矫正散光的复曲面人工晶体课件

矫正散光的复曲 面人工晶体 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 散光 v由于眼球各经线的屈光力量不同，平行光线 进入眼内在视网膜上不能形成焦点而是形成 焦线的一种屈光状态 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 散光历史 v1727年，牛顿首先考虑到散光问题，发现 自己有散光 v1793年，Young测量出自己存在-1.70D近视 散光，散光最早记载 v1827年，英国Airy利用圆柱镜矫正散光 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 散光矫正 v非手术矫正 框架眼镜矫正 角膜接触镜 v手术矫正 角膜屈光手术 晶状体摘除联合复曲面人工晶体植入手术 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 复曲面人工晶体材料和设计 vPMMA 优点：无刺激，性能稳定，可铸压成形，可抛光切削 缺点：角膜内皮细胞毒性大，可被YAG激光损伤 vSilicone 优点：结构稳定，组织相容性好，可在眼内长期存留 缺点：易产生静电，吸附空气中微粒和眼内新陈代谢产物 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 手术适应症 v白内障手术前存在角膜规则散光， 1.5D v高度近视或远视伴散光 v穿透性角膜移植术后散光 v角膜屈光性手术后残留或回退散光 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 复曲面人工晶体的屈光度选择 v根据患者的生物测量检查值和角膜地形图结 果 vStaar SRK/T toric version 1.0计算机软件计 算选择 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 手术前特殊准备 v根据眼生物测定和角膜地形图结果确定角膜 散光轴的方向 v在角膜缘或透明角膜标记方位 v用染料或YAG激光进行标记 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 手术特殊并发症 v复曲面人工晶体的旋转而偏离了原先确定的散光轴 将严重影响手术后视力效果 v人工晶体轴位偏移0-30度，对散光矫正影响较小 ，临床上多数患者可以接受 v人工晶体轴位偏移超过30度，原有散光几乎得不 到任何矫正 v人工晶体轴位偏移超过45度，会使患者原有散光 加重，严重影响术后视功能恢复 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 人工晶体轴位偏移原因 v重力因素 v眼球运动 v囊袋变化，囊袋大小、囊袋内纤维化和上皮 细胞增生 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 人工晶体轴位稳定原因 v人工晶体的襻和光学部与囊袋之间的压力和 摩擦力保持稳定性 vPMMA复曲面人工晶体稳定性较好 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 复曲面人工晶体偏移处理 v研究表明植入复曲面人工晶体发生严重偏移（大 于30度）大约5% v最佳处理时间手术后1-2周，因为时间一长囊袋收 缩，容易发生悬韧带离断，处理困难 Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 手术效果 v1999年，Andreas Frohn一例 v患者57岁，27年前曾行左眼角膜移植术，手术前左眼最佳 矫正视力+4.50/-5.75X75=20/50，角膜地形图散光13.4D， 手术中植入球面+19D，柱面+12D的PMMA复曲面人工晶 体，手术后矫正视力+1.50/-3.00X90=20/25 v1999年，Irene Ruhswurn37眼平板状折叠复曲面 人工晶体 v手术后31眼（83.8%）球面屈光不正矫正，34眼（91.9%) 最佳矫正视力0.5,术后总体散光由术前2.68D矫正到 0.84D Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile .Created with Aspose.Slides for .NET 3.5 Client Profile . Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd. 手术效果 v2000年xiao-yi Sun130例，对比复曲面人工晶 体和人工晶体植入联合角膜松解切开术 v复曲面人工晶体植入组 裸眼视力（LogMAR)由术前0.740.25减少到0.210.21 散光度由2.571.75到1.030.79 v人工晶体植入联合角膜松解切开术组 裸眼视力（LogMAR)由术前0.780.30减少到0.340.22 散光度由2.580.89到1.49