有晶体眼后房型人工晶体植入术治疗高度近视的早期临床研究

发布时间：2018-01-11 17:01

本文关键词：有晶体眼后房型人工晶体植入术治疗高度近视的早期临床研究　出处：《华中科技大学》2013年硕士论文　论文类型：学位论文

【摘要】：【目的】通过观察有晶体眼后房型人工晶体植入术手术前后裸眼视力、低对比度视力、中央前房深度、前房角、眼压及角膜内皮细胞密度等，分析和评价有晶体眼后房型人工晶体植入术治疗高度近视的早期临床效果。【方法】按照拟定的入选标准选取行有晶体眼后房型人工晶体植入术治疗的高度近视患者48例90眼，术后随访6月。记录术前及术后各随访时间点的裸眼视力、等效球镜度、低对比度视力、眼压、角膜内皮细胞密度，用pentacam眼前节全景分析仪测量各时间点的中央前房深度、3点方位前房角、角膜曲率、Q值、角膜像差等指标。使用SPSS19.0统计软件，描述术前术后各指标的分布特征，采用非参数检验对裸眼视力进行手术前后的差异性比较，采用配对t检验对其余各指标进行手术前后的差异性比较。【结果】90眼均成功植入ICL。所有观察指标除术前裸眼视力呈偏态分布外，其余指标术前术后各时间点均呈正态分布。全部患者在术后随访期中，裸眼视力均达到术前最佳矫正视力，52.2％的眼数超出最佳矫正视力一行及以上；等效球镜度维持在-1.0D～+1.0D；低对比度视力较术前矫正屈光不正后测得值有所提高，角膜Q值增大，差异均有统计学意义（P0.05）。角膜像差中，，总像差及低阶像差较术前无统计学差异（P0.05），高阶像差则较术前有所增加，差异有统计学意义（P0.05）；中央前房深度、3点方位前房角较术前降低，角膜曲率略有减小，差异均有统计学意义（P0.05）。角膜厚度和眼压较术前比较均无统计学差异（P0.05）。角膜内皮细胞密度较术前减少，差异有统计学意义（P0.05）。对于术后有统计学意义变化的指标，除低对比度视力在术后三月达稳定水平外，其余各指标均在术后一月时即达到稳定状态。91.7％的患者对ICL植入术早期效果表示满意，全部患者术后均未出现严重并发症。【结论】有晶体眼后房型人工晶体植入术矫正高度近视在术后早期随访中显示出良好的有效性、安全性、稳定性及可预测性，取得了初步满意的临床效果。
[Abstract]:[Objective] through the observation of phakic intraocular lens implantation after operation visual acuity, low contrast visual acuity, anterior chamber depth, anterior chamber angle, intraocular pressure and corneal endothelial cell density, analysis and evaluation of the early clinical effect of phakic posterior chamber intraocular lens implantation for high myopia.
[method] in accordance with the inclusion criteria for selection of intraocular lens implantation for the treatment of crystal eyes after high myopia patients 48 cases 90 eyes, postoperative follow-up of June. Record the preoperative and postoperative follow-up time points uncorrected visual acuity, spherical equivalent, low contrast visual acuity, intraocular pressure, corneal density the endothelial cells with Pentacam anterior segment analyzer panoramic measurement of central anterior chamber depth at each time point, 3 point range of anterior chamber angle, corneal curvature, corneal aberration index Q value. The use of SPSS19.0 statistical software to describe the distribution characteristics of each index before and after surgery, using non parametric test to compare the difference before and after the operation of the uncorrected visual acuity, using the paired t test of the other indicators to compare the difference before and after operation.
[results] 90 eyes were successfully implanted ICL. all the observed indexes except the preoperative uncorrected visual acuity showed a skewed distribution, the indexes before and after surgery were all normal distribution. All patients in the postoperative follow-up, visual acuity reached preoperative best corrected visual acuity, the number of 52.2% eyes beyond the best a line of vision correction and above; spherical equivalent at -1.0D ~ +1.0D; low contrast visual acuity correction of ametropia after corneal measured value increased, Q value increased, the differences were statistically significant (P0.05). Corneal aberration, total aberration and low order aberrations than before surgery had no statistical difference (P0.05), high order aberrations compared with the preoperative increased, the difference was statistically significant (P0.05); the central anterior chamber depth, anterior chamber angle range 3 points lower than the preoperative corneal curvature decreases slightly, the differences were statistically significant (P0.05). The corneal thickness and intraocular pressure were compared with the preoperative No statistical difference (P0.05). Corneal endothelial cell density decreased, the difference was statistically significant (P0.05). The postoperative change was statistically significant indicators, in addition to low contrast visual acuity after surgery in March reached a stable level, the rest of the indicators in the postoperative January is reached to the stable state of.91.7% patients were satisfied with the early effect of ICL implantation, all patients had no serious complications.
[Conclusion] posterior chamber intraocular lens implantation for correction of high myopia has good efficacy, safety, stability and predictability in early follow-up, and has achieved initial satisfactory clinical results.

【学位授予单位】：华中科技大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R779.6

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