光适应治疗人工晶体眼眩光幻影的临床研究

发布时间：2018-05-17 17:57

本文选题：眩光 + 眩光幻影　；参考：《汕头大学》2011年硕士论文

【摘要】：目的探讨应用同视机闪烁眩光源适应性训练治疗人工晶体眼眩光幻影的临床疗效。方法2009年1月至10月在惠州市中心人民医院行白内障超声乳化术联合人工晶体植入术,术后一周自诉眩光、光晕等眩光幻影症状明显的年龄相关性白内障患者,按照入选标准和排除标准共选取24例(32只眼)做为研究对象。研究入选标准:(1)术前诊断为年龄相关性白内障;(2)手术方法为白内障超声乳化术联合人工晶体植入术;(3)术后一周眩光症状分级为中重度。选取对象随机分两组,结果采用盲法评定。治疗组(12例)接受同视机下闪烁眩光源适应性训练,对照组(12例)不接受治疗。治疗组从术后第二周开始训练,每周一次,连续三周,每次20分钟。。在术后3个月和术后18个月对两组患者进行视觉质量评估。视觉质量评价包括视觉症状严重程度(眩光、光晕分级)、视功能障碍程度(视功能和生存质量量表评估)和整体视觉评价(视觉满意度和视觉困难程度)。结果术后1周、3个月、18个月治疗组和对照组间视功能与生存质量量表、视觉满意度和视觉忧虑程度分级、光晕程度分级结果的差异均无统计学意义。术后3个月两组间眩光程度分级差异有统计学意义。眩光适应性训练之前,治疗组和对照组发生中重度眩光的比例为100%。治疗组经过训练,3个月后发生中重度眩光的比例明显减少,而对照组的比例同样降低,但两组变化的差异有统计学意义(P=0.046),术后18个月与术后1周比较,两组间差异则无统计学意义(P=0.44)。对于发生光晕的患者而言,随着时间延长,两组发生光晕的患者比例逐渐减少,两组变化的差异无论是短期还是长期都无统计学意义(P0.05)。结论人工晶体眼异常眩光幻影患者早期应用同视机闪烁眩光源适应性训练可以有效减少患者眩光适应的时间,改善早期眩光患者的眩光症状,但不能改善光晕症状。18个月的长期观察显示,早期光适应治疗对持续性眩光患者无明显临床疗效。
[Abstract]:Objective to investigate the clinical effect of adaptive training on glare source in intraocular lens (IOL) eyes. Methods from January to October 2009, cataract phacoemulsification combined with intraocular lens implantation was performed in Huizhou Central people's Hospital. One week after operation, patients with age-related cataract with obvious glare symptoms, such as glare and halo, were treated with phacoemulsification and intraocular lens implantation. A total of 24 patients with 32 eyes were selected according to the inclusion criteria and exclusion criteria. One week after cataract phacoemulsification combined with intraocular lens implantation was performed for cataract patients with moderate to severe glare symptoms. The subjects were randomly divided into two groups, and the results were evaluated by blind method. The treatment group (n = 12) received adaptive training of flicker glare under the same vision machine, while the control group (n = 12) received no treatment. Treatment group from the second week of training, once a week, three consecutive weeks, each 20 minutes. Visual quality was evaluated 3 months after operation and 18 months after operation. Visual quality assessment included the severity of visual symptoms (glare, halo grading), visual dysfunction (visual function and quality of life scale) and overall visual evaluation (visual satisfaction and visual difficulties). Results there was no significant difference in visual function and quality of life scale, visual satisfaction degree, visual anxiety degree and halo grade between the treatment group and the control group 1 week, 3 months and 18 months after operation. There was significant difference in the degree of glare between the two groups 3 months after operation. Before glare adaptation training, the proportion of moderate to severe glare in the treatment group and the control group was 100. After training, the proportion of moderate and severe glare in the treatment group decreased significantly after 3 months, while the proportion in the control group was also decreased, but the difference between the two groups was statistically significant, 18 months after operation and 1 week after operation, the difference between the two groups was statistically significant. There was no significant difference between the two groups (P = 0.44). For the patients with halo, the proportion of patients with halo in the two groups gradually decreased with the prolongation of time. The difference between the two groups was not statistically significant in the short or long term. Conclusion the early application of adaptive training of blinking glare source in patients with abnormal glare of intraocular lens can effectively reduce the time of glare adaptation and improve the glare symptoms of early glare patients. The long-term observation of 18 months showed that early photoadaptation therapy had no obvious clinical effect on persistent glare patients.
【学位授予单位】：汕头大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R779.6

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