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

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ReSTOR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( ±s)表示。Bigbag人工晶状体组和ReSTOR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ReSTOR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ReSTOR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ReSTOR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ReSTOR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ReSTOR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ReSTOR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ReSTOR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ReSTOR人工晶状体更具优势。

Clinical analysis of intraocular biological measurement changes and intraocular lens design after cataract phacoemulsification combined with intraocular lens implantation

ObjectiveTo investigate the changes of intraocular biometrics and the selection of intraocular lens types after phacoemulsification and intraocular lens implantation. MethodsA total of 60 cases (60 eyes) who received phacoemulsification and intraocular lens implantation from February 2016 to February 2018 in the Ophthalmology Department of Baotou Central Hospital of Inner Mongolia Autonomous Region were studied. There were 33 males (33 eyes) and 27 females (27 eyes). The age ranged from 42 to 78 years, with an average of (60.8±10.2) years. According to the type of intraocular lens selected during surgery, all the cases included in this study were divided into two groups: Bigbag intraocular lens group and ReSTOR intraocular lens group. The visual acuity, the best corrected visual acuity, the distance from posterior capsule to retina, the length of eye axis, the depth of anterior chamber and intraocular pressure were examined before and after operation. Use ( ±s) to express. Bigbag intraocular lens group and ReSTOR intraocular lens group were compared by t test and paired t test. ResultsThere were no significant differences 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, best corrected vision, distance from posterior capsule to retina, axial length and intraocular pressure between the two groups before treatment (t=0.683, 0.432, 0.963, 0.862, 0.634; P>0.05). There was no significant difference in intraocular pressure between the two groups (t=0.031, 0.079, 0.091, 0.29; P>0.05). After treatment, the naked eye vision of the two groups was significantly improved compared with that before treatment (t=21.779, 13.326; P<0.05). After treatment, the naked eye vision of Bigbag intraocular lens group was significantly higher than that of ReSTOR intraocular lens group (t=5.136, P<0.05). The best corrected 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 group was significantly higher than that of ReSTOR 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 Bigbag intraocular lens group was significantly higher than that in ReSTOR intraocular lens group (t=2.924, P<0.05). The difference of naked vision, best corrected visual acuity, posterior capsular to retina distance between Bigbag intraocular lens group and ReSTOR intraocular lens group before and after surgery was significantly smaller than that of ReSTOR intraocular lens group (t=35.45, 27.25, 2.05; P<0.05). After treatment, 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 in ReSTOR intraocular lens group (t=13.982, P<0.05). After treatment, the anterior chamber depth of the two groups was significantly deeper than before treatment (t=16.489, 8.0951; P<0.05). The anterior chamber depth of Bigbag intraocular lens group was significantly deeper than that of ReSTOR intraocular lens group (t=12.97, P<0.05). The difference of axial length and anterior chamber depth before and after operation in Bigbag intraocular lens group was significantly greater than that in ReSTOR intraocular lens group (t=8.45, 16.49; P<0.05). ConclusionsAfter phacoemulsification combined with intraocular lens implantation, 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 intraocular pressure did not change significantly. Bigbag intraocular lens implantation in phacoemulsification combined with intraocular lens implantation has more advantages than ReSTOR intraocular lens implantation.