超声乳化白内障吸除联合人工晶状体植入术后眼内生物测量参数变化及人工晶状体类型选择的临床研究
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摘要
目的探讨超声乳化白内障吸除联合人工晶状体植入术后眼内生物测量参数变化及人工晶状体类型的选择方法。方法收集2016年2月至2018年2月在内蒙古自治区包头市中心医院眼科就诊且接受超声乳化白内障吸除联合人工晶状体植入术治疗的患者60例(60只眼)进行研究。其中,男性33例(33只眼),女性27例(27只眼)。年龄42～78岁,平均(60.8±10.2)岁。依据选用的人工晶状体类型,将全部患者分为Bigbag人工晶状体组和Re STOR人工晶状体组两组。检查患者手术前后的裸眼视力、最佳矫正视力、晶状体后囊膜至视网膜的距离、眼轴长度、前房深度及眼压变化,采用均数±标准差(x珋±s)表示。Bigbag人工晶状体组和Re STOR人工晶状体组的组间比较采用t检验,组内比较采用配对t检验。结果两组年龄、性别、发病类型、晶状体核硬度及合并症,经统计学分析,差异均无统计学意义(t=1.89,χ2=1.32,0.86,0.76,0.45; P> 0.05)。治疗前两组患者裸眼视力、最佳矫正视力、晶状体后囊膜至视网膜的距离、眼轴长度及眼压的比较,差异无统计学意义(t=0.683,0.432,0.963,0.862,0.634; P>0.05)。治疗后两组患者眼压之间、眼压和两组间眼压比较,差异无统计学意义(t=0.031,0.079,0.091,0.29; P>0.05)。治疗前后两组患者裸眼视力的比较,治疗后比治疗前有显著提高,差异有统计学意义(t=21.779,13.326; P<0.05)。治疗后,Bigbag人工晶状体组患者的裸眼视力明显高于Re STOR人工晶状体组,差异有统计学意义(t=5.136,P<0.05)。治疗后与治疗前两组患者最佳矫正视力的比较,治疗后比治疗前有显著提高,差异有统计学意义(t=13.689,9.683; P<0.05)。治疗后Bigbag人工晶状体组患者的最佳矫正视力明显高于Re STOR人工晶状体组,差异有统计学意义(t=3.679,P<0.05)。治疗后与治疗前两组患者晶状体后囊膜至视网膜距离的比较,治疗后比治疗前有显著增加,差异有统计学意义(t=19.689,12.683; P<0.05)。治疗后,Bigbag人工晶状体组的患者晶状体后囊膜至视网膜距离明显高于Re STOR人工晶状体组(t=2.924,P<0.05)。Bigbag人工晶状体组患者手术前后的裸眼视力、最佳矫正视力、晶状体后囊膜到视网膜距离差值均显著小于Re STOR人工晶状体组,差异有统计学意义(t=35.45,27.25,2.05; P<0.05)。治疗后与治疗前比较,两组患者的眼轴长度均有显著提高,差异有统计学意义(t=15.249,7.358; P<0.05)。Bigbag人工晶状体组患者手术后的眼轴长度均显著高于Re STOR人工晶状体组,差异有统计学意义(t=13.982,P<0.05)。治疗后与治疗前比较,两组患者的前房深度均有显著加深,差异有统计学意义(t=16.489,8.0951; P<0.05)。Bigbag人工晶状体组患者手术后的前房深度均显著深于Re STOR人工晶状体组,差异有统计学意义(t=12.97,P<0.05)。Bigbag人工晶状体组患者手术前后的眼轴长度及前房深度的差值均显著大于Re STOR人工晶状体组,差异有统计学意义(t=8.45,16.49; P<0.05)。结论超声乳化白内障吸除联合人工晶状体植入术后眼内生物测量参数裸眼视力、最佳矫正视力、晶状体后囊膜至视网膜的距离、眼轴长度、前房深度会发生变化,而眼压无明显变化。选用Bigbag人工晶状体较Re STOR人工晶状体更具优势。
Objective To investigate the changes of intraocular biometrics and the selection ofintraocular lens types after phacoemulsification and intraocular lens implantation. Methods A total of 60 cases(60 eyes) who received phacoemulsification and intraocular lens implantation from February 2016 toFebruary 2018 in the Ophthalmology Department of Baotou Central Hospital of Inner Mongolia AutonomousRegion were studied. There were 33 males(33 eyes) and 27 females(27 eyes). The age ranged from 42 to78 years,with an average of(60.8± 10.2) years. According to the type of intraocular lens selected duringsurgery,all the cases included in this study were divided into two groups: Bigbag intraocular lens group andRe STOR intraocular lens group. The visual acuity,the best corrected visual acuity,the distance fromposterior capsule to retina,the length of eye axis,the depth of anterior chamber and intraocular pressurewere examined before and after operation. Use(x珋±s) to express. Bigbag intraocular lens group and Re STORintraocular lens group were compared by t test and paired t test. Results There were no significantdifferences in age,sex,type of onset,lens nucleus hardness and complications between the two groups(t =1.89,χ2= 1. 32,0. 86,0. 76,0. 45; P > 0. 05). There was no significant difference in naked vision,bestcorrected vision,distance from posterior capsule to retina,axial length and intraocular pressure between thetwo groups before treatment(t = 0.683,0.432,0.963,0.862,0.634; P> 0.05). There was no significantdifference in intraocular pressure between the two groups(t = 0.031,0.079,0.091,0.29; P> 0.05). Aftertreatment,the naked eye vision of the two groups was significantly improved compared with that beforetreatment(t = 21.779,13.326; P< 0.05). After treatment,the naked eye vision of Bigbag intraocular lensgroup was significantly higher than that of Re STOR intraocular lens group(t = 5. 136,P < 0.05). The bestcorrected visual acuity of the two groups after treatment was significantly higher than that before treatment(t= 13.689,9.683; P<0.05). After treatment,the best corrected visual acuity of Bigbag intraocular lens groupwas significantly higher than that of Re STOR intraocular lens group(t = 3.679,P< 0.05). After treatment,the distance from posterior capsule to retina was significantly increased compared with that before treatment(t= 19.689,12.683; P< 0.05). After treatment,the distance from posterior capsule to retina in Bigbagintraocular lens group was significantly higher than that in Re STOR intraocular lens group(t = 2.924,P<0.05). The difference of naked vision,best corrected visual acuity,posterior capsular to retina distancebetween Bigbag intraocular lens group and Re STOR intraocular lens group before and after surgery wassignificantly smaller than that of Re STOR intraocular lens group(t = 35.45,27.25,2.05; P< 0.05). Aftertreatment,compared with before treatment,the axial length of the two groups was significantly increased(t =15.249,7.358; P<0.05). Axis length in Bigbag intraocular lens group was significantly longer than that inRe STOR intraocular lens group(t = 13. 982,P < 0. 05). After treatment,the anterior chamber depth of thetwo groups was significantly deeper than before treatment(t = 16. 489,8.0951; P < 0.05). The anteriorchamber depth of Bigbag intraocular lens group was significantly deeper than that of Re STOR intraocular lensgroup(t = 12. 97,P < 0. 05). The difference of axial length and anterior chamber depth before and afteroperation in Bigbag intraocular lens group was significantly greater than that in Re STOR intraocular lensgroup(t = 8.45,16.49; P < 0. 05). Conclusions After phacoemulsification combined with intraocular lensimplantation,the intraocular biometric parameters such as naked eye vision,best corrected visual acuity,distance from posterior capsule to retina,axial length and anterior chamber depth changed,but intraocularpressure did not change significantly. Bigbag intraocular lens implantation in phacoemulsification combinedwith intraocular lens implantation has more advantages than Re STOR intraocular lens implantation.
Objective To investigate the changes of intraocular biometrics and the selection ofintraocular lens types after phacoemulsification and intraocular lens implantation. Methods A total of 60 cases(60 eyes) who received phacoemulsification and intraocular lens implantation from February 2016 toFebruary 2018 in the Ophthalmology Department of Baotou Central Hospital of Inner Mongolia AutonomousRegion were studied. There were 33 males(33 eyes) and 27 females(27 eyes). The age ranged from 42 to78 years,with an average of(60.8± 10.2) years. According to the type of intraocular lens selected duringsurgery,all the cases included in this study were divided into two groups: Bigbag intraocular lens group andRe STOR intraocular lens group. The visual acuity,the best corrected visual acuity,the distance fromposterior capsule to retina,the length of eye axis,the depth of anterior chamber and intraocular pressurewere examined before and after operation. Use(x珋±s) to express. Bigbag intraocular lens group and Re STORintraocular lens group were compared by t test and paired t test. Results There were no significantdifferences in age,sex,type of onset,lens nucleus hardness and complications between the two groups(t =1.89,χ2= 1. 32,0. 86,0. 76,0. 45; P > 0. 05). There was no significant difference in naked vision,bestcorrected vision,distance from posterior capsule to retina,axial length and intraocular pressure between thetwo groups before treatment(t = 0.683,0.432,0.963,0.862,0.634; P> 0.05). There was no significantdifference in intraocular pressure between the two groups(t = 0.031,0.079,0.091,0.29; P> 0.05). Aftertreatment,the naked eye vision of the two groups was significantly improved compared with that beforetreatment(t = 21.779,13.326; P< 0.05). After treatment,the naked eye vision of Bigbag intraocular lensgroup was significantly higher than that of Re STOR intraocular lens group(t = 5. 136,P < 0.05). The bestcorrected visual acuity of the two groups after treatment was significantly higher than that before treatment(t= 13.689,9.683; P<0.05). After treatment,the best corrected visual acuity of Bigbag intraocular lens groupwas significantly higher than that of Re STOR intraocular lens group(t = 3.679,P< 0.05). After treatment,the distance from posterior capsule to retina was significantly increased compared with that before treatment(t= 19.689,12.683; P< 0.05). After treatment,the distance from posterior capsule to retina in Bigbagintraocular lens group was significantly higher than that in Re STOR intraocular lens group(t = 2.924,P<0.05). The difference of naked vision,best corrected visual acuity,posterior capsular to retina distancebetween Bigbag intraocular lens group and Re STOR intraocular lens group before and after surgery wassignificantly smaller than that of Re STOR intraocular lens group(t = 35.45,27.25,2.05; P< 0.05). Aftertreatment,compared with before treatment,the axial length of the two groups was significantly increased(t =15.249,7.358; P<0.05). Axis length in Bigbag intraocular lens group was significantly longer than that inRe STOR intraocular lens group(t = 13. 982,P < 0. 05). After treatment,the anterior chamber depth of thetwo groups was significantly deeper than before treatment(t = 16. 489,8.0951; P < 0.05). The anteriorchamber depth of Bigbag intraocular lens group was significantly deeper than that of Re STOR intraocular lensgroup(t = 12. 97,P < 0. 05). The difference of axial length and anterior chamber depth before and afteroperation in Bigbag intraocular lens group was significantly greater than that in Re STOR intraocular lensgroup(t = 8.45,16.49; P < 0. 05). Conclusions After phacoemulsification combined with intraocular lensimplantation,the intraocular biometric parameters such as naked eye vision,best corrected visual acuity,distance from posterior capsule to retina,axial length and anterior chamber depth changed,but intraocularpressure did not change significantly. Bigbag intraocular lens implantation in phacoemulsification combinedwith intraocular lens implantation has more advantages than Re STOR intraocular lens implantation.
引文
[1]陈媛.Bigbag人工晶体植入在高度近视并发白内障超声乳化术中的观察[J].江西医药,2018,53(9):999-1001.
[2]王华华,吕志刚.基层医院表面麻醉下白内障超声乳化联合人工晶体植入术的疗效分析[J].浙江临床医学,2017,19(6):1091-1092.
[3]俞华,张燕.Bigbag人工晶状体在高度近视眼白内障手术的临床应用[J].临床眼科杂志,2013,21(3):211-213.
[4]戴红梅,李兰,李云川,等.Bigbag人工晶状体在高度近视合并白内障应用研究[J].中国实用眼科杂志,2014,32(1):60-63.
[5]刘静薇,朱福景,王鑫峥.高度近视白内障患者植人Bigbag人工晶状体的疗效观察[J].临床眼科杂志,2012,20(3):222-225.
[6]郑丽,李敏,肖红.Bigbag及Rayner 620H两种不同人工晶状体在白内障合并高度近视眼内的有效性探讨[J].河北医学,2018,24(5):767-771.
[7]蒋云海,徐文荣,段聪.Bigbag人工晶状体在高度近视并发白内障中的应用研究[J].浙江医学,2017,39(11):900-907.
[8]王宏伟,孙鹏.Acry Sof Re STOR多焦点人工晶状体应用的临床研究[J].齐齐哈尔医学院学报,2016,37(30):3772-3773.
[9]Kohnen T,Allen D,Boureau C,et al.European Multicenter Study of the Acrysof Re STOR Apodized diffractive intraocular Lens[J].Ophthalmology,2006,113:578-584.
[10]黄蒂,施玉英.Acrysof Re STOR多焦点人工晶状体临床应用的初步报告究[J].眼科杂志,2006,15(5):344-347.
[11]肖燕,王骞,朱俊英,等.Acry Sof Re STOR及AT LISA tri839MP多焦点人工晶状体植入术后视觉质量的比较[J].实用防盲技术,2018,13(3):113-116.
[12]廖莹琳,刘春兰,夏侯梨.不同联合手术方式治疗青光眼合并白内障效果研究[J].中国医学前沿杂志(电子版),2015,3(7):111-113.
[13]陈冲.白内障超声乳化联合人工晶体植入术对葡萄膜炎并发白内障患者术后视力及生活质量的影响[J].河南医学研究,2017,26(12):2261-2262.
[14]汪玲,朱秀萍,赵平,等.缩瞳后前房角的形态与青光眼手术方式的选择[J].中华眼外伤职业眼病杂志,2013,35(12):922-924.
[15]张宏光,沙爱娟,关文雯等.超声乳化联合房角分离术治疗原发性闭角型青光眼的临床研究[J].山西医药杂志,2017,46(1):45-48.
[16]宋超,王于蓝,谷树严.晶状体摘除对不同程度的房角关闭术后疗效观察[J].齐齐哈尔医学院学报,2014,18(6):2724-2725.
[17]师雅益.糖尿病患者行白内障超声乳化联合人工晶体植入术的临床效果[J].临床医学研究与实践,2017,2(21):46-47.
[18]关改新.白内障超声乳化联合房角分离治疗原发闭角型青光眼的效果观察[J].河南医学研究,2014,23(7):32-34.
[19]沈凌飞,林志博.白内障超声乳化联合人工晶体植入术对急性闭角型青光眼合并白内障患者临床疗效[J].浙江创伤外科,2017,22(3):478-480.
[20]张为中,王润,杨勤.Acry SofToric人工品状体植入矫正角膜散光的临床应用[J].中华显微外科杂志,2015,38(2):194-196.
[21]张仙,张瑞勇,张雪梅等.白内障超声乳化联合人工晶体植入术手术配合[J].航空航天医学杂志,2017,28(8):1025-1026.
[22]罗永旗,王力,王健等.同期小梁切除联合白内障超声乳化人工晶体植入术治疗青光眼合并白内障的疗效[J].临床医学研究与实践,2017,2(2):83-84.
[23]Ma X,Li Z.Capsular tension ring implantation after lens extraction for management of subluxated cataracts[J].Int J Clin Exp Pathol,2014,7(7):3733-3738.
[2]王华华,吕志刚.基层医院表面麻醉下白内障超声乳化联合人工晶体植入术的疗效分析[J].浙江临床医学,2017,19(6):1091-1092.
[3]俞华,张燕.Bigbag人工晶状体在高度近视眼白内障手术的临床应用[J].临床眼科杂志,2013,21(3):211-213.
[4]戴红梅,李兰,李云川,等.Bigbag人工晶状体在高度近视合并白内障应用研究[J].中国实用眼科杂志,2014,32(1):60-63.
[5]刘静薇,朱福景,王鑫峥.高度近视白内障患者植人Bigbag人工晶状体的疗效观察[J].临床眼科杂志,2012,20(3):222-225.
[6]郑丽,李敏,肖红.Bigbag及Rayner 620H两种不同人工晶状体在白内障合并高度近视眼内的有效性探讨[J].河北医学,2018,24(5):767-771.
[7]蒋云海,徐文荣,段聪.Bigbag人工晶状体在高度近视并发白内障中的应用研究[J].浙江医学,2017,39(11):900-907.
[8]王宏伟,孙鹏.Acry Sof Re STOR多焦点人工晶状体应用的临床研究[J].齐齐哈尔医学院学报,2016,37(30):3772-3773.
[9]Kohnen T,Allen D,Boureau C,et al.European Multicenter Study of the Acrysof Re STOR Apodized diffractive intraocular Lens[J].Ophthalmology,2006,113:578-584.
[10]黄蒂,施玉英.Acrysof Re STOR多焦点人工晶状体临床应用的初步报告究[J].眼科杂志,2006,15(5):344-347.
[11]肖燕,王骞,朱俊英,等.Acry Sof Re STOR及AT LISA tri839MP多焦点人工晶状体植入术后视觉质量的比较[J].实用防盲技术,2018,13(3):113-116.
[12]廖莹琳,刘春兰,夏侯梨.不同联合手术方式治疗青光眼合并白内障效果研究[J].中国医学前沿杂志(电子版),2015,3(7):111-113.
[13]陈冲.白内障超声乳化联合人工晶体植入术对葡萄膜炎并发白内障患者术后视力及生活质量的影响[J].河南医学研究,2017,26(12):2261-2262.
[14]汪玲,朱秀萍,赵平,等.缩瞳后前房角的形态与青光眼手术方式的选择[J].中华眼外伤职业眼病杂志,2013,35(12):922-924.
[15]张宏光,沙爱娟,关文雯等.超声乳化联合房角分离术治疗原发性闭角型青光眼的临床研究[J].山西医药杂志,2017,46(1):45-48.
[16]宋超,王于蓝,谷树严.晶状体摘除对不同程度的房角关闭术后疗效观察[J].齐齐哈尔医学院学报,2014,18(6):2724-2725.
[17]师雅益.糖尿病患者行白内障超声乳化联合人工晶体植入术的临床效果[J].临床医学研究与实践,2017,2(21):46-47.
[18]关改新.白内障超声乳化联合房角分离治疗原发闭角型青光眼的效果观察[J].河南医学研究,2014,23(7):32-34.
[19]沈凌飞,林志博.白内障超声乳化联合人工晶体植入术对急性闭角型青光眼合并白内障患者临床疗效[J].浙江创伤外科,2017,22(3):478-480.
[20]张为中,王润,杨勤.Acry SofToric人工品状体植入矫正角膜散光的临床应用[J].中华显微外科杂志,2015,38(2):194-196.
[21]张仙,张瑞勇,张雪梅等.白内障超声乳化联合人工晶体植入术手术配合[J].航空航天医学杂志,2017,28(8):1025-1026.
[22]罗永旗,王力,王健等.同期小梁切除联合白内障超声乳化人工晶体植入术治疗青光眼合并白内障的疗效[J].临床医学研究与实践,2017,2(2):83-84.
[23]Ma X,Li Z.Capsular tension ring implantation after lens extraction for management of subluxated cataracts[J].Int J Clin Exp Pathol,2014,7(7):3733-3738.