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。

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.

目錄
中文摘要...………..….…………………………………………….……I
英文摘要………………………………………………………………..III
目錄...…………….………..………………….…….…………….….V
圖目錄…………...…………….…..……………………….………….VII
表目錄……………...…………..………………………………….…...X
第一章 序論……….……...…..………………………………………..1
1-1前言…………...…………….…….....……………...…..1
1-2研究背景與研究動機…………………….…………….3
1-3超音波晶體乳化手術簡介…………...…………....….6
1-4文獻回顧……...………………...……..……...............8
第二章 研究方法……………………..………………………………10
2-1 有限元素法概述………...…………….......…………………11
2-2 應用軟體…………….………….……...……………………13
2-2-1 Pro/Engineer…………...……..……….............…….13
2-2-2 ANSYS………………..……………………..…….....14
2-3 研究過程……………......……………….…….…................15
2-4分析理論……...………..…….……….……………………...16
第三章 元素、材料參數與邊界條件設定…………..…..……….…18
3-1 選定分析元素……………...……………………....…....…..18
3-1-1 房水流體分析元素……..…………..………..…..….18
3-1-2水晶體及玻璃體分析元素…………………………...19
3-2 材料參數設定………...…………………………………..20
3-3 分析模型建立……...……………………….…...………..21
3-4 初始條件…………………………………..........….……..26
3-4-1 邊界條件……………………………....……….……28
第四章 超音波晶體乳化手術術後模擬……...………….…..………31
4-1隅角閉鎖型青光眼………………….……………….....…31
4-2超音波晶體乳化手術………………….………..…...……33
4-3人工水晶體與前房深度…….………………..……...……34
4-4超音波晶體乳化手術術後模擬……………..………..…..37
4-4-1術後房水趨勢與壓力之分析…….................………..38
4-4-2術後一週房水趨勢與壓力之分析………………..….42
4-4-3術後一個月房水趨勢與壓力之分析………………..46
4-4-4術後三個月房水趨勢與壓力之分析………………..50
第五章 結論……………………………………..……....……………57
第六章 未來展望……………………………..………………………59
參考文獻…………………………………………..…………………..60
專有名詞中英文對照表……...………………………………………...64
圖目錄
圖 1-1青光眼後期之視野........................................................................2
圖1-2 眼球構造剖面示意圖...................................................................4
圖 1-3房水流動示意圖............................................................................5
圖 1-4(a)超音波晶體乳化手術過程(一)………………..………..……..7
圖 1-4(b)超音波晶體乳化手術過程(二)…...…………………....……..7
圖 1-4(c)超音波晶體乳化手術過....................……………………..…..7
圖3-1 FLUID142元素圖….….…………….……………………….18
圖3-2 SOLID45元素圖……………….……………………………..19
圖3-3眼球前後房模型(剖面)……………….…………………………24
圖3-4眼球整體模型………………………………………….…..……24
圖3-5眼球分析模型圖……………….………………………....……25
圖3-6網格分析圖.................................................................................25
圖3-7房水流場設定….……….…………………….……………….27
圖3-8模擬負載條件示意圖...…………………..….……………….28
圖3-9 真實眼球結構圖……….…………………………………….30
圖3-10 模擬簡化示意圖.........………………………………..………30
圖4-1 隅角閉鎖型青光眼房水流動示意圖………………………..31
圖4-2人工水晶體實體……………………………………………....34
圖4-3人工水晶體植入前前房深度示意圖….………………….…..35
圖4-4人工水晶體植入後前房深度示意圖…………………….…..35
圖4-5術後房水所造成眼壓之壓力分佈………………………..…..38
圖4-6術後房水流場圖(剖面圖)……………………………….……40
圖4-7術後房水流線圖(剖面圖)……………………………….……40
圖4-8術後水晶體與玻璃體之壓力分佈圖(剖面圖)………….……41
圖4-9術後一週房水所造成眼壓之壓力分佈(剖面圖)……..….……42
圖4-10術後一週房水流場圖(剖面圖)…………………….………..44
圖4-11術後一週房水流線圖(剖面圖)………………………….…..44
圖4-12術後一週水晶體與玻璃體之壓力分佈圖(剖面圖)…….…..45
圖4-13 術後一個月房水所造成眼壓之壓力分佈(剖面圖……….….46
圖4-14術後一個月房水流場圖(剖面圖)…………………………...48
圖4-15術後一個月房水流線圖(剖面圖)…………………….……..48
圖4-16術後一個月水晶體與玻璃體之壓力分佈圖(剖面圖)….…..49
圖4-17術後三個月房水所造成眼壓之壓力分佈(剖面圖)………...50
圖4-18術後三個月房水流場圖(剖面圖)………………….………..52
圖4-19術後三個月房水流線圖(剖面圖)…………………………...52
圖4-20術後三個月水晶體與玻璃體之壓力分佈圖(剖面圖)….…..53
圖5-1  眼壓下降趨勢百分比(與術前比較)…………………………55
圖5-2  流速下降趨勢百分比(與術前比較)………………….……….56
表目錄
表3-1房水材料參數表………………………………..…………..…20
表3-2 水晶體材料參數表…………....………………………….......21
表3-3 玻璃體材料參數表………………………...…………………21

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