玻璃体视网膜手术后眼球屈光系统的变化

目的 研究玻璃体视网膜手术后眼球屈光系统的变化及其影响因素.方法 应用眼科A型超声仪、i-Trace像差仪等对玻璃体切除术及部分联合视网膜内界膜剥除术的20例(20只眼),单纯玻璃体积血、混浊和20例(24只眼)特发性黄斑裂孔术前及术后1、4、12周时角膜厚度、前房深度、晶体厚度、玻璃体腔长度、眼轴长度及眼球角膜曲率、屈光度等低阶像差和高阶像差进行测量并将结果进行比较.结果 术后1周前房深度加深、晶状体厚度变小(P＜0.05);术前散光轴多在0度和90度附近,术后散光度加大,散光轴主要在30度和150度附近,术后12周同术前比较差异无统计学意义;角膜曲率在术后1周明显增加(P＜0.05),在切口径线的角膜曲率变化最大;黄斑裂孔组高阶像差术前显著高于对侧眼,术后4周玻璃体疾病组和黄斑裂孔组的高阶像差仍偏高(P＜0.05),12周后接近对侧眼水平.结论 玻璃体视网膜手术后眼球低阶像差在1个月内变化较大,3个月后恢复正常,黄斑裂孔术后3个月高阶像差较术前明显改善,视觉质量显著提高.

Refractive changes of ocular after para plana vitectomy

Objective To investigate the refractive changes of ocular after pars plana vitrectomy.Methods A total of 44 eyes of vitreous opacities or hemorrhage and idiopathic macular hole undergoing conventional PPV combined with or without internal limiting membrane peeling underwent A-scan and i-trance before surgery as well as 1,4 and 12 weeks after surgery.The refractive factors included the depth of anterior chamber,thickness of lens,length of vitreous,axial length of eye,corneal curvature,refraction and higher-order aberrations.Results Compared with preoperative measurements,the depth of anterior chamber was increased and thickness of lens was decreased significantly at 1 weeks post-operation(P＜0.05).Corneal astigmatism in axis was redistributed and corneal curvature and astigmatism were increased significantly at land 4 weeks postoperation(P＜0.05);Aberrations of IMH were increased significantly at preoperative period and 4 weeks postoperation,and recovered normal at 12 months after operation.Conclusions The refractive and astigmatism were changed significantly at 1 and 4 weeks post-operation,but no significant changes were observed at 12 months after operation.Higher-order aberrations of IMH were decreased significantly at preoperative period and recovered normal at 12 month after operation,getting better visual function.