【作者】 赵琳；

【导师】 李筱荣；

【作者基本信息】 天津医科大学 ， 眼科学， 2008， 硕士

【摘要】 目的通过检测术后视力、主观调节幅度和药物诱导前后前房深度的变化值,探讨Tetraflex(福来视)(美国Lenstec公司生产)可调节人工晶状体植入术后的临床疗效方法全部患者行白内障超声乳化联合囊袋内人工晶状体植入术,根据植入人工晶状体的不同分为试验组:22例(30眼)植入Tetraflex AIOL,对照组:22例(29眼)植入AcrySofSN60AT IOL。观察并记录术后6个月和12个月时术眼的裸眼远视力、裸眼近视力、最佳矫正远视力、最佳矫正近视力、最佳矫正远视力下的近视力、主观调节幅度,以及应用OCULUS Pentacam三维前段分析仪测量2%匹罗卡品眼液诱导前后的前房深度变化值结果术后6个月时,试验组患者的裸眼近视力为0.43±0.15,最佳矫正远视力下的近视力为0.33±0.10,对照组分别为0.16±0.07和0.15±0.05,两组数据分别比较差异均有统计学意义(p=0.000);术后12个月时,试验组患者裸眼近视力为0.29±0.15,最佳矫正远视力下的近视力为0.23±0.10,与对照组相比(裸眼近视力为0.15±0.06,最佳矫正远视力下的近视力为0.14±0.05)差异有统计学意义(p=0.000);两组患者术后的最佳矫正远视力和最佳矫正近视力分别比较,差异均无统计学意义(p＞0.05)。应用主观移近法测得的调节力:术后6个月时,试验组为1.60±0.57D,对照组为1.10±0.70D,两组数据比较差异有统计学意义(p=0.004);术后12个月时,试验组为1.38±0.52 D,对照组为1.06±0.61 D,差异有统计学意义(p=0.036)。应用OCULUS Pentacam三维前段分析仪测量的2%匹罗卡品眼液诱导前后前房深度的变化值:术后6个月时,试验组为0.50±0.37mm,对照组为0.08±0.06mm;有明显统计学差异(p=0.000);术后12个月时,试验组为0.30±0.27mm,对照组为0.10±0.09mm,差异有统计学意义(p=0.000)。对试验组患者术后6个月和术后12个月数据进行线性相关性分析发现:试验组患者最佳矫正远视力下的近视力和主观调节幅度之间呈现相关性(r=0.530,p=0.003:r=0.569,p=0.001)。对试验组患者术后6个月和术后12个月的资料进行统计学分析发现:术后12个月时,患者的裸眼近视力、裸眼远视力、最佳矫正视力、最佳矫正远视力下的近视力、主观调节幅度和应用OCULUS Pentacam三维前段分析仪测量的2%匹罗卡品眼液诱导前后前房深度变化值,与术后6个月相比,均呈现不同程度的下降趋势(p＜0.05)。结论本研究显示,与传统的单焦点人工晶状体相比,Tetraflex可调节人工晶状体可以为患者提供较好的近视力和主观调节幅度;手术安全、有效,无特殊并发症。远期疗效有待进一步观察。更多还原

【Abstract】 PURPOSETo assess and compare the visual outcomes and accommodative amplitude in cataract patients after implantation of the Tetraflex accommodating intraocular lens(IOL) versus standard monofocal IOLs.METHODSThirty eyes of 22 patients with cataract were performed phacoemulsification and implantation of Tetraflex AIOL.29 eyes of 22 age-matched and sex-matched patients with cataract had the same surgery but with a foldable acrylic IOLs.The Tetraflex accommodating intraocular lens were used in the test group,and conventional IOLs in the control group.All the patients had assessments of amplitude of accommodation, uncorrected distance vision acuity(UCDVA),uncorrected near vision acuity (UVNVA),best corrected near vision acuity(BCNVA),best corrected near vision acuity(BCNVA),distance corrected near vision acuity(DCNVA),accommodative amplitude and the change of anterior chamber depth at 6 month after the surgery,and repeated it at 12 month after the surgery.Accommodative amplitude was measured with pushing-up test.The change of ACD was measured with OCULUS Pentacam analysis system induced by 2%pilocarpine eyedrops.RESULTSAt 6 months after the surgery,the patients in the test group had a UCNVA of 0.43±0.15,while the patients in the control group got a UCNVA of 0.16±0.07.There was statistical difference between the groups(p=0.000).The DCNVA noted in the test group and that noted in the control group was also different(0.33±0.10 versus 0.15±0.05,p=0.000).At 12 months after the surgery,the patients in the test group had better UCNVA and DCNVA(0.29±0.15 versus 0.15±0.06 p=0.000,and 0.23±0.10 versus 0.14±0.05 p=0.000).The patients in the test group had similar BCDVA and BCNVA with the patients in the control group(p＞0.05).At 6 months after the surgery,the push-up test showed that the mean accommodative amplitude was 1.60±0.57 D in the test group and 1.10±0.70D in the control group.There was statistical difference between the groups(p=0.000).At 12 months after the surgery, the results was 1.38±0.52D in the test group versus 1.06±0.61D in the control group. There was statistical difference between the groups(p=0.000).At 6 months after the surgery,the change of the ACD was 0.50±0.37 mm in the test group and 0.08±0.06mm in the control group.At 12 months after the surgery,the results was 0.30±0.27mm versus 0.10±0.09mm.There was statistical difference between the groups(p=0.000).At 6 months after the surgery,there has been found correlation between the DCNVA of the test group and the subjective amplitude of accommodation(r=0.530 p=0.003).The data noted at 12 months after the surgery also showed the correlation between the DCNVA and the subjective amplitude of accommodation in the test group(r=0.569 p=0.001).All the measurements were based on a linear correlation.The UCNVA,DCNVA,BCDVA,BCNVA,UCDVA, subjective amplitude of accommodation and the change of ACD after induced by 2% pilocarpine were noted decreased at 12 months after the surgery,compared with the data noted at 6 months after the surgery(p＜0.05).CONCLUSIONSIn the present study,the Tetraflex AIOL showed greater accommodative amplitude and better near visual acuity than the control group with conventional IOL.The surgery were safe,effective,and without complications.Further research is necessary to confirm these results.更多还原