波前像差引导的个体化SBK手术治疗屈光不正的疗效研究

发布时间：2018-05-10 12:34

本文选题：波前像差引导的SBK手术 + 波前像差　；参考：《河北医科大学》2011年硕士论文

【摘要】：目的:观察屈光不正患者行前弹力层下角膜磨镶术(SBK)术前及术后视力、波前像差及角膜地形图特点、并发症及其影响因素,为屈光不正患者进一步提高视觉质量提供新型手术方式。方法:回顾分析16例(32只眼)行波前像差引导的个体化SBK手术治疗的屈光不正患者的临床资料。所有患者在术前和术后均行常规检查,包括裸眼视力(UCVA)、最佳矫正视力(BCVA)、眼压、屈光度、角膜厚度、角膜地形图以及波前像差检查,并对患者术前、术后的观测指标的变化进行对比研究,从而全面评价波前像差引导的个体化SBK手术的疗效。结果:术后未见影响视力的严重并发症。16例患者中(32眼)有5例(31.25%)诉夜间“光晕”和“星芒”现象,1例(6.25%)诉夜间有眩光。术后1月及6月裸眼视力除1例患者(2眼)外,其余都达到1.0以上,且30眼(93.75%)的屈光矫正在预计矫正视力0.5D范围内;32眼均未出现术后BCVA降低;14眼(43.75%)BCVA提高1行,4眼(12.5%)BCVA提高2行;术后角膜曲率及角膜厚度较术前降低,差异有统计学意义;术后角膜后表面高度较术前未见增高,差异无统计学意义;术后各高价像差比例显著增加,以彗差和球差为主,三叶草的变化无统计学意义。结论: 1波前像差引导的SBK术后裸眼视力位于预期矫正度数±0.5D之内,在屈光矫正方面具有良好的可预测性。 2个体化SBK手术可提高部分患者BCVA,尤其是高度近视者。 3个体化SBK术后角膜后表面高度均无显著增加,无明显角膜膨隆,安全性较高。 4个体化SBK术后眼高价像差均有所增加,以彗差和球差的增加为主,手术前后差异具有统计学意义,但对术后视觉质量无明显影响。
[Abstract]:Objective: To observe the preoperative and postoperative visual acuity, wavefront aberration and corneal topography, complications and its influencing factors, and to provide a new mode of operation for the patients with ametropia to further improve the visual quality of the patients with ametropia (SBK).
Methods: the clinical data of 16 patients (32 eyes) of 16 patients with ametropia guided by traveling wave front aberration were reviewed. All patients underwent routine examination before and after operation, including naked eye (UCVA), best corrected visual acuity (BCVA), intraocular pressure, refractive index, corneal thickness, corneal topography and wavefront aberration. Preoperative and postoperative changes in the observational indicators were compared to evaluate the effect of wavefront guided individualized SBK surgery.
Results: there was no serious complication after operation in.16 patients (32 eyes), 5 cases (31.25%) complained of night "halo" and "star awn" phenomenon, 1 cases (6.25%) complained of night glare. The rest of the eyes in January and June except 1 cases (2 eyes), the rest were up to 1, and 30 eyes (93.75%) of refractive correction in the range of corrected visual acuity of 0.5D range. In the 32 eyes, there were no postoperative BCVA reduction, 14 eyes (43.75%), 1 lines, 4 eyes (12.5%) BCVA, and 2 lines. The corneal curvature and thickness of the cornea were lower than those before the operation. The posterior surface height of the cornea was not significantly higher than that before the operation, and the difference was not statistically significant after the operation; the proportion of high price aberrations increased significantly after the operation, with comet difference and ball difference. There is no significant change in the change of clover.
Conclusion:
1 after wavefront guided SBK, the corrected visual acuity is within the expected degree of correction (0.5D), and has good predictability in refractive correction.
2 individualized SBK surgery can improve BCVA in some patients, especially those with high myopia.
3 after SBK, there was no significant increase in posterior corneal surface height, no obvious corneal bulge and high safety.
4 after SBK, the ocular high value aberrations were increased, mainly with the increase of comet difference and spherical aberration, and the difference was statistically significant before and after operation, but there was no obvious effect on visual quality after operation.

【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R779.63

【参考文献】