作者：王红星，徐庆 作者单位：100022)中国北京市垂杨柳医院眼科
【摘要】 目的：比较白内障患者散瞳前后眼部生物测量变化，比较散瞳前后人工晶状体屈光度选择的准确性。
【关键词】 散瞳；超声生物测量；人工晶状体
Comparison of ocular biomeasurement before and after mydriasis in cataract patients and analysis of precise selection of intraocular lens diopter HongXing Wang, Qing Xu Department of Ophthalmology, Chuiyangliu Hospital, Beijing 100022, China Abstract AIM: To compare the changes of ocular biomeasurement and the accuracy of selection of intraocular lens (IOL) diopter before and after mydriasis in cataract patients.
METHODS: The axial length(AL), lens thickness(LT) and anterior chamber depth(ACD) were measured in 36 eyes of 50 patients with cateract before and after mydriasis by tropicamide，comparing the difference of predicted (IOL) diopter.
RESULTS: ACD was 2.95±0.07mm before mydriasis and 3.05±0.08mm after mydriasis with statistical significance between two examinations (P<0.05). LT was 4.83±0.06mm before mydriasis and 4.73±0.06mm after mydriasis with statistical significance between the two examinations (P<0.01). AL was 22.98±0.24mm before mydriasis and 22.95±0.24mm after mydriasis, and there was no statistical significance between the two examinations. Range of predicted diopter for IOL was（0.00～0.50D），and predicted IOL diopter was 22.38±0.44D before mydriasis and 22.56±0.47D after mydriasis. There was no statistical significance between the two examinations. But predicted diopter for IOL after mydriasis was 0.50D higher than that before mydriasis.
CONCLUSION: In the present study sample size，anterior chamber deepening may occur after mydriasis; lens may attenuate; there was no significant difference in the changes of axis oculi and predicted IOL diopter; but after mydriasis, predicted IOL diopter may be 0.50D higher than that before mydriasis. Ocular biomeasurement in normal pupil eye, especially for eyes with adjustable intraocular lenses may be recommended.
KEYWORDS: mydriasis; ultrasound biomicroscopy; intraocular lens
方法：选择白内障患者26例36眼，在托品卡胺散瞳前后分别行眼部前房深度、晶状体厚度、眼轴长度测量，比较散瞳前后预期人工晶状体屈光度的差异。
结果：前房深度散瞳前后分别为2.95±0.07mm和3.05±0.08mm，具有统计学意义（P<0.05）；晶状体厚度散瞳前后分别为4.83±0.06mm和4.73±0.06 mm ，具有统计学意义（P<0.01）；眼轴长度散瞳前后分别为22.98±0.24mm和22.95±0.24mm，无统计学意义；人工晶状体预留屈光度范围（0 .00～0.50D），预期屈光度散瞳前后分别为22.38±0.44D和22.56±0.47D，无统计学意义。但散瞳后预期人工晶状体屈光度明显高于散瞳前0.50D。
结论：在目前研究样本量下，散瞳后前房加深，晶状体变薄，眼轴变化无统计学意义，预期人工晶状体屈光度无统计学意义，但散瞳后预期人工晶状体屈光度多数高于散瞳前0.50D，建议正常瞳孔下行眼部生物测量，尤其应用于可调节人工晶状体。
0引言
超声乳化联合人工晶状体植入术已经由单纯的复明手术发展成为屈光手术。提高白内障术后的全程视力已经成为眼科医生关注的话题。随着手术技术的提高、生物参数测量的精确化，准确地计算所植入的人工晶状体的屈光度，是术后获得理想屈光状态的重要环节之一。尤其多焦人工晶状体的应用，需要精确的屈光结果，才能有良好的临床效果。那么，临床中常规白内障散瞳检查，是否对预期人工晶状体屈光度的精确选择有影响呢？我们对在我院拟行白内障手术的患者26例36眼，散瞳前后行眼部生物测量，现将结果报告如下。
1对象和方法
1.1对象 我们对200904/07在我院拟行白内障手术的患者中随机抽取26例36眼，其中男11例16眼，女15例20眼，平均年龄62±6.3岁。排除眼部病变如角膜病、青光眼、糖尿病视网膜病变、黄斑病变等。
1.2方法 使用法国BVI公司眼科专用AB型超声诊断系统中的A型超声生物测量系统。探头为眼压式生物测量专用，频率10MHz，脉冲式。分别于托品卡胺散瞳前后进行生物测量。操作时，拭去眼部液体（眼液及泪液），探头与角膜面垂直正交，勿施压力，嘱患者固视正上方。启动仪器，A型生物测量波形屏幕自动显示，每眼均自动测量10次，数据由计算机自动处理并显示，取均值登记，所取数据s<0.1，所有对象均由同一人操作完成。
统计学分析：采用SPSS 12.0统计软件包进行配对资料t检验。
[1] [2] 下一页 |
