瞳孔大小与植入ReSTOR渐进衍射型多焦点人工晶状体术后视觉质量相关关系

发布时间：2018-04-16 01:38

本文选题：多焦点人工晶状体 + 瞳孔　；参考：《郑州大学》2011年硕士论文

【摘要】：背景与目的随着白内障超声乳化手术的日益完善和人工晶状体设计技术的不断进步,白内障手术由单纯的复明手术向屈光性手术转变。多焦点人工晶状体在临床上应用日益广泛,最新研究表明多焦点人工晶状体术后视觉质量与瞳孔直径有关。Acrysof ReSTOR渐进衍射型多焦点人工晶状体(爱尔康公司)是新型的衍射-折射型多焦点人工晶状体,本文主要观察研究瞳孔大小与植入Acrysof ReSTOR渐进衍射型多焦点人工晶状体术后视力以及对比敏感度相关关系,旨在提高多焦点人工晶状体的临床效果。方法本研究系前瞻性临床研究,选择收集2008年12月～2010年10月在郑州大学二附属医院眼科行白内障超声乳化吸出联合植入Acrysof ReSTOR渐进衍射型多焦点人工晶状体的单纯性年龄相关性白内障病例,共63例(126眼)。术前按瞳孔直径分组,瞳孔直径2～3.5mm为A组,共44例(88眼)；瞳孔直径3.6-5.5mm为B组,共19(38眼)。术后3月检查术眼单眼和双眼最佳矫正远、近视力,并测量2-3.5mm、4-6mm、8mm三种瞳孔直径下远距对比敏感度。远视力检查距离为5m,近视力检查距离为33cm。对比敏感度采用OPTEC 6500视功能分析仪,选择5种空间频率1.5 cpd、3 cpd、6 cpd、12 cpd和18 cpd,分别在明视(光照度为85cd/m2)和暗视(光照度为3cd/m2)2种光照度下检查无眩光和有眩光时的对比敏感度。结果瞳孔直径与单眼最佳矫正远视力存在正相关关系(r=0.440,P0.01),与单眼最佳近视力存在负相关关系(r=-0.365,P0.01)。单眼和双眼最佳矫正远视力2组差异有统计学意义(χ2=7.461,P0.05；χ2=4.398,P0.05),B组优于A组。单眼最佳矫正近视力2组差异有统计学意义(χ2=10.006,P0.05),A组优于B组。双眼最佳矫正近视力2组差异无统计学意义(χ2=0.154,P0.05)。3种瞳孔状态下明视对比敏感度在各个空间频率差异有统计学意义(P0.05)。大瞳孔(4～6mm)状态下明视对比敏感度优于小瞳孔(2～3.5mm)和8mm瞳孔直径；暗视下两种瞳孔状态的对比敏感度在各个空间频率差异均有统计学意义(P0.05),瞳孔直径为8mm状态下的对比敏感度要低于瞳孔直径为4-6mm时的对比敏感度(P0.05)。结论植入ReSTOR多焦点人工晶状体后较大瞳孔直径时最佳矫正远视力更好,单眼最佳矫正近视力随瞳孔直径的增加而下降。较大瞳孔组和小瞳孔组双眼矫正近视力相似。远距对比敏感度较大瞳孔直径(4～6mm)时优于较小瞳孔直径。
[Abstract]:Background and purposeWith the improvement of phacoemulsification and the development of intraocular lens design technique, cataract surgery has changed from simple recuperation operation to refractive surgery.Multi-focus intraocular lens is widely used in clinic.Recent studies have shown that postoperative visual quality of multi-focus intraocular lens is related to pupil diameter. Acrysof ReSTOR diffractive multifocal intraocular lens (Alcon) is a new type of diffractation-refraction multi-focus intraocular lens.The relationship between pupil size and visual acuity and contrast sensitivity after implantation of Acrysof ReSTOR progressive diffractive multi-focus intraocular lens was studied in order to improve the clinical effect of multi-focus intraocular lens.MethodThis study is a prospective clinical study,From December 2008 to October 2010, a total of 63 patients (126 eyes) with simple age-related cataract underwent phacoemulsification combined with Acrysof ReSTOR progressive diffractive multi-focus intraocular lens implantation in the second affiliated Hospital of Zhengzhou University.Before operation, the pupil diameter was divided into two groups: group A (n = 44) with pupil diameter 2~3.5mm (n = 88) and group B (n = 19) with pupil diameter 3.6-5.5mm (n = 19).Three months after operation, the best corrected distance and near visual acuity of single eye and both eyes were examined, and the distance contrast sensitivity of 3 kinds of pupil diameter (2-3.5mm ~ 4-6mm ~ 8mm) was measured.The distance of distant visual acuity examination was 5 m, and the distance of close vision examination was 33 cm.ResultThere was a positive correlation between the pupil diameter and the best corrected far visual acuity of a single eye (P 0.01) and a negative correlation between the pupil diameter and the best near visual acuity of a single eye.There was significant difference between the two groups in the best corrected far visual acuity of one eye and two eyes (蠂 2 7.461% P 0.05, 蠂 2 4.398 P 0.05) and group B was better than group A (P 0.05).There was significant difference in the best corrected near visual acuity between the two groups (蠂 2: 10.006). Group A was better than group B (P 0.05).There was no significant difference in the best corrected near visual acuity between the two groups (蠂 ~ 2 = 0.154U, P 0.05.3).The contrast sensitivity was better in large pupil (4 ~ 6 mm) than in small pupil (2 ~ 3.5 mm) and 8mm pupil diameter.The contrast sensitivity of two kinds of pupil states under dark vision was significantly different in each space frequency (P 0.05). The contrast sensitivity of pupil diameter with 8mm was lower than that with pupil diameter of 4-6mm.ConclusionThe best corrected far visual acuity was better when ReSTOR polyfocal intraocular lens was implanted with larger pupil diameter, and the best corrected near visual acuity of single eye decreased with the increase of pupil diameter.The corrected near visual acuity was similar in the larger pupil group and the small pupil group.The sensitivity of long-distance contrast was better than that of small pupil when the diameter of pupil was 4 ~ 6 mm.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R779.66

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