ICL植入术治疗高度近视的超声生物显微镜观察及临床疗效评估

发布时间：2018-08-21 09:14

【摘要】：[目的]评估ICL后房型有晶体眼人工晶体植入术治疗高度近视的有效性、安全性、预测性及术后前房结构的稳定性。 [方法]收集2009年10月～2010年8月在浙二眼科中心行ICL植入术的高度近视患者13人21眼,术后2周、1月、3月进行随访,观察指标包括裸眼视力UCVA、最佳矫正视力BCVA、屈光度、眼压、角膜内皮细胞数量、波前像差、对比敏感度及超声生物显微镜UBM检查。UBM检查包括前房深度ACD、晶体拱高ICL-vault、房角开放距离AOD500及小梁虹膜角TIA在下、鼻、颞、上四个方向上的变化。数据结果应用SPSS 16.0统计软件分析。 [结果]术后3月UCVA等于术前BCVA 7眼(33.3%),UCVA大于术前BCVA10眼(47.6%)。术后BCVA大于术前BCVA16眼(76.2%),无术后BCVA的下降。术后3月球镜度在预期±1.0D范围内19眼(90.5%)。术前术后眼压无显著性差异(p=0.079)。术后3月角膜内皮细胞数较术前减少(p0.001)。术后3月眩光对比敏感度在各空间频率较术前均有显著性提高(p0.001)。术后3月各高阶像差观察值与术前相比无显著性差异(p0.05)。UBM观察术后1月ACD、AOD500及TIA均比术前显著减小(p0.001),术后1月及3月ACD、AOD500、TIA及ICL-vault无显著性差异(p0.05)。随访期内未发现瞳孔阻滞性青光眼和晶体前囊膜下混浊等并发症。 [结论]ICL有晶体眼人工晶体植入术矫正高度近视有效、安全、预测性好、术后视觉质量佳。术后3月UBM观察ICL植入前房结构稳定,但远期疗效需更长期的临床观察。
[Abstract]:[objective] to evaluate the efficacy, safety, predictability and stability of ICL posterior chamber intraocular lens implantation in the treatment of high myopia. [methods] from October 2009 to August 2010, 13 patients (21 eyes) with high myopia underwent ICL implantation in Zhejiang second Eye Center. The patients were followed up for 2 weeks, 1 month and 3 months after operation. The indexes of observation included naked vision, best corrected visual acuity (BCVA), diopter, intraocular pressure (IOP), visual acuity (UCVA), best corrected visual acuity (BCVA) and intraocular pressure (IOP). The number of corneal endothelial cells, wavefront aberration, contrast sensitivity and ultrasound biomicroscopy (UBM) included anterior chamber depth (ACD), lens arch height (ICL-vault), angle opening distance (AOD500) and trabecular iris angle (TIA) in the lower, nasal, temporal and upper directions. The data were analyzed by SPSS 16.0 statistical software. [results] 3 months after operation, UCVA was equal to BCVA in 7 eyes (33.3%), which was higher than that in BCVA10 eyes before operation (47.6%). Postoperative BCVA was higher than that of preoperative BCVA16 (76.2%), and no decrease of BCVA was observed. After operation, 19 eyes (90.5%) were within the range of 卤1.0 D. There was no significant difference in intraocular pressure before and after operation (p0. 079). The number of corneal endothelial cells decreased 3 months after operation (p 0.001). Three months after operation, the contrast sensitivity of glare was significantly higher in each space than that before operation (p 0.001). There was no significant difference in the observed values of higher order aberrations between before and after operation (p0.05). The values of ACD-AOD500 and TIA decreased significantly in the first month after operation (p0.001), and there was no significant difference in ACD-AOD500-TIA and ICL-vault in the first and third month after operation (p0.05). No complications such as pupillary block glaucoma and anterior capsular opacification were found during the follow-up period. [conclusion] ICL intraocular lens implantation for high myopia is effective, safe and predictable, and visual quality is good. 3 months after operation, UBM was used to observe the stability of anterior chamber structure of ICL implantation, but long-term clinical observation was needed.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R779.6

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