IOL_Master联合A...合人工晶状体植入术中的应用_唐浩英.pdf

doi:1011659/jjssx08E022097临床研究IOL Master 联合 A 超在白内障超声乳化联合人工晶状体植入术中的应用唐浩英1，张跃红2，黄丹菊1，卢美仪1，王璟1，明国英1，曾昭荣1(1 佛山市三水区人民医院/佛山市第六人民医院眼科，广东 佛山 528100;2 广州市第一人民医院眼科，广东 广州 510080)摘要 目的探讨 IOL Master 联合 A 超在白内障超声乳化联合人工晶状体(IOL)植入术中的应用价值。方法选取于佛山市三水区人民医院接受手术的老年白内障患者 80 例，按照随机数字表法分为 A 超组与联合组，每组40 例。2 组均接受超声乳化联合 IOL 植入术，A 超组于术前使用接触式 A 超测量眼轴长度(AL)、前房深度(ACD)、晶状体厚度(LT)，用 Pentacam 测量角膜曲率(K);联合组采用 IOL Master 5 5 联合 A 超获得上述参数。根据 SK-T 公式计算 IOL 度数。比较 2 组患者术后 3 个月的裸眼远视力(UDVA)、裸眼中视力(UIVA)、裸眼近视力(UNVA)、屈光误差，并采用 IOL 植入术后视觉评估问卷调查患者术后情况(脱镜率、不良视觉现象、屈光满意度评分)。结果2 组患者术后 3 个月的 UDVA 比较差异无统计学意义(P 0 05);联合组术后 3 个月的 UIVA、UNVA 均明显高于 A 超组，差异有统计学意义(P 0 05)。联合组散光 1 0 1 5 D 患眼的屈光误差及总屈光误差明显低于 A 超组，差异有统计学意义(P 0 05)。2 组患者术后不良视觉现象发生率比较差异无统计学意义(P 0 05)。联合组脱镜率与屈光满意度评分均高于 A 超组，差异有统计学意义(P 0 05)。结论IOL Master 联合 A 超可通过优势互补最大限度地降低屈光误差，使患者术后获得更理想的裸眼视力，更高的脱镜率与屈光满意度。关键词白内障;超声乳化联合人工晶状体植入术;IOL Master;A 超;眼轴长度 中图分类号459 9 文献标识码A 收稿日期2022-08-17Application of IOL Master combined with A-ultrasound in cataract phacoemulsification combined with intraocu-lar lens implantationTANG Hao-ying1，ZHANG Yue-hong2，HUANG Dan-ju1，LU Mei-yi1，WANG Jing1，MING Guo-ying1，ZENG Zhao-rong1(1 Department of Ophthalmology，People s Hospital of Sanshui District in Foshan/Sixth People s Hospital of Foshan，Foshan Guangdong528100，China;2 Department of Ophthalmology，Guangzhou First People s Hospital，Guangzhou Guangdong 510080，China)Abstract:ObjectiveTo investigate the application value of IOL Master combined with A-ultrasound in cataract phacoemulsificationcombined with intraocular lens(IOL)implantation MethodsA total of 80 elderly cataract patients who underwent surgery in People sHospital of Sanshui District in Foshan were selected and divided into the A-ultrasound group and the combination group according to randomnumber table method，with 40 cases in each group Both groups received phacoemulsification combined with IOL implantation In the A-ultrasoundgroup，the axial length(AL)，anterior chamber depth(ACD)and lens thickness(LT)were measured by contact A-ultrasound before surgery，and the Keratometer(K)was measured by Pentacam In the combination group，IOL Master 5 5 combined with A-ultrasound was used toobtain the above parameters The IOL degree was calculated according to the SK-T formula The uncorrected distant visual acuity(UDVA)，uncorrected intermediate visual acuity(UIVA)，uncorrected near visual acuity(UNVA)and refractive error 3 months after surgery of the twogroups were compared The visual evaluation questionnaire after IOL implantation was used to investigate the postoperative conditions ofpatients(demirrorization rate，adverse visual phenomena，refractive satisfaction score)esultsThere was no significant difference in 基金项目广东省基础与应用研究基金(2020A1515011402);佛山市医学类科技攻关项目(2020001004715)通信作者张跃红，E-mail:carmenzhangyh163 com 15Sun P，Yang H，Niu W Concerns over thyroid cancer surgeries andquality of lifeJ JAMA Surg，2022，157(8):739 740 doi:101001/jamasurg20220813 16Zheng G，Ma C，Sun H，et al Safety and surgical outcomes of transoralendoscopic thyroidectomy vestibular approach for papillary thyroid cancer:a two-centre study J Eur J Surg Oncol，2021，47(6):1346 1351doi:101016/j ejso 202101 028 17Kang YJ，Cho JH，Stybayeva G，et al Safety and efficacy of transoralrobotic thyroidectomy for thyroid tumor:a systematic review and meta-analysis J Cancers(Basel)，2022，14(17):4230 doi:10 3390/cancers14174230 18Zhang GL，Zhang GL，Lin YM，et al Endoscopic thyroidectomy versustraditional open thyroidectomy for identification of the external branchof the superior laryngeal nerve J Surg Endosc，2021，35(6):2831 2837 doi:101007/s00464 020 07718 x(编辑:刘艺)832局解手术学杂志J EG ANAT OPE SUG2023，32(3)http:/www jjssxzz cnUDVA 3 months after surgery between the two groups(P 0 05)The UIVA and UNVA 3 months after surgery in the combination groupwere significantly higher than those in the A-ultrasound group，and the differences were statistically significant(P 0 05)The refractiveerror of the eyes with astigmatism from 1 0 to 1 5 D and the total refractive error in the combination group were significantly lower than thosein the A-ultrasound group，and the differences were statistically significant(P 0 05)There was no significant difference in the incidenceof postoperative adverse visual phenomena between the two groups(P 0 05)The demirrorization rate and refractive satisfaction score inthe combination group were higher than those in the A-ultrasound group，and the differences were statistically significant(P 0 05)ConclusionIOL Master combined with A-ultrasound can minimize the refractive error through complementary advantages，so that patientscan obtain more ideal naked eye vision，higher demirrorization rate and refractive satisfaction after surgeryKeywords:cataract;phacoemulsification combined with intraocular lens implantation;IOL Master;A-ultrasound;axial length白内障是全球居于首位的致盲性眼病，临床治疗首选外科手术，且随着医疗技术的进步，白内障手术已从复明手术发展为屈光手术1。有研究表明，人工晶状体(intraocular lens，IOL)植入术后患者的屈光状态不仅与手术技巧有关，还与预设的术后屈光状态的准确性有关2。IOL 度数的计算依赖于术眼眼轴长度(axial length，AL)的测量，测量的准确性直接决定 IOL植入术后患者的实际屈光状态，因此