眼罩遮盖法鸡形觉剥夺眼的形态及屈光状态

目的 :研究眼罩遮盖的鸡形觉剥夺眼眼球形态及屈光状态随不同遮盖、去遮盖时间的变化。方法 :5 5只雏鸡行单眼眼罩遮盖 ,于不同遮盖时及去遮盖时期行双眼散瞳验光及眼球径测量。结果 :眼罩遮盖造成遮盖眼形成近视 ,眼球各径线增长 ,以前后径变化最为明显 ,双眼屈光度及眼轴差异随遮盖时间延长而更加明显 ;去除遮盖后原遮盖眼近视逐渐恢复 ,双眼各径线差异逐渐缩小。结论 :遮盖 (形觉剥夺 )可使幼小动物眼形成近视 ,眼轴延长是近视的主要原因 ;在动物发育成熟以前去除遮盖 ,形觉剥夺性近视是可逆的     

豚鼠形觉剥夺性近视眼巩膜胶原密度变化

目的探讨新生豚鼠形觉剥夺性近视发生时巩膜胶原密度的变化.方法 20只新生花豚鼠随机分成形觉剥夺组(单眼眼睑缝合组)和正常对照组(无处理组),21 d后测量屈光度,眼球冰冻切片行VanGieson氏天狼猩红染色,以锯齿缘为界分别分析前、后部巩膜胶原密度.结果新生豚鼠21 d的形觉剥夺缝合眼后部巩膜胶原密度明显低于对照眼和正常对照组双眼(P＜0.001);前部巩膜胶原密度在形觉剥夺组和正常对照组相比较,差异无统计学意义(P＞0.05);形觉剥夺组缝合眼和对照眼屈光度差值与后部巩膜胶原密度差值呈明显正相关(r=0.866,P＜0.001).结论新生豚鼠眼形觉剥夺性近视时后部巩膜胶原密度减少,影响胶原代谢的机制需进一步研究.     

外伤性白内障形觉剥夺与轴性近视

目的探讨外伤性白内障形觉剥夺与轴性近视的关系.方法A超测量24例单眼发病的外伤性白内障形觉剥夺眼及对照眼的眼轴,并进行双眼对比分析.结果外伤性白内障形觉剥夺眼和对照眼眼轴相比差异有显著意义(P＜0.05).结论尽早设法恢复视力,解除形觉剥夺,以预防近视.     

眼科研究(2001年)第19卷文题分类索引

1 .视力、视觉、视野多巴胺对兔实验性形觉剥夺性近视形成的影响　　　　　　高前应等 19( 1)∶19纤维连接蛋白在形觉剥夺眼和正常眼的差异表达初歌今等 19( 2 )∶10 1扫描翻转图像视觉诱发电位视力与对数视力表视力的比较　　　　　　朱　捷等 19( 3)∶2 46酒精中毒眼部损害视觉电生理检测　　　　　尹卫靖等 19( 4 )∶36 2国产ｂＦＧＦ在鸡形觉剥夺性近视形成中的作用　　　　　王淑华等 19( 5 )∶413视觉剥夺对不同发育期鸡近视性眼球生长的影响　　　　　肖　林等 19( 6 )∶5 0 02 .眼肌、斜视、屈光、调节先天性白内障近视发生的危险因…     

视黄酸在早期形觉剥夺性近视豚鼠后巩膜中的变化

目的检测豚鼠早期形觉剥夺性近视（FDM）眼巩膜中视黄酸（RA）的水平,探讨RA在FDM眼后极部巩膜中的作用。方法3周龄三色豚鼠30只随机分组,正常对照组6只,形觉剥夺15d组和形觉剥夺24d组各12只,左眼用气球头套分别遮盖15d和24d,右眼为自身对照。实验前后均测量屈光度,实验结束后摘除眼球,测量眼轴长,应用高效液相色谱法（HPLC）测定后极部巩膜RA含量。结果形觉剥夺15d组、形觉剥夺24d组动物实验眼诱导出明显的相对近视,且与正常组比较差异有统计学意义（F=23.053,P〈0.05）。形觉剥夺15d组、形觉剥夺24d组实验眼眼轴均长于自身对照眼（P〈0.05）。形觉剥夺15d组、形觉剥夺24d组实验眼巩膜中RA水平较自身对照眼均明显升高（P〈0.01）,但形觉剥夺15d组、形觉剥夺24d组间比较差异无统计学意义（P=0.857）。结论形觉剥夺可诱导近视,且近视程度在早期随时间递增,形觉剥夺眼眼轴增长。豚鼠早期形觉剥夺眼后极部巩膜RA含量增多,但在15～24d时段内差异无统计学意义。     

近视儿童主导眼相关因素研究

目的:探讨近视儿童主导眼与屈光度、眼别、裸眼视力的关系。方法:随机抽取经散瞳检影验光后,待瞳孔恢复正常复诊配镜患儿99例,用卡洞法检查主导眼,进行分类统计分析。结果:在99例近视患儿中,以右眼为主导眼,即右型(Rtype)者占66.7%(66/99),两者比较差异有显著统计学意义(P=0.0001);当双眼屈光度不相等时,以屈光度相对较低眼为主导眼者42例(52.5%),两者比较差异无统计学意义(P=0.527);当双眼屈光度相等时,以右眼为主导眼,占68.4%,两者比较差异具有统计学意义(P=0.0231);在双眼裸眼视力不等64例中,以裸眼视力低眼为主导眼者34例(53.1%),两者差异无统计学意义(P=0.4795);在双眼裸眼视力相等35例中,右眼为主导眼29例(82.9%),两者比较差异极具统计学意义(χ2=30.2286,P<0.01)。结论:近视儿童主导眼以右型多见,主导眼与屈光度、裸眼视力高低的相关性差异无统计学意义。     

外源性碱性成纤维细胞生长因子对鸡形觉剥夺性近视眼的调控

目的：探讨外源性碱性成纤维细胞生长因子（bFGF）对形觉剥夺性近视眼的调控作用.方法：出生2d龄的来亨雏鸡共35只,随机分为3组,即空白对照组、阴性对照组和实验组,各组雏鸡右眼采用眼罩遮盖1wk,左眼作为自身对照眼.空白对照组的形觉剥夺眼不作任何处理;阴性对照组采用空白载体20 μL对形觉剥夺眼行玻璃体腔注射;实验组形觉剥夺眼玻璃体腔注射20 μL含载体的1,2,4ng bFGF.1wk后测量各组雏鸡形觉剥夺眼及自身对照眼的屈光度和眼轴长度.结果：实验组较空白对照组及阴性对照组明显抑制形觉剥夺造成眼轴过度生长所形成的近视,其差异有显著意义（P＜0.05）;并且实验组的不同剂量即1,2,4ng,对形觉剥夺眼近视的抑制作用呈剂量依赖性（P＜0.05）;所有组自身对照眼屈光度及眼轴长度两两比较均无显著差异.结论：碱性成纤维细胞生长因子能抑制形觉剥夺造成眼轴过度生长所形成的近视眼.     

外伤性白内联IOL植入术后继发性近视

目的 分析外伤性白内障IOL植入术后继发性近视发生的情况。方法 观察4例外伤性白内障IOL植入术后发生继发性近视的原发性损伤、治疗经过及矫正结果。结果 受伤年龄11－31岁,受伤前均系正视眼,白内障摘出及IOL植入术都在受伤后2月内施行,IOL屈光度合适,继发性近视的形成／发展于术后3月以上甚至3年或者更长的时间。结论 外伤性白内障IOL植入术后继发性近视的发生可能与眼穿孔伤造成伤眼角膜散光、角膜疤痕、晶状体浑浊、玻璃体浑浊等多种形觉剥夺因素有关,强调对眼外伤尤其严重性眼外伤者长期随访的重要性,及时去除各种形觉剥夺因素,以恢复和保持伤眼的有用视力。     

豚鼠短期形觉剥夺性近视屈光度眼轴及巩膜改变

目的:观察豚鼠短期形觉剥夺性近视(form deprivationmyopia,FDM)眼轴、屈光度变化及后极部巩膜病理性改变。方法:4周龄健康豚鼠40只,随机分成形觉剥夺实验组和年龄匹配正常对照组各20只。形觉剥夺实验组分为剥夺1,4,7和14d4个亚组,右眼为剥夺眼,采用半透明眼罩遮盖诱导轴性近视,左眼不予处理。对剥夺前后实验组和对照组双眼屈光度、眼轴进行测量,并对后极部巩膜进行HE染色光镜观察和透射电镜观察。结果:形觉剥夺7d近视程度和眼轴长度改变迅速,之后减慢并趋于平稳。4个实验亚组剥夺眼与实验前比较相对近视-0.30±0.45D,-3.65±0.78D,-6.98±0.65D,-8.68±1.12D,相对眼轴延长4.8±3.2,129.0±12.6,159.0±10.1,184.4±10.4μm。其中4,7,14d实验亚组剥夺眼与对照眼差别有统计学差异(P<0.01),剥夺眼后极部巩膜明显变薄,成纤维细胞密度降低,细胞外基质增多。1,4,7,14d实验亚组形觉剥夺眼后极部巩膜胶原纤维平均直径102.0,67.4,52.2,49.8nm,与正常对照眼比较差别有统计学意义(P<0.05)。结论:4周龄豚鼠单眼形觉剥夺4d即可出现轴性近视,1d即有巩膜病理改变,形态学改变先于生物学改变,形觉剥夺7d为近视发展高峰期。     

先天性白内障形觉剥夺时间对眼主要屈光参数的影响

目的评价先天性白内障形觉剥夺时间对眼屈光系统主要参数的影响。方法选取单眼先天性白内障患者48例,年龄(6个月～35岁);术前综合验光仪进行主觉验光,对不能配合主觉验光者进行检影验光,按形觉剥夺时间分为0-4a组(13眼)、4-8a组(18眼)、>8a组(17眼),测量双眼眼轴长度、角膜曲率。最佳矫正视力低于正常视力,或者两眼最佳矫正视力相差两行及其以上者为弱视。结果先天性白内障患者形觉剥夺时间在0-4a组、4-8a组,眼轴长度在双眼之间差异均无统计学意义(P=0.563、0.547);剥夺时间与双眼眼轴长度差值(0.92±0.41)mm、(1.64±1.49)mm并无明显相关性(P=0.703、0.890);各形觉剥夺时间段,双眼角膜曲率差异均无统计学意义(均为P>0.05)。在形觉剥夺时间大于8a组:双眼眼轴长度之间差异有统计学意义(P<0.01);且眼轴长度差值(3.05±1.88)mm与形觉剥夺时间正相关(r=0.816,P<0.01);但是角膜曲率在两眼之间差异均无统计学意义(均为P>0.05)。42例患者双眼等效球镜屈光度绝对值差值(3.66±3.00)D与眼轴长度绝对值差值(2.23±1.46)mm呈正相关(r=0.782,P<0.01)。结论先天性白内障在形觉剥夺初期,并不对眼轴长度产生明显影响,早期的形觉剥夺主要是形成形觉剥夺性弱视;单眼先天性白内障引起的屈光参差,主要由眼轴延长引起。     

One-year outcomes of a bilateral randomized prospective clinical trial comparing laser subepithelial keratomileusis and photorefractive keratectomy

PURPOSE: To compare laser subepithelial keratomileusis (LASEK) and photorefractive keratectomy (PRK) in different eyes of the same patients in terms of visual acuity, refractive error, and complications over 1 year. METHODS: This prospective, randomized, double-masked study comprised 30 active-duty military personnel with myopia who underwent LASEK in one eye and PRK in the other eye. RESULTS: Twenty-eight patients' results were available for 1-year follow-up. The primary outcome measures were visual acuity and refractive error. The mean visual acuity for the LASEK group was 1.56 and 1.67 for the PRK group (z = -0.18, P = .15). The mean spherical equivalent refraction for the LASEK group was -0.007 D and +0.124 D for the PRK group (t = 0.982, P = .40). No significant differences were noted in visual acuity or refractive error in the eyes that had LASEK versus the eyes that had PRK. CONCLUSIONS: After 1-year follow-up, LASEK and PRK show similar levels of visual acuity and refractive error.     

角膜屈光手术治疗成人弱视的疗效分析

目的:观察角膜屈光手术治疗成人屈光不正性弱视的疗效。方法:对53例76眼成人屈光不正性弱视患者行角膜屈光手术治疗,其中38眼行LASIK手术,32眼行薄瓣LASIK手术,6眼行LASEK手术。随访观察12mo,回顾性分析其疗效。结果:患者术前屈光度球镜-13.50～+3.00(平均-7.33±3.36)D,散光-4.25～+2.00(平均-1.40±0.92)D,最佳矫正视力平均0.57±0.06。术后1mo,裸眼视力平均0.64±0.16,与术前最佳矫正视力有显著性差异(P<0.05)。术后12mo,裸眼视力进一步提高,平均0.72±0.20,与术前最佳矫正视力有显著性差异(P<0.05),与术后1mo裸眼视力比较,有显著性差异。术后视力高于术前最佳矫正视力者43眼(57%)。术后视力与术前最佳矫正视力相同者33眼(43%)。结论:准分子激光角膜屈光手术治疗成人弱视,疗效可靠,可有效提高患者视力。     

形觉剥夺性近视豚鼠巩膜形态及TGF-β2表达的变化

目的:观察形觉剥夺性近视豚鼠巩膜组织学改变和TGF-β2在巩膜中的表达。方法:用头套形觉剥夺右眼的方法诱导近视动物模型,实验前后检测豚鼠双眼屈光状态及眼轴长度。HE染色观察后极部巩膜形态学改变,免疫组织化学法对TGF-β2在巩膜内的表达进行定性及半定量测定。结果:实验组巩膜变薄、胶原纤维排列紊乱,粗细不均,纤维间隙变大,纤维走向不一,板层结构不清;巩膜TGF-β2表达明显下调。结论:形觉剥夺性近视眼的巩膜产生一系列的退行性改变,TGF-β2是形觉剥夺性近视形成的重要因素之一。     

负度数折叠式人工晶状体植入术治疗白内障合并轴性高度近视

目的:探讨超声乳化白内障吸除联合负度数人工晶状体植入术治疗白内障合并高度近视的临床疗效。方法:对30例41眼白内障合并高度近视患者行超声乳化白内障吸除联合负度数折叠式人工晶状体植入术,随访6mo,观察术中和术后并发症、术后视力、眼底情况。结果:术前平均眼轴长度为32.11mm。术后视力<0.1者3眼,0.1～0.5者26眼,>0.5者12眼。术中2眼晶状体后囊膜破裂;1眼角膜水肿,未见视网膜脱离。24眼眼底有明显的高度近视眼底病变。结论:超声乳化白内障吸除联合负度数人工晶状体植入术是治疗白内障合并高度近视眼安全、有效的方法。     

Comparison between LASEK with mitomycin C and LASIK for the correction of myopia of -7.00 to -13.75 D

PURPOSE: To compare laser epithelial keratomileusis (LASEK) and LASIK for the correction of high myopia. METHODS: A prospective, single-masked study was conducted. Patients treated with LASEK to correct myopia > or = -7.00 diopters (D) (spherical equivalent manifest refraction) with a cylinder < or = -3.50 D (LASEK group) were compared to patients treated with LASIK (LASIK group) using the same excimer laser (Technolas 217C). Mitomycin C (MMC) 0.02% was applied for 1 minute in all LASEK-treated eyes. RESULTS: A total of 228 consecutive eyes were included in the study (114 in each group, matched for preoperative refraction). The mean preoperative spherical equivalent manifest refraction was -8.72 +/- 1.20 D in the LASEK group and -8.74 +/- 1.20 D in the LASIK group (range: -7.00 to -13.75 D) (P = .9). Uncorrected visual acuity (UCVA) was significantly lower in LASEK eyes 1, 7, and 30 days postoperatively (P = .0001 for each comparison). No significant differences were found at 3 months postoperatively in UCVA (P = .3), best spectacle-corrected visual acuity (BSCVA) (P = .2), or in the safety (P = .6) and efficacy (P = .8) indices. Uncorrected visual acuity was 1.0 or better in 34.2% of LASEK eyes and 44.7% of LASIK eyes. Spherical refraction was +0.25 +/- 0.6 D after LASEK and -0.06 +/- 0.5 D after LASIK (P = .0001). Sixty-eight percent of LASEK eyes and 79% of LASIK eyes were within +/- 0.50 D of intended refraction. No LASEK eye versus 7 LASIK eyes lost 2 lines of BSCVA. Eight LASEK eyes gained 2 or more lines of BSCVA versus 1 LASIK eye. CONCLUSIONS: Visual improvement after LASEK with intraoperative MMC was significantly slower than after LASIK. Visual outcomes (UCVA, BSCVA, and safety and efficacy indices) 3 months after surgery were similar with both techniques for the correction of high myopia. Ten percent more eyes after LASIK were within +/- 0.50 D of intended refraction.     

Wavescan波前像差仪测量屈光不正的准确性研究

目的:评价Wavescan波前像差仪测量近视眼屈光不正的准确性。方法:对33例66眼行屈光不正矫正术的患者分别用电脑验光(睫状肌麻痹和非睫状肌麻痹下)、显然验光、Wavescan波前像差仪法测量眼屈光不正,并将患者按屈光不正度数分为3组:低度近视组(-0.50～-3.00D)17眼,中度近视组(-3.00～-6.00D)27眼,高度近视组(-6.00～D)22眼。对测量的结果进行两两比较,采用配对t检验分析。结果:四种验光方法测量的验光结果(球镜、柱镜、等效球镜)显示,低度近视及高度近视组,显然验光与Wavescan波前像差仪验光球镜及柱镜度数比较没有统计学差异(P=0.289,P=0.814,P=0.057,P=0.246),睫状肌麻痹状态下验光与Wavescan波前像差仪验光在中高度近视组,球镜度数及柱镜度数之间的比较差异没有统计学意义(P=0.052,P=0.111,P=0.539,P=0.154),并且结果不随屈光状态的不同而不同,而等效球镜度数之间的差异具有统计学意义。Wavescan波前像差仪和显然验光及睫状肌麻痹状态下验光测量,结果比较,随屈光不正度数增加,球镜相符率降低,柱镜相符率升高。结论:Wavescan波前像差仪测量屈光不正有较高的准确性,可以很好地用于VISXSTARS4准分子激光治疗系统个体化切削治疗使用,但与显然验光和睫状肌麻痹状态下验光比较仍有差异,可以作为以上两种验光方法的参考和补充。     

角膜塑形镜去片裸眼视力低下的影响因素及近视控制效果

目的：探讨配戴角膜塑形镜6个月后去片裸眼视力低下的影响因素及近视控制效果。方法：回顾性系列病例研究。收集2015年4月至2017年1月于北京同仁医院验光配镜中心验配角膜塑形镜并随访至少6个月的青少年儿童,以去片后即刻裸眼视力能否达到0.8为标准将入选儿童分为2组。比较2组间年龄、视力、屈光度、眼压、角膜曲率、e值、角膜直径、瞳孔直径、非对称性指数、规则性指数的异同,以及对近视的控制效果。采用单因素及多因素线性回归分析去片裸眼视力的影响因素。结果：共50例（96眼）入组,年龄（10.6±2.4）岁,球镜度（-3.62±1.18）D,柱镜度（-0.33±0.43）D,眼轴长度（25.18±0.75）mm。其中裸眼视力≤0.8组52眼,裸眼视力>0.8组44眼,通过单因素分析,较差的裸眼视力与基础较长的眼轴长度（b=-0.09,β=-0.29,P=0.003）、较高的球镜度（b=0.07,β=0.36,P<0.001）、较高的柱镜度（b=0.12,β=0.22,P=0.030）有关。通过多因素线性回归分析,较差的裸眼视力与基础较高的球镜度（b=0.05,β=0.27,P=0.018）有关。6个月后裸眼视力≤0.8组儿童眼轴增长（0.07±0.15）mm,裸眼视力>0.8组儿童眼轴增长（0.11± 0.15）mm,差异无统计学意义。结论：影响角膜塑形镜去片裸眼视力的主要因素是屈光度和眼轴长度,屈光度越高、眼轴越长,去片后裸眼视力越差,但其对近视仍有较好的控制作用。     

A randomized paired eye comparison of two techniques for treating moderately high myopia: LASIK and artisan phakic lens

OBJECTIVE: To compare refractive performance and safety of laser in situ keratomileusis (LASIK) and Artisan phakic intraocular lens (PIOL) for moderately high myopia. DESIGN: A prospective, randomized trial with paired eye control. PARTICIPANTS: Twenty-five patients with myopia ranging from -8.00 to -12.00 diopters (D). INTERVENTION: For each patient, one eye received LASIK and the other one was implanted with an Artisan phakic intraocular lens. The treated eye and the surgical technique were randomized. MAIN OUTCOME MEASURES: Primary outcome measure was spherical equivalent refraction. Main secondary outcome measures were the change of two or more lines and safety index (ratio postoperative to preoperative best-corrected visual acuity). RESULTS: One year after surgery, the mean spherical equivalent refraction was -0.74 +/- 0.67 D for LASIK-treated eyes and -0.95 +/- 0.45 D for Artisan-treated eyes, and the majority of LASIK-treated eyes (64%) and Artisan-treated eyes (60%) were within +/-1.00 D of the intended result. At 1 month, the mean spherical equivalent refraction was -0.28 +/- 0.71 D for LASIK and -1.07 +/- 0.59 D for Artisan (P < 0.01). The changes of two or more lines were in favor of Artisan (P < 0.05). The safety index was significantly better for Artisan (1.12 +/- 0.21) than for LASIK (0.99 +/- 0.17) at 1 year (P < 0.02). CONCLUSIONS: In cases of moderately high myopia, LASIK and Artisan phakic intraocular lenses seemed to produce a similar predictability. The best-corrected visual acuity and subjective evaluation of quality of vision were better for Artisan.     

Form deprivation myopia in mature common marmosets (Callithrix jacchus)

PURPOSE: Experimental manipulations of visual experience are known to affect the growth of the eye and the development of refractive state in a variety of species including human and nonhuman primates. For example, it is well established that visual form deprivation causes elongation of the eye and myopia. The effects of such manipulations have generally been examined in neonatal or juvenile animals. Whether adolescent common marmosets (a new world primate) are susceptible to form deprivation myopia was studied. METHODS: Five adolescent marmosets were used in this study. Monocular form deprivation was induced by lid closure for 12 to 20 weeks, starting between 299 and 315 days of age. The effects of deprivation were assessed with keratometry, A-scan ultrasonography, and cycloplegic refractions. Both eyes (treated and fellow control) were measured before lid-closure, at the end of the deprivation period, and several times over the following 8 to 12 weeks. RESULTS: Adolescent marmosets are susceptible to visual form deprivation myopia. The experimental eyes showed significant axial elongation and myopia relative to the fellow control eyes. These changes were smaller, however, than those observed in younger eyes deprived for comparable periods. Like juvenile animals, the adolescent marmosets did not show recovery from myopia over the period monitored. CONCLUSIONS: The period for susceptibility to form deprivation myopia in the marmoset monkey extends beyond the early developmental period when ocular growth is rapid and emmetropization normally takes place. Visual form deprivation in adolescent marmosets with adult-sized eyes results in increased ocular growth and myopia. These data suggest that visual factors may influence the growth and refractive development of the human eye after puberty and may be involved in late-onset myopia.