超音波晶體乳化手術併人工水晶體植入後隅角閉鎖型青光眼治療之分析與研究

A Study in the Prognosis of Angle-Closure Glaucoma Treatment after Phacoemulsification Surgery and Intraocular Lens Implantation applied

陳定杰(Ding-Jie Chen)

指導教授 ： 李宗翰

共同指導教授 ： 黃曼菁

淡江大學/工學院/機械與機電工程學系碩士班/碩士(2011年)

https://doi.org/10.6846/TKU.2011.00826

摘要

目的: 近年來超音波晶體乳化手術併人工水晶體植入為主要治療隅角閉鎖型青光眼的方式，但對於術後恢復的追蹤並不完整。故，本研究則專門針超音波晶體乳化手術術後恢復之情形進行模擬與討論。
方法: 本研究以數值模擬之方式，研究超音波晶體乳化手術用於治療隅角閉鎖型青光眼所造成的現象，並將眼內之壓力以及房水流動情形以具體呈現並以動畫表示，供眼科醫師治療之參考，期望可以用更簡單而明確的方式治療病患。
超音波晶體乳化手術是將水晶體置換成人工水晶體，此舉將造成前房深度的巨幅改變，亦造成眼內流場與壓力分佈的根本性變化，故以此做為實驗的主要變因，模擬術後眼球前後房的壓力與房水流動之異動情形，並探討超音波晶體乳化手術在治療隅角閉鎖型青光眼之成效與其復發的可能性。
實驗結果: 本研究之結果顯示，超音波晶體乳化手術後一週，眼壓由術後的15~18 mmHg降至14~16 mmHg，房水流速由0.072299 mm/s降至0.055857 mm/s；術後一個月，眼壓降至13~15 mmHg房水流速降至0.052997 mm/s；術後三個月，眼壓降至12~15 mmHg而房水流速則降至0.05144 mm/s。
結論: 由於眼壓與房水之變化均趨於穩定，眼壓過度上升導致青光眼復發的情況也受到有效控制，由此明確了房水流動狀態與眼內前後房壓力變化的正相關性；也肯定了超音波晶體乳化手術對於治療隅角閉鎖型青光眼之成效。

關鍵字

超音波晶體乳化手術 ； 隅角閉鎖型青光眼 ； 眼壓 ； 前房深度

並列摘要

Purpose: In this study, a numerical model is constructed to simulate the progressiveness of the pressure and flow field of an eye with angle closure glaucoma after phacoemulsification surgery being done.

Methods: Clinical data of the depth of anterior chamber is used as the main factor to simulate aqueous humor flow in the chambers and intraocular pressure when the depth varies.

Results: After the surgery, the intraocular pressure decreases from 15 ~ 18 mmHg to 14 ~ 16 mmHg and aqueous humor flow rate reduces from the 0.072299 mm/s to 0.055857 mm/s in a week. Intraocular pressure keeps decreasing to 13~15mmHg and aqueous humor flow rate declines to 0.052997mm/s in a month, and the pressure falls to 12~15 mmHg and aqueous humor flow rate reduces to 0.05144 mm/s after three month. It is found that the decrease of intraocular pressure and aqueous humor flow rate turn to be stable after then.

Conclusions: The recrudescence of angle closure glaucoma can be effectively controlled through doing phacoemulsification surgery. The numerical results evidently show the mechanism how the aqueous humor flow rate and intraocular pressure are changed after the surgery done.

並列關鍵字

Angle-closured glaucoma ； Phacoemulsification ； Pressure ； Anterior chamber depth

參考文獻

24. 蕭天偉，「超音波晶體乳化手術併人工水晶體植入於隅角閉鎖型青光眼治療之研究」，淡江大學 機械與機電工程研究所，2010。

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