本文關鍵詞： 飛秒激光微小切口基質(zhì)透鏡取出術 切削中心 瞳孔中心EPC 角膜最高點CV kappa角 高階像差　出處：《浙江大學》2015年博士論文　論文類型：學位論文

【摘要】：目的：觀察飛秒激光微小切口基質(zhì)透鏡取出術(SMILE)的切削中心與瞳孔中心EPC、角膜最高點CV的位置關系,評價SMILE術中定位方法的有效性。 方法：選取于我院行SMILE手術的病例共54人(105眼),使用Orbscan II角膜地形圖儀測定患者術前及術后3月的角膜地形圖,通過兩種不同方法從地形圖上測定切削中心,觀察切削中心與CV、EPC的位置關系。分析κ角大小、方向?qū)η邢髦行牡挠绊?并對偏心距離與術后高階像差的關系進行相關性分析。 結果：SMILE術后3月時105眼相對CV平均偏心距離分別為0.219±0.130mm(方法1)和0.261±0.167mm(方法2),切削中心相對CV在水平方向偏鼻側(cè),垂直方向偏上方。切削中心與EPC距離分別為0.245±0.141mm(方法1)和0.261±0.161mm(方法2),切削中心相對EPC在水平方向偏鼻側(cè),垂直方向隨機分布。切削中心分布與kappa角分布模式一致者分別占70%(方法1)和67%(方法2)。kappa角大小與切削中心相對CV距離無明顯相關性,與方法1測定的切削中心相對EPC距離呈正相關(r=0.303,p=0.002)。SMILE術后總高階像差、球差、垂直彗差、水平彗差均較術前顯著增加,多重線性回歸顯示偏心距離與術后水平彗差變化量(方法1：β=0.241,p=0.015；方法2：β=0.457,p=0.000)和彗差變化量(方法1：β=0.253,p=0.007；方法2：β=0.335,p=0.000)相關,與球差、垂直彗差、總高階像差的變化量無明顯相關性。 結論：SMILE術中定位方式有效,切削中心更靠近CV。切削中心分布與kappa角分布模式基本一致,kappa角大小對切削偏心距離無明顯影響。偏心距離與術后水平彗差、彗差變化量呈正相關,減小偏心距離有助于提高術后視覺質(zhì)量。
[Abstract]:Objective: to observe the relationship between the cutting center of femtosecond laser microincision matrix lens extraction (Smil) and the position of the center of pupil and the highest point of cornea CV, and to evaluate the effectiveness of the localization method in SMILE. Methods: a total of 54 patients (105 eyes) who underwent SMILE operation in our hospital were selected. The corneal topographic maps of the patients before and after March were measured by Orbscan II corneal topographic instrument, and the cutting center was measured from the topographic maps by two different methods. The position relationship between cutting center and CVN EPC was observed, the effect of 魏 angle and direction on cutting center was analyzed, and the relationship between eccentric distance and postoperative high order aberration was analyzed. Results the mean eccentric distance of relative CV in 105 eyes was 0.219 鹵0.130mm (method 1) and 0.261 鹵0.167mm (method 2) on March after the operation. The distance between cutting center and EPC is 0.245 鹵0.141mm (method 1) and 0.261 鹵0.161mm (method 2). The distribution of cutting center was consistent with the pattern of kappa angle distribution in 70 cases (method 1) and 67 parts (method 2. Kappa angle size had no significant correlation with the relative CV distance of cutting center, respectively). The relative EPC distance of cutting center measured by method 1 was positively correlated with the total high order aberration, spherical aberration, vertical coma and horizontal coma after operation. Multiple linear regression analysis showed that the eccentric distance was correlated with the changes of horizontal coma (method 1: 尾 = 0.241 p0. 015; method 2: 尾 = 0. 457; method 2: 尾 = 0. 457) and the amount of coma (method 1: 尾 = 0. 253, p0. 007; method 2: 尾 = 0. 335, P 0. 000), but not correlated with spherical aberration, vertical aberration, and total higher order aberration. ConclusionThe operative localization method is effective and the cutting center is closer to the kappa. The distribution of the cutting center and the distribution pattern of the kappa angle have no significant effect on the eccentric distance of the cutting, and the eccentric distance is positively correlated with the horizontal coma and the change of the coma after operation. Reducing eccentric distance is helpful to improve postoperative visual quality.
【學位授予單位】：浙江大學
【學位級別】：博士
【學位授予年份】：2015
【分類號】：R779.63

【參考文獻】

相關期刊論文 前1條

1 ;External sclerostomy with the femtosecond laser versus a surgical knife in rabbits[J];International Journal of Ophthalmology(English Edition);2012年03期

，

本文編號：1523192