前节<span>OCT三维重建对Nd∶YAG激光后囊膜切开术后IOL稳定性的评估</span>

doi:DOI:10.3760/cma.j.issn.1674-845X.2016.06.008

摘要
图/表
参考文献(15)
相关文章 (15)

全文: PDF 825KB HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要

目的通过检测Nd∶YAG激光后囊膜切开术前与术后前房深度、人工晶状体（IOL）倾斜度和偏心量的变化，评估其对IOL稳定性的影响。方法前瞻性研究。纳入2013年3月至2014年9月在温州医科大学附属眼视光医院行Nd∶YAG激光后囊切开术的符合入选标准的后发性白内障患者29例（35眼）。术前及术后1个月予以常规眼科检查[包括裸眼视力（UCVA）、最佳矫正视力（BCVA）、眼压（IOP）、眼前段及眼底检查]，并利用眼前节扫频光源相干断层扫描结合Matlab图像分析软件对眼前节进行三维重建，测量前房深度及IOL在x轴（水平方向）和y轴（垂直方向）的倾斜度和偏心量。应用配对样本t检验和符号秩和检验对BCVA、IOP、前房深度及IOL倾斜度和偏心量做相应的统计学分析。结果 BCVA从术前的0.57±0.34（logMAR）提高到术后1个月的0.15±0.15（logMAR），差异有统计学意义（t=7.753，P＜0.01）。术前、术后IOP的差异无统计学意义。术前前房深度为（4.15±0.37）mm，术后1个月为（4.16±0.39）mm，差异无统计学意义。术前、术后1个月IOL在x轴的倾斜度分别为-0.099°（-0.840°～0.057°）和-0.125°（-0.757°～0.067°），在y轴的倾斜度分别为-0.015°（-0.564°～0.113°）和 -0.014°（-0.210°～0.155°），在x轴的偏心量分别为0.051（-0.066～0.192）mm和0.049（-0.038～0.127）mm，在y轴的偏心量分别为0.111（0.009～0.204）mm和0.106（0.013～0.194）mm，差异均无统计学意义。结论Nd:YAG激光后囊膜切开术是治疗后发性白内障安全有效的方法，术后视力显著提高，IOL稳定，前房深度、IOL的倾斜度和偏心量均无明显改变。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	赵泽林
	谭美迪
	黄胜海
	陈绮
	沈梅晓
	徐栩

关键词 ：激光, 固体, 体层摄影术, 光学相干, 晶体, 人工, 后发性白内障, 倾斜度, 偏心量　

Abstract：

Objective In order to evaluate the stability of intraocular lens after Nd∶YAG laser capsulotomy with the assessments of anterior chamber depth, intraocular lens (IOL) tilt and decentration. Methods In this prospective study, total 29 patients (35 eyes) enrolled in from March 2013 to September 2014 in Eye Hospital of Wenzhou Medical University. Preoperatively and postoperatively, routine examinations including uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), intraocular pressure (IOP), slit lamp microscope examination of anterior segment, and fundus examination were taken, meanwhile, the assessments of the anterior chamber depth, IOL tilt and decentration by rebuilding three-dimensional model of anterior segment swept-source optical coherence tomography (AS-SSOCT) were evaluated. All these data were analyzed using paired t test and rank sum test. Results BCVA of this 35 eyes was improved from (0.57±0.34)logMAR preoperatively to (0.15±0.15)logMAR 1 month postoperatively (t=7.753, P＜0.01). There was no significant statistical differences among the IOP variation. Anterior chamber depth was (4.15±0.37)mm preoperatively and (4.16±0.39)mm 1 month postoperatively. Preoperative and 1 month postoperative IOL tilt in x orientation was -0.099°(-0.840°～0.057°) and -0.125°(-0.757°～0.067°), IOL tilt in y orientation was -0.015°(-0.564°～0.113°) and -0.014°(-0.210°～0.155°), IOL decentration in x orientation was 0.051(-0.066～0.192)mm and 0.049(-0.038～0.127)mm, IOL decentration in y orientation was 0.111(0.009～0.204)mm and 0.106(0.013～0.194)mm; the differences were without statistical significance. Conclusion Nd∶YAG laser capsulotomy is effective and safe to treat posterior capsule opacification, BCVA improve postoperatively, the position of IOL is stable postoperatively, and postoperative anterior chamber depth, intraocular tilt and decentration have not siginificant changed.

Key words： Laser, solid Tomography, optical coherence Lenses, intraocular Posterior capsule opacification Tilt Decentration

收稿日期: 2016-04-20

通讯作者: 徐栩，Email：xuxuwz@126.com

引用本文:

赵泽林,谭美迪,黄胜海,陈绮,沈梅晓,徐栩. 前节OCT三维重建对Nd∶YAG激光后囊膜切开术后IOL稳定性的评估[J]. 中华眼视光学与视觉科学杂志, 2016, 18(6): 358-362. Zhao Zelin,Tan Meidi,Huang Shenghai,Chen Qi,Shen Meixiao,Xu Xu. Evaluate the stability of intraocular lens after Nd∶YAG laser capsulotomy by reconstructing three-dimensional model of anterior segment optical coherence tomography . Chinese Journal of Optometry Ophthalmology and Visual science, 2016, 18(6): 358-362.

链接本文:

http://www.cjoovs.com/CN/DOI:10.3760/cma.j.issn.1674-845X.2016.06.008 或 http://www.cjoovs.com/CN/Y2016/V18/I6/358

[1]	Sundelin K, Almarzouki N, Soltanpour Y, et al. Five-year incidence of Nd:YAG laser capsulotomy and association with in vitro proliferation of lens epithelial cells from individual specimens: a case controlstudy[J]. BMC Ophthalmol,2014,14:116. DOI:10.1186/1471-2415-14-116.
[2]	Hawlina G, Perovsek D, Drnovsek-Olup B, et al. Optical coherence tomography for an in-vivo study of posterior-capsule-opacification types and their influence on the total-pulse energy required for Nd:YAG capsulotomy: a case series[J]. BMC Ophthalmol,2014, 14:131. DOI:10.1186/1471-2415-14-131.
[3]	Aslam TM, Devlin H, Dhillon B. Use of Nd∶YAG laser capsulotomy[J]. Surv Ophthalmol,2003,48:594-612. DOI:10.1016/j.survophthal.2003.08.002.
[4]	Taketani F, Matuura T, Yukawa E, et al. Influence of intraocular lens tilt and decentration on wavefront aberrations[J]. J Cataract Refract Surg,2004,30(10):2158-2162. DOI:10.1016/j.jcrs.2004.02. 072.
[5]	Zhao M, Kuo AN, Izatt JA. 3D refraction correction and extraction of clinical parameters from spectral domain optical coherence tomography of the cornea[J]. Opt Express,2010,18(9):8923-8936. DOI:10.1364/OE.18.008923.
[6]	Ozkurt YB, Seng?觟r T, Evciman T, et al. Refraction, intraocular pressure and anterior chamber depth changes after Nd:YAG laser treatment for posterior capsular opacification in pseudophakic eyes[J]. Clin Exp Optom,2009,92(5):412-415. DOI:10.1111/j.1444-0938.2009.00401.x.
[7]	Oztas Z, Palamar M, Afrashi F, et al. The effects of Nd∶YAG laser capsulotomy on anterior segment parameters in patients with posterior capsular opacification[J]. Clin Exp Optom,2015, 98(2):168-171. DOI:10.1111/cxo.12205.
[8]	Findl O, Drexler W, Menapace R, et al. Changes in intraocular lens position after neodymium: YAG capsulotomy[J]. J Cataract Refract Surg,1999,25(5):659-662. DOI:10.1016/S0886-3350(99)00010-3.
[9]	Hayashi K, Harada M, Hayashi H, et al． Decentration and tilt of polymethyl methacrylate, silicone, and acrylic soft intraocular lenses[J]． Ophthalmology,1997,104(5):793-798．
	[10] Montés-Micó R, López-Gil N, Pérez-Vives C, et al. In vitro optical performance of nonrotational symmetric and refractive-diffractive aspheric multifocal intraocular lenses: Impact of tilt and decentration[J]. J Cataract Refract Surg,2012,38(9):1657-1663. DOI:10.1016/j.jcrs.2012.03.040.
	[11] 王珂,潘清,刘文艳,等. 人工晶状体的倾斜度和偏心量测量方法的研究进展[J]. 中国医疗设备,2014,29(2):66-69. DOI:10.3969/j.issn.1674-1633.2014.02.019.
	[12] 方艳文,卢奕,汪琳. 折叠式人工晶状体囊袋内植入后偏心与倾斜的临床研究[J]. 眼视光学杂志,2008,10(4):252-258. DOI:10.3760/ cma.j.issn.1674-845X.2008.04.004.
	[13] De Castro A, Rosales P, Marcos S. Tilt and decentration of intraocular lenses in vivo from Purkinje and Scheimpflug imaging. Validation study[J]. J Cataract Refract Surg,2007,33(3):418-429. DOI:10.1016/j.jcrs.2006.10.054.
	[14] Kumar DA, Agarwal A, Prakash G. Evaluation of intraocular lens tilt with anterior segment optical coherence tomography[J]. Am J Ophthalmol,2011,151(3):406-412. DOI:10.1016/j.ajo.2010.09. 013.
	[15] Ding X, Wang Q, Chang P, et al. The repeatability assessment of three-Dimensional capsule-intraocular lens complex measurements by means of high-speed swept-source optical coherence tomography[J]. PLoS One,2015,10(11):e0142556. DOI:10.1371/journal.pone.0142556.