CAJ | 학술논문

目的通过观察多焦点人工晶状体兔眼植入术后视网膜光凝参数及效果,为临床多焦点人工晶状体植入术后视网膜光凝提供参考.方法健康成年青紫蓝兔6只6只眼,2只眼植入ZM900型人工晶状体,2只眼植入Rezoom人工晶状体,2只眼作为对照.人工晶状体植入术后两周,行视网膜光凝.于光凝术后1h,24 h,1周,4周分别行眼底荧光血管造影(fundus fluorescein angiography,FFA)和视网膜断层扫描(Optical Coherence Tomography,OCT),分别观察激光斑处荧光素渗漏情况和光凝后视网膜组织变化情况.结果 ZM900组200μm光凝斑,平均能量(200.6±14.31) mW; 500 μm光凝斑,平均能量(219.2±3.93) mW; Rezoom组200 μm光凝斑,平均能量(203.6±9.77) mW,500 μm光凝斑平均能量(206.0±9.19) mW;对照组200μm光凝斑平均能量(116.2±14.99) mW,500μm平均能量(133.5±4.78) mW.两种多焦点人工晶状体200 μm和500 μm光凝斑能量差异无统计学意义(P＞0.05)；与对照组两种直径的光凝斑比较差异有统计学意义(P＜0.05),多焦点人工晶状体组激光能量大于对照组.所有组在光凝后1h、24 h、1周、4周,相同观察时间点内,光凝斑在眼底彩照和FFA中表现基本相同.OCT表现:ZM900组和Rezoom组在光凝后24h,光凝斑处神经纤维层增厚,光斑旁伴有明显的神经上皮脱离,而对照组光斑旁并未出现明显的神经上皮脱离.结论折射型和衍射型人工晶状体都可以顺利完成视网膜光凝,但多焦点人工晶状体植入术后目视观察光凝斑强度可能造成光凝过度,建议对植入多焦点人工晶状体的患者进行治疗时适当减小光凝强度.
목적 통과관찰다초점인공정상체토안식입술후시망막광응삼수급효과,위림상다초점인공정상체식입술후시망막광응제공삼고.방법 건강성년청자람토6지6지안,2지안식입ZM900형인공정상체,2지안식입Rezoom인공정상체,2지안작위대조.인공정상체식입술후량주,행시망막광응.우광응술후1h,24 h,1주,4주분별행안저형광혈관조영(fundus fluorescein angiography,FFA)화시망막단층소묘(Optical Coherence Tomography,OCT),분별관찰격광반처형광소삼루정황화광응후시망막조직변화정황.결과 ZM900조200μm광응반,평균능량(200.6±14.31) mW; 500 μm광응반,평균능량(219.2±3.93) mW; Rezoom조200 μm광응반,평균능량(203.6±9.77) mW,500 μm광응반평균능량(206.0±9.19) mW;대조조200μm광응반평균능량(116.2±14.99) mW,500μm평균능량(133.5±4.78) mW.량충다초점인공정상체200 μm화500 μm광응반능량차이무통계학의의(P＞0.05)；여대조조량충직경적광응반비교차이유통계학의의(P＜0.05),다초점인공정상체조격광능량대우대조조.소유조재광응후1h、24 h、1주、4주,상동관찰시간점내,광응반재안저채조화FFA중표현기본상동.OCT표현:ZM900조화Rezoom조재광응후24h,광응반처신경섬유층증후,광반방반유명현적신경상피탈리,이대조조광반방병미출현명현적신경상피탈리.결론 절사형화연사형인공정상체도가이순리완성시망막광응,단다초점인공정상체식입술후목시관찰광응반강도가능조성광응과도,건의대식입다초점인공정상체적환자진행치료시괄당감소광응강도.
Objective To provide reference for retina photocoagulation through multifocal-intraocular lens (MIOL) in patients.By studying retinal photocoagulation parameters and the effects after MIOL implantation in rabbit eyes. Methods Total 6 adult purple blue rabbits were included in this study.Two ZM900 MIOLs and two Rezoom MIOLs were implanted in 4 eyes separately,and 2 eyes as a comparison.Fundus fluorescein angiography (FFA) and retina Optical Coherence Tomography (OCT) were performed 1 hour,24 hours,1 week,4 weeks after retinal photocoagulation.The fluorescent leak of laser spots and retina tissue changes were observed. Results The average energy was 200.6±14.31mW in ZM900 group with 200μm spot and 219.2±3.93mW with 500μm.In Rezoom group,the average energy was 203.6±9.77mW with 200μm spot,and 206.0±9.19mW with 500μm spot.In the control group,the average energy was 116.2±14.99mW with 200μm photocoagulation spot and 133.5±4.78mW with 500μm spot.There was no statistically significance between the 200μm and 500μm spot in MIOL groups (P ＞0.05).Laser energy in control group was greater than MIOL groups,and there was statistical significance between control and MIOL group in two diameter spot (P ＜0.05).Twenty-four hours after photocoagulation,there was significant neural epithelial detachment in ZM900 group and Rezoom group,whereas detachment was not observed in the control group. Conclusions Retina photocoagulation can be successfully completed through both refraction and diffraction MIOLs,but excessive photocoagulation is observed in MIOL implanted eyes.Thus it suggests proper reduction of laser intensity for treatment patients with MIOL implantation.