屈光性白内障手术未脱镜相关因素分析

发布时间：2018-07-20 20:15

【摘要】：背景和目的随着白内障手术技术的不断完善,人们生活水平的不断提高和人工晶状体设计制造工艺的不断改进,白内障手术已由过去的单纯复明手术向屈光性手术过渡。多焦点人工晶状体应用于屈光性白内障手术,可使患者获得良好的裸眼全程视力,减少对眼镜的依赖,但仍有部分患者术后未脱镜,这既给患者带来了痛苦,也加剧了临床工作的风险。本研究旨在通过研究影响脱镜率的因素,为临床工作提供指导性意见。方法本文为回顾性研究。分析自2006年6月到2009年4月在我科行白内障超声乳化吸出联合ReSTOR多焦点人工晶状体植入术的患者182例(222只眼),其中年龄相关性白内障155例(190只眼),先天性白内障5例(10只眼),小梁切除术后白内障患者15例(15只眼),伴有糖尿病的白内障患者7例(7只眼)。记录戴镜人数及戴镜率；戴镜人群的屈光状态及其裸眼远、近视力；戴镜人群术前、术后眼球生物学测量；戴镜人群眼部并发症。统计学处理：对上述观察指标的结果采用t检验和χ2检验,全部资料应用SPSS 13.0统计软件包进行统计学处理。结果 1.术后戴镜36例(39只眼),单眼植入ReSTOR多焦点人工晶状体者术后戴镜率23.2%(33/142),双眼植入者戴镜率为7.5%(3/40),两组之间差异具有统计学意义(χ2=4.872,P=0.027)。 2.戴镜者裸眼远视力平均0.46,裸眼近视力平均0.41,视远矫正视力的等效球镜度数平均(+0.38±1.25)D,等效球镜度数与裸眼远视力、近视力显著负相关(r=-0.615,-0.427；P0.05)。 3.年龄相关性白内障患者术前、术后眼轴测量差异有统计学意义(t=3.262,P0.05),而角膜曲率测量差异无统计学意义(-0.248,P0.05)。 4.戴镜者裂隙灯检查发现瞳孔异常4眼,后发性白内障6眼,人工晶状体偏心3眼。结论 1.双眼植入多焦点人工晶状体可降低戴镜率 2.眼轴测量误差可能导致术后戴镜 3.角膜曲率测量对戴镜率未造成明显影响 4.手术并发症可能导致术后戴镜
[Abstract]:Background and objective with the continuous improvement of cataract surgery technology, people's standard of living and the design and manufacture of intraocular lens have been continuously improved. Cataract surgery has transitioned from simple recuperation to refractive surgery. The application of multi-focus intraocular lens in refractive cataract surgery can make the patients obtain good eyesight and reduce their dependence on glasses. However, some patients still have not removed the lens after surgery, which has brought pain to the patients. It also increases the risk of clinical work. The purpose of this study is to provide guidance for clinical work by studying the factors affecting the removal rate of endoscopy. Methods this article is a retrospective study. 182 cases (222 eyes) of cataract phacoemulsification combined with retor intraocular lens implantation in our department from June 2006 to April 2009 were analyzed, including 155 cases (190 eyes) with age-related cataract and congenital cataract. 5 cases (10 eyes), 15 cases (15 eyes) with cataract after trabeculectomy and 7 cases (7 eyes) with cataract with diabetes mellitus. The number of people wearing glasses and the rate of wearing glasses were recorded. The refractive state and the distant and near visual acuity of the people wearing glasses were recorded. The biological measurement of eyeball before and after operation in the group of wearing glasses and the complications of eyes in the people with glasses were also observed. Statistical processing: t test and 蠂 2 test were used for the results of the above observation indexes, and all the data were statistically processed by SPSS 13.0 statistical software package. Result 1. Among the 36 cases (39 eyes) who wore glasses, the rate of wearing glasses was 23.2% (33 / 142) in monocular eyes and 7.5% (3 / 40) in binocular implants. The difference between the two groups was statistically significant (蠂 ~ (2 +) 4.87 ~ (2) P ~ (0.027). The distance visual acuity of naked eyes was 0.46, the average of near-visual acuity was 0.41, the mean degree of distance corrected vision was (0.38 卤1.25) D, the degree of equivalent spherical vision was negatively correlated with the distance visual acuity of naked eyes, and the near visual acuity was negatively correlated (r ~ (-0.615) ~ (-0.427) P 0.05). There was significant difference between preoperative and postoperative eye axis measurements in patients with age-related cataract (t = 3.262 P 0.05), but there was no significant difference in corneal curvature measurement (-0.248 P 0.05). 4. Slit-lamp examination showed abnormal pupil in 4 eyes, posterior cataract in 6 eyes and eccentricity of intraocular lens in 3 eyes. Conclusion 1. Binocular implantation of multi-focus intraocular lens can reduce the wear rate of 2. 5%. The measurement error of eye axis may result in wearing mirror after operation. Corneal curvature measurement had no significant effect on wear rate. Surgical complications may lead to postoperative wear of mirrors
【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

【参考文献】