2=0.0385)。 结论 1、德国人类光学MCX11ASP非球面人工晶体眼术后三个月裸眼视力及最佳矫正视力相比AS球面人工晶体眼无显著性差异。 2、在6.3°视角(低空间频率)下MCX11ASP非球面人工晶体组的对比敏感度优于AS球面人工晶体组。 3、在瞳孔直径为5.0mmm时,MCX11ASP非球面人工晶体相比AS球面人工晶体能够显著减少白内障术后总像差,提高白内障患者术后的视觉质量。
[Abstract]:objective
The visual acuity, the best corrected visual acuity, and the difference of contrast sensitivity and aberration were compared between the cataract phacoemulsification and the MCX11ASP aspheric intraocular lens and the AS spherical intraocular lens.
Method
1, a prospective clinical control study was carried out in a continuous selection of patients with age-related cataract in June 2011 - December 2011 in our hospital and performed routine cataract surgery (such as slit lamp microscope examination, fundus examination, A, B), corneal curvature, intraocular pressure, electrophysiology, etc., and preoperative removal of corneal lesions, glaucoma, and grapes Meningitis, subluxation of lens, retina disease, middle high myopia. Before operation, two groups of.A groups were implanted in the German human optical MCX11ASP aspheric intraocular lens, and the B group was implanted with AS spherical intraocular lens.
2, postoperative screening criteria: follow up patients after surgery, routine examination of Ophthalmology, corneal pathological changes without slit lamp microscope, no atrophy of the iris, no pigmentation, direct pupil and indirect reflection of light, the intraocular lens is located in the bag, in the middle, no obvious tilt, no apparent pigmentation, no cloudy surface of the artificial lens surface, no cloudy, no cloudy. The surface was damaged, the posterior capsule was cloudy, and there was no pathological change in vitreous and retina.
3, A, and B two groups were used to measure the visual acuity of the naked eye with the normal visual acuity, and the best corrected visual acuity. Three months after the operation, the Talcagi-CGT-1000 automatic glare contrast sensitivity test was used for the non glare and glare contrast sensitivity examination, the Nidek optometry was used to check the refractive state, and the aberration of the three months after the operation was examined by the OPD-Scan wavefront aberrometry.
4, the SPSS13.0 software package was used for statistical analysis, and T test and X2 test were used for the two groups of measurement results.
Result
1, all the subjects were examined one week after the operation. 3 patients (4 eyes) were out of visit one month after the operation, including 2 cases (3 eyes) in group A and 1 cases (1 eyes) in group B. 5 cases (7 eyes) were out of visit in 5 cases (7 eyes) and B group 3 cases (4 eyes) at three months after operation.
2, in group two, the average degree of intraocular lens implantation was 21.23 + 2.16 (D) in group A and 21.97 + 2.24 (D) in group B. There was no significant difference between the two groups (t=1.692, P = 0.0936). Among them, 6 patients (6 eyes) were slightly biased, partial center was less than 0.25mm, A group 2 (2 eyes), B group 4 cases (4 eyes). (-1.25D to 0.75D), group B -0.1258 + 0.6159D (-1.25D ~ 1.25D), the difference between the two groups was not statistically significant (t = 0, P=1.000). The degree of astigmatism in the A group was 0.5486 + 0.3526D (0 ~ 1.25D), and the group was 0.5333 + (1 to 1). The two groups had no statistical significance (0.2083, 0.8354 = 0.8354).
3, one week after the operation, the visual acuity of the two groups was 0.35 + 0.16 in group A, and in group B 0.31 + 0.18. There was no statistically significant difference between the two groups (t = 1.1715, P = 0.2440). The visual acuity was 0.58 + 0.18 in group A and 0.54 + 0.17 in group B (t=1.0918, P=0.2777). The best corrected visual acuity in group A in three months after operation was 0.91 + 0.12, group B was 0.88 + 0.11, and group two was not statistically significant (t=1.2502, P=0.2143). The pupil size A group 3.49 + 0.53 (mm), B group (mm) T=0.0895, P=0.9289.
4, in the three months after the operation, the two groups were measured in 6.3, 4, 2.5, 1.6, 1, and 0.7, respectively, under the condition of non glare and glare, and the two groups were significantly different in the 6.3 angle (P0.01), and the group A was better than the B group.
5, when the pupil was measured from 3 to 4mm three months after the operation, the spherical aberration of group A was 0.003 + 0.015 mu m, the difference was 0.004 + 0.01 u m, and the difference was 0.040 + 0.025 M. between two groups, and the difference was not statistically significant (t1=0.3554, P1=0.6961; t2=1.1254, P2=0.2165). The spherical aberration of the group m.B was 0.120 + 0.095 m, and the difference between the two groups was statistically significant (0.202, 0.129, M.) (t1=4.8398, P1=0.001:t2=2.0993, P2=0.0385).
conclusion
1, there was no significant difference in the visual acuity and best corrected visual acuity between three months after the operation of MCX11ASP aspheric intraocular lenses in Germany compared with AS spherical intraocular lenses.
2, the contrast sensitivity of MCX11ASP aspheric intraocular lens group is better than that of AS spherical intraocular lens group at 6.3 degree angle (low spatial frequency).
3, when the pupil diameter is 5.0mmm, MCX11ASP aspheric intraocular lens can significantly reduce the total aberration after cataract surgery and improve the visual quality of cataract patients after cataract surgery compared with AS spherical intraocular lens.
【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】：R779.66
本文编号：2127443
[Abstract]:objective
The visual acuity, the best corrected visual acuity, and the difference of contrast sensitivity and aberration were compared between the cataract phacoemulsification and the MCX11ASP aspheric intraocular lens and the AS spherical intraocular lens.
Method
1, a prospective clinical control study was carried out in a continuous selection of patients with age-related cataract in June 2011 - December 2011 in our hospital and performed routine cataract surgery (such as slit lamp microscope examination, fundus examination, A, B), corneal curvature, intraocular pressure, electrophysiology, etc., and preoperative removal of corneal lesions, glaucoma, and grapes Meningitis, subluxation of lens, retina disease, middle high myopia. Before operation, two groups of.A groups were implanted in the German human optical MCX11ASP aspheric intraocular lens, and the B group was implanted with AS spherical intraocular lens.
2, postoperative screening criteria: follow up patients after surgery, routine examination of Ophthalmology, corneal pathological changes without slit lamp microscope, no atrophy of the iris, no pigmentation, direct pupil and indirect reflection of light, the intraocular lens is located in the bag, in the middle, no obvious tilt, no apparent pigmentation, no cloudy surface of the artificial lens surface, no cloudy, no cloudy. The surface was damaged, the posterior capsule was cloudy, and there was no pathological change in vitreous and retina.
3, A, and B two groups were used to measure the visual acuity of the naked eye with the normal visual acuity, and the best corrected visual acuity. Three months after the operation, the Talcagi-CGT-1000 automatic glare contrast sensitivity test was used for the non glare and glare contrast sensitivity examination, the Nidek optometry was used to check the refractive state, and the aberration of the three months after the operation was examined by the OPD-Scan wavefront aberrometry.
4, the SPSS13.0 software package was used for statistical analysis, and T test and X2 test were used for the two groups of measurement results.
Result
1, all the subjects were examined one week after the operation. 3 patients (4 eyes) were out of visit one month after the operation, including 2 cases (3 eyes) in group A and 1 cases (1 eyes) in group B. 5 cases (7 eyes) were out of visit in 5 cases (7 eyes) and B group 3 cases (4 eyes) at three months after operation.
2, in group two, the average degree of intraocular lens implantation was 21.23 + 2.16 (D) in group A and 21.97 + 2.24 (D) in group B. There was no significant difference between the two groups (t=1.692, P = 0.0936). Among them, 6 patients (6 eyes) were slightly biased, partial center was less than 0.25mm, A group 2 (2 eyes), B group 4 cases (4 eyes). (-1.25D to 0.75D), group B -0.1258 + 0.6159D (-1.25D ~ 1.25D), the difference between the two groups was not statistically significant (t = 0, P=1.000). The degree of astigmatism in the A group was 0.5486 + 0.3526D (0 ~ 1.25D), and the group was 0.5333 + (1 to 1). The two groups had no statistical significance (0.2083, 0.8354 = 0.8354).
3, one week after the operation, the visual acuity of the two groups was 0.35 + 0.16 in group A, and in group B 0.31 + 0.18. There was no statistically significant difference between the two groups (t = 1.1715, P = 0.2440). The visual acuity was 0.58 + 0.18 in group A and 0.54 + 0.17 in group B (t=1.0918, P=0.2777). The best corrected visual acuity in group A in three months after operation was 0.91 + 0.12, group B was 0.88 + 0.11, and group two was not statistically significant (t=1.2502, P=0.2143). The pupil size A group 3.49 + 0.53 (mm), B group (mm) T=0.0895, P=0.9289.
4, in the three months after the operation, the two groups were measured in 6.3, 4, 2.5, 1.6, 1, and 0.7, respectively, under the condition of non glare and glare, and the two groups were significantly different in the 6.3 angle (P0.01), and the group A was better than the B group.
5, when the pupil was measured from 3 to 4mm three months after the operation, the spherical aberration of group A was 0.003 + 0.015 mu m, the difference was 0.004 + 0.01 u m, and the difference was 0.040 + 0.025 M. between two groups, and the difference was not statistically significant (t1=0.3554, P1=0.6961; t2=1.1254, P2=0.2165). The spherical aberration of the group m.B was 0.120 + 0.095 m, and the difference between the two groups was statistically significant (0.202, 0.129, M.) (t1=4.8398, P1=0.001:t2=2.0993, P2=0.0385).
conclusion
1, there was no significant difference in the visual acuity and best corrected visual acuity between three months after the operation of MCX11ASP aspheric intraocular lenses in Germany compared with AS spherical intraocular lenses.
2, the contrast sensitivity of MCX11ASP aspheric intraocular lens group is better than that of AS spherical intraocular lens group at 6.3 degree angle (low spatial frequency).
3, when the pupil diameter is 5.0mmm, MCX11ASP aspheric intraocular lens can significantly reduce the total aberration after cataract surgery and improve the visual quality of cataract patients after cataract surgery compared with AS spherical intraocular lens.
【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】：R779.66
【参考文献】
相关期刊论文 前1条
1 毕宏生;对比敏感度在眼科的临床应用[J];中华眼科杂志;2004年09期
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