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透明角膜切口矫正散光扩大多焦点人工晶状体植入适应证的观察
随着白内障手术技术的提高和新型多焦点人工晶状体(multifocal intraocular lens,MIOL)面市,白内障患者通过植入人工晶状体而不需要依赖眼镜即可获得满意的全程视力已成为现实。今天的白内障患者已经不仅要求能够看到,而且要求能够获得佳的视觉质量,他们希望能获得更高质量的视力并能够减少眩光和光晕,同时减少对眼镜的依赖。要使这些患者术后达到好的视觉效果,矫正散光是一个十分重要的因素。目前白内障手术角膜散光的矫正方法有透明切口矫正散光法、角膜缘切开松解术、角膜屈光手术以及散光矫正型人工晶体。本文总结了2011年5月至2012年1月在我院行白内障手术,并通过白内障手术源性散光减小术后角膜散光而植入MIOL的患者32例(47眼),现将结果报道如下。
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重视屈光不正手术性治疗的适应证及并发症
流行病学研究表明,人眼近视的发生率不仅位居各类屈光不正之首,而且在临床眼病中也首屈一指。长期以来,人们不断地探索治疗近视的有效方法,但是,由于近视的发生机制复杂不清,因此保守性治疗方法,如药物、仪器及中医针灸等,均无确切疗效。近30年来,人们从干预人眼屈光因素着手治疗近视,包括非手术性方法(如OK镜)和手术性方法两类,虽然取得一定疗效,其中手术性方法为临床治疗屈光不正带来希望,但是大量相关研究和实践证明,目前治疗屈光不正的各类方法仍存在诸多问题,因此在临床实际工作中应持慎重态度。 一、手术类型 治疗屈光不正手术性方法主要从两个屈光因素着手:(1)角膜:包括放射状角膜切开术(radial keratotomy,RK)、准分子激光角膜切削术(photorefractive keratectomy,PRK)、准分子激光原位角膜磨镶术(laser in situ keratomileusis,LASIK)及角膜基质环术(intrastromal corneal ring,ICR);(2)晶状体:包括透明晶状体前眼内透镜植入术 (phakic intraocular lens)和透明晶状体摘除术。
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人工晶状体研究新进展
1 非球面人工晶状体波阵面像差检测结果表明,功能性视觉的降低与晶状体的球差增加密切相关.随着波阵面像差检测技术的不断提高,临床认识到对比敏感度和功能性视觉质量与高阶像差密切相关.
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目的:对比观察后房型人工晶状体植入术后晶状体表面细胞染色前后的数量、形态.方法:20只兔行后房型人工晶状体植入术.分别于术后1,3,7,14和28 d分组取出人工晶状体放入1640细胞培养液于倒置显微镜下观察.结果:术后1~28 d人工晶状体表面有细胞粘附,染色后细胞形态失去立体外观,体积小,细胞数量较染色前明显减少.结论:人工晶状体表面细胞在染色过程中有部分脱落.脱落的细胞数量可以计数比较,但细胞类型无法确定.因此需寻找更精确可靠的仪器及方法,以免造成实验误差.
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人工晶状体的分类及研究进展
白内障足全球主要的致盲眼病之一[1],其中,年龄相关性白内障是为常见的类型,多发生于60岁及以上的老年人[2].
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多焦点折叠式人工晶状体植入术的临床观察
我科2005年10月至2006年6月行超声乳化白内障摘出植入多焦点人工晶状体(multifocal intraocular lens,MIOL)86眼,效果满意.
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Toric人工晶状体矫正散光的临床效果评价
据统计,15%~29%的白内障患者存在≥1.5D的角膜散光[1],这些散光明显影响了白内障患者术后的视觉质量.散光型人工晶状体(Toric intraocular lens,Toric IOL)是将散光矫正与IOL的球镜度数相结合的一种新型屈光性IOL.本研究通过对Acrysof Toric IOL植入术后的临床观察,评价该散光型IOL矫正散光的效果和其在囊袋内的稳定性.
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ReSTOR多焦点人工晶状体植入术后远期视觉质量评价
ReSTOR多焦点人工晶状体(multifocal intraocular lens,MIOL)能改善远近视力,其短期(3~6个月)效果已被证实[1-3],但是评价其远期效果的报道少见.
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后房型人工晶状体缝线固定术临床观察
我院2000年1月~2003年3月对后囊不完整或阙如的无晶状体眼行后房型人工晶状体(posterior chamber intraocular lens,PC-IOL)缝线固定术,报告如下.
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Purpose: To compare vision quality following phacoemulsifi-cation cataract extraction and implantation of a Big Bag or Akreos Adapt intraocular lens (IOL) in patients diagnosed with high myopia complicated with cataract. Methods:.This was a randomized prospective control study. The patients with high myopia complicated with cataract , with axial length ≥28 mm,.and corneal astigmatism ≤1D were enrolled and randomly divided into the Big Bag and Akreos Adapt IOL groups. All patients underwent phacoemulsification cataract extraction and lens implantation..At 3 months after surgery,.intraocular high-order aberration was measured by a Tracey-iTrace wavefront aberrometer at a pupil diameter of 5 mm in an absolutely dark room and statistically compared be-tween two groups. The images of the anterior segment of eyes were photographed with a Scheimpflug camera using Penta-cam three-dimensional anterior segment analyzer..The tilt and decentration of the IOL were calculated by Image-pro plus 6.0 imaging analysis software and statistically compared between two groups. Results:.In total,.127 patients (127 eyes),..including 52 males and 75 females, were enrolled in this study. The total high-or-der aberration and coma in the Akreos Adapt group (59 eyes) were significantly higher compared with those in the Big Bag (P<0.05)..The clover and spherical aberration did not differ between the two groups (P>0.05). The horizontal and vertical decentration were significantly smaller in the Big Bag lens group than in the Akreos Adapt group (both P<0.05), where-as the tilt of IOL did not significantly differ between the two groups (P>0.05). Conclusion:.Both Big Bag and Akreos Adapt IOLs possess relatively good intraocular stability implanted in patients with high myopia. Compared with the Akreos Adapt IOL, the Big Bag IOL presents with smaller intraocular high-order aberra-tion. Coma is the major difference between the two groups.
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Purpose:To report on the clinical findings of a case of late opacification of the hydrophobic acrylic intraocular lens (IOLs) in both eyes after cataract surgery.Methods:A 79-year-old man with a history of decreased visual acuity and complaints of glare and blurred vision in both eyes over the past 3 years.He had received an uneventful phacoemulsification combined with posterior chamber IOL implantation for senile cataract in both eyes 13 years ago,and had undergone neodymium:YAG (Nd:YAG) laser posterior capsulotomy on both eyes 6 years ago,for posterior capsular opacification (PCO).The optical portion of the IOLs showed uniform gray haze.Binocular posterior capsular laser holes were clearly noted.Results:IOL exchange was performed by the same surgeon on both eyes,three days apart.Postoperatively,the patient's visual acuity was elevated to 6/12 (OD) and 6/9 (OS) at 6months,and intraocular pressure (IOP) reached 16.8 mmHg (OD) and 18.4 mmHg (OS).Neither glare or blurred vision were observed in either eye.Conclusion:IOL exchange can be used to effectively manage clinically significant optic opacification.
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多焦点人工晶状体术后的视功能
自1987年Keates等首次报道多焦点人工晶体(Multifocal intraocular lens,MIOL)的植入以来,MIOL在白内障手术日趋完美的同时,其设计及制造工艺也得到改进,两者的进步提高了白内障手术效果及患者的生活质量.现就MIOL术后的视功能作一综述.