虹膜固定折叠型人工晶体在后囊膜异常无晶体眼的应用初探

发布时间：2018-03-29 13:23

本文选题：虹膜固定　切入点：后囊膜异常　出处：《山东大学》2010年硕士论文

【摘要】： 目的：探讨虹膜固定法植入折叠型人工晶体应用于晶体后囊膜异常无晶体眼的治疗效果。方法：2008年1月至2010年1月在山东大学第二医院眼科行手术治疗的无足够晶体后囊膜支撑的无晶体眼患者,除外术前角膜散光1.5D以上,最佳矫正视力(best-corrected visual acuity, BCVA)低于0.1的病例,通过随机数字法分为观察组和对照组,观察组13例13眼,经3.Omm透明角膜切口,应用晶体植入器植入折叠型人工晶体,双襻用10-0聚丙烯缝线缝合固定于虹膜中周部。对照组10例10眼,经4.Omm透明角膜切口,应用晶体植入镊植入折叠型人工晶体,双襻用10-0聚丙烯缝线缝合固定于巩膜上。所有病例随访3个月,对术前裸眼视力、最佳矫正视力、屈光状态、眼前节及眼压；术后裸眼视力、最佳矫正视力、屈光状态、眼前节及眼压、术后并发症等情况进行总结,分析比较裸眼视力、最佳矫正视力、手术源性散光(Surgery induced astigmatism, SIA)度数、术前预期屈光度与术后实际屈光度差值的绝对值,即绝对预计误差以及眼压等资料。结果：术前裸眼视力及最佳矫正视力两组相比无显著性差异,而术后3个月裸眼视力观察组高于对照组(t=2.258,P=0.035)。术前预期屈光度数以及术后实际残余屈光度数的绝对值两组相比差异无显著性,而术前预期屈光度与术后实际屈光度的差值的绝对值即绝对预计误差,观察组要小于对照组(t=2.363,P=0.028)。手术源性散光方面,观察组的平均手术源性散光度数小于对照组(t=3.77,P=0.01)。手术前后两组眼压差异均无统计学意义。观察组人工晶体位置保持良好的居中性；对照组出现1例人工晶体偏位。两组病例术后均未出现严重的并发症。结论：对后囊膜异常的无晶体眼来说,虹膜固定法植入折叠型人工晶体相比巩膜固定法,具有术后视力恢复好,人工晶体度数的可预测性好,手术源性散光小,术后并发症少等优点,是一种安全、有效、可行的方法。
[Abstract]:Objective: to investigate the therapeutic effect of foldable intraocular lens (IOL) implantation with iris fixation in the treatment of posterior capsular abnormalities. Methods: from January 2008 to January 2010, patients without adequate posterior capsular support were treated by surgery in the second Hospital of Shandong University, except those with preoperative corneal astigmatism over 1.5 D and best corrected visual acuity (BCVA) less than 0.1. 13 cases (13 eyes) in the observation group were divided into the observation group and the control group by random number method. The foldable intraocular lens were implanted with the lens implants through 3.Omm transparent corneal incision. Double loops were sutured to the middle and periiris of iris with 10-0 polypropylene suture. In the control group, 10 cases (10 eyes) were treated with 4.Omm transparent corneal incision and foldable intraocular lens (IOL) was implanted with lens implantation forceps. Double loops were fixed on the sclera with 10 ~ (-0) polypropylene suture. All the patients were followed up for 3 months to evaluate the preoperative uncorrected visual acuity, best corrected visual acuity, refractive state, anterior segment and intraocular pressure, postoperative uncorrected visual acuity, best corrected visual acuity, refractive state. The anterior segment and intraocular pressure (IOP) and postoperative complications were summarized, and the absolute values of the uncorrected visual acuity, the best corrected visual acuity, the degree of surgical induced astigmatismand the difference between preoperative and postoperative diopters were analyzed and compared. That is, absolute prediction error and IOP data. Results: there was no significant difference in preoperative uncorrected visual acuity and best corrected visual acuity between the two groups. 3 months after operation, the naked visual acuity in the observation group was higher than that in the control group (2.258%). There was no significant difference between the two groups in the absolute values of the preoperative expected diopter and the postoperative residual diopter. However, the absolute value of the difference between preoperative and postoperative diopters was the absolute prediction error, which was less in the observation group than in the control group, and was less than that in the control group in the aspect of surgical astigmatism, and the difference between the preoperative diopter and the postoperative actual diopter was less than that in the control group. The mean astigmatism of operation source in the observation group was less than that in the control group (3.77). There was no significant difference in IOP between the two groups before and after operation. In the control group, IOL deviation occurred in 1 case, and no serious complications occurred in both groups. Conclusion: the iris fixation is more effective than scleral fixation in the recovery of postoperative visual acuity, the degree of intraocular lens is predictable, and the operative astigmatism is small in patients with abnormal posterior capsule. It is a safe, effective and feasible method with less complications.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R779.66

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