对放射状角膜切开术后角膜穿孔的分析

放射状角膜切开术(RK)是目前治疗中、低度近视眼时应用较广的手术。角膜穿孔是RK术中多见的并发症。笔者对RK术患者发生角膜穿孔的情况作如下回顾性分析。 1 临床资料 在我院行RK术的患者60人,118眼,角     

近视眼角膜厚度与眼内压关系的探讨

目的探讨近视眼内压与角膜厚度之间的内在关系。方法随机选取非青光眼性近视眼患者183例(353眼),按角膜厚度分为三组。常规外眼、眼底检查,视野检查,Goldmann压平式眼压计测眼压,测量角膜厚度。将所得数据用统计学方法处理,分析眼压与角膜厚度的关系。结果近视眼患者角膜厚度不同,其眼压有非常显著性差异(P<0.0001)。近视眼患者的眼压与角膜中央厚度呈正相关(r=0.549,P<0.0001)。结论近视眼患者,角膜薄,可能低估眼压。角膜厚,可能高估眼压。建议在青光眼的诊治过程中,应考虑角膜中央厚度与眼压的关系。     

飞秒激光辅助LASIK治疗高角膜前表面屈光力近视患者术后角膜生物力学观察

目的研究飞秒激光辅助LASIK治疗高角膜前表面屈光力近视患者术后角膜生物力学的变化情况。方法高角膜前表面屈光力近视患者64例104只眼,根据ORBSCAN角膜地形图检查角膜前表面屈光力不同,分为实验组和对照组两组。实验组患者32例52只眼,角膜前表面屈光力47 D;对照组患者32例52只眼,角膜屈光力47 D。两组患者均采用飞秒激光辅助LASIK手术治疗,观察两组患者术前、术后3和6个月角膜前表面屈光力、眼反应分析仪检测的角膜补偿眼压、Goldmann相关眼压、角膜阻力因子、角膜滞后量以及超声测量中央角膜厚度的变化。结果两组患者角膜厚度、ORA各测量值及角膜前表面屈光力术后3个月的测量值明显低于术前,差异均有显著意义(P0.05);两组患者术后3个月的测量值与术后6个月比较,差异无显著意义(P0.05)。结论飞秒激光辅助LASIK手术治疗单纯角膜前表面屈光力47 D但角膜后表面高度正常、角膜厚度正常的患者,其术后3个月后角膜生物力学各测量值基本稳定,术后6个月角膜生物力学与正常角膜前表面屈光力改变基本一致。     

近视眼角膜中心厚度的超声方法测量

用ｐａｘｉａｌ眼超声对６７例正常眼及６９例轻度近视眼，１３８例中度近视眼，２６１例高度近视眼角膜中心厚度进行测量，高度近视眼角膜中心厚度较正常眼，轻，中度近视眼角膜中心厚度薄，并对超声方法测量角膜中心厚度的意义加以讨论。     

LASIK后角膜后表面曲率变化的研究

目的 研究准分子激光原位角膜磨镶术(LASIK)手术前后角膜后表面前凸的变化,探讨手术后应保留角膜的安全厚度.方法 将135例269只眼近视患者依据近视程度分为3组,使用Orbscan裂隙扫描角膜地形图/角膜测厚系统,观察3组LASIK手术前后角膜后表面差值(Diff)的变化.结果 术前3组Diff值1组为(0.023±0.008)mm;2组为(0.024±0.010)mm;3组为(0.024±0.010)mm,平均值为(0.024±0.009)mm,各组间比较,差异无显著性意义(P＞0.05).厚度＞500μm的角膜后表面Diff值为(0.023±0.008)mm,厚度＜500 μm的角膜后表面Diff值为(0.035±0.014)mm,两组相差非常显著(P＜0.001).术后3组Diff值均较术前增大,1组为(0.052±0.014)mm;2组为(0.052±0.018)mm;3组为(0.053±0.018)mm,平均值为(0.052±0.017)mm,术前术后两组比较相差非常显著(P＜0.001).术后根据保留角膜厚度不同分3组,1组保留角膜厚度＞450 μm,Diff值为(0.041±0.008)mm;2组保留角膜厚度为410～450 μm,Diff值为(0.057±0.013)mm;3组保留角膜厚度为＜410 μm;Diff值为(0.080±0.014)mm.3组间比较,差异均非常显著.术后保留角膜床厚度＞280 μm者,角膜后表面前凸值为(0.016±0.005)mm;术后保留角膜床厚度＜280 μm,角膜后表面前凸值为(0.034±0.009) mm;角膜后表面前凸值平均为(0.017±0.006)mm.结论 术前角膜后表面Diff值与近视程度无关,而与角膜厚度有关,较薄的角膜后表面前凸程度较厚的角膜明显.LASIK术后角膜后表面中央部均有不同程度的前凸.保留角膜床厚度和角膜后表面前凸值呈负相关.LASIK后角膜厚度至少应在410 μm,残留角膜床厚度安全值应为280 μm.     

飞秒激光术后外伤致角膜瓣卷曲及上皮植入1例

病例男,27岁,半年前曾行飞秒激光近视矫正术（右眼角膜瓣厚度110μm,磨削深度98μm）,因“塑料片划伤右眼后眼痛、视力下降7 d”入院。入院专科查体：右眼：视力0.25,眼压 Tn,结膜轻度充血,角膜下方可见长约5 mm 划伤,表面污秽,可见少量脓苔附着。入院诊断：右眼角膜溃疡。给予左氧氟沙星滴眼液点右眼（1次/ h）抗感染等治疗。入院后第4 d 右眼视力提高至0.6,但患者仍诉右眼视物重影。     

Alcon Wavelight FS200飞秒激光和Moria SBK角膜刀制作角膜瓣对比分析

目的:探讨使用Alcon Wavelight FS200飞秒激光和MO-RIASBK角膜刀制作110μm角膜瓣的相关影响因素。方法:在LASIK手术中分别使用FS200飞秒激光和MO-RIASBK角膜刀制作110μm角膜瓣各30例60只眼,先右眼后左眼,术中测量中心角膜及角膜床厚度,得出中心角膜瓣厚度后与术前各种相关因素(年龄、屈光度、角膜厚度、曲     

对影响近视眼眼内压各因素的探讨

目的　通过对影响近视眼眼内压各因素的分析 ,探讨近视眼与青少年型青光眼的内在关系。方法　随机选取非青光眼性近视患者 2 2 1例 (4 0 0眼 ) ,按屈光程度分为低、中、高、超高度近视四组 ,常规外眼、眼底检查、散瞳检影 ,视野检查、Goldmann压平式眼压计测眼压 ,同时测角膜中央厚度、角膜屈力、眼轴长度 ,将所得数据应用统计学方法处理 ,分析其影响眼压的因素。结果　 (1)不同程度近视眼患者的眼压、眼轴长度均值有显著性差异 (P <0 .0 0 1)。 (2 )近视眼患者的眼压与角膜中央厚度、眼轴长度呈正相关 (r=0 .5 89,P <0 .0 0 0 1;r =0 .2 0 6 ,P <0 .0 0 0 1) ,与屈光度呈负相关 (r=- 0 .341,P <0 .0 0 0 1)。结论　影响近视眼眼压的主要因素是屈光度、眼轴长度、角膜中央厚度 ,对患有近视眼的青少年型青光眼的诊断时应特别注意这些因素对眼压值的影响。     

在中高度近视眼LARK手术中应用飞秒激光和机械刀制瓣的对比研究

目的 比较在中高度近视LARK手术中应用飞秒激光和微型角膜刀制作角膜瓣的厚度,并对术后视力及屈光度进行对比.方法 中高度近视患者82例164眼,根据制作角膜瓣方法分为A,B两组,各41例82眼,A组由飞秒激光(Intralase FS 60KHz)制作角膜瓣,B组由Moria M2 90号微型角膜刀制瓣.所有病例均在Wavescan波前引导下采用VixsS4IR准分子激光机进行切削.采用美国DGH-550A超测量术前角膜厚度及术中角膜基质床厚度,计算角膜瓣厚度后加以比较,并比较术后1天、1周、1月及3个月的视力和屈光度.结果 A组平均角膜瓣厚度为(109.56 ±12.89)um,B组平均角膜瓣厚度为(148.83±13.28)um,两组比较差异有统计学意义(P<0.05).术后各阶段裸眼视力超过术前最佳娇正视力1行以上的比例A组均高于B组,在术后1天、1个月及3个月时两组比较差异有统计学意义.术后各阶段平均等效球镜度的恢复两组比较差异均无统计学意义.结论 中高度近视眼LASIK手术中采用飞秒激光制作角膜瓣可以获得更薄的角膜瓣,并在术后大多阶段可获得更好的视力.术后视力恢复的速度以及术后屈光度恢复的程度与机械刀制作角膜瓣相似.     

超声诊断仪在眼科招飞体检中的应用分析

目的:观察眼科超声诊断仪(A超)在招飞体检正常视力眼屈光要素检查中的应用价值。方法:选择参加招飞体检的男性应届高中毕业生430例(860眼),采用眼科A超测量前房深度、晶状体厚度、玻璃体腔长度及视轴长度;采用自动验光仪检测屈光度数。结果:屈光度数与前房深度、晶状体厚度、玻璃体腔长度、眼轴长度值显著相关(P<0.05),屈光度越接近近视,前房深度、晶状体厚度、玻璃体腔长度、眼轴长度越大。眼轴长度均进入以晶状体厚度、玻璃体腔长度为因变量的回归方程。结论:采用招飞体检中,眼科A超有助于能增强对屈光性质判别及近视眼发展倾向的预测,从而提高角膜屈光手术眼及角膜塑性术眼的检出率。     

汽车安全气囊致眼外伤临床分析

目的 探讨汽车安全气囊致眼外伤的临床特点及诊治方法.方法 对2004～2006年于我院眼科住院的15例30眼汽车安全气囊致眼外伤病例进行回顾性分析.结果 闭合性眼球钝挫伤15例30眼,均伴有角膜挫伤(占100%),其中合并有前房积血12例20眼(占66.67%),瞳孔括约肌撕裂6例9眼(占30%),视神经挫伤5例6眼(占20%),玻璃体积血3例3眼(占10%).经治疗12例24眼角膜恢复透明,合并前房积血全部吸收,其中18眼视力恢复至1.0;1例1眼在临时角膜下行玻璃体切割、穿透性角膜移植术,术后视力0.1;4例5眼形成角膜瘢翳,因为同时合并有视神经挫伤,视力0.2～0.3.结论 汽车安全气囊可导致多种类型眼损伤,其中尤以角膜挫伤发病率高,且多为双眼性,角膜恢复透明时间长,治疗棘手,可延误合并有眼后段损伤的诊断及治疗,因此对合并有眼后段损伤的病例临床上容易漏诊,早期诊治有利于患者视力恢复.     

A comparison of the spine posture among several sit-and-reach test protocols

The purpose of the study was to compare the thoracic and lumbar spine posture among different sit-and-reach tests. Fifty-eight men and 47 women were asked to perform three trials of sit-and-reach test (SR), toe-touch test (TT), back-saver sit-and-reach test (BS) right and left, unilateral seated sit-and-reach test (USR) right and left, and V sit-and-reach test (VSR). Thoracic and lumbar angles were assessed with an inclinometer when subjects reached forward maximally. Women had a lower thoracic angle than men on all tests (p < 0.05). No differences were found in the lumbar angle between genders. The thoracic angle was the highest in VSR (75.3° in men and 65.8° in women) and the lowest in TT (61.7° in men and 53.1° in women). No differences were found among some pairwise comparisons (SR–BS in both genders, SR–TT, SR–VSR and others in women). The VSR test presented the highest values in lumbar spine when compared to other tests (30.5° in men and 32.0° in women). Unilateral seated sit-and-reach test presented the lowest lumbar angle in men (24.2° for right leg and 23.9° for left leg) and women (23.9° in both legs) and there were significant differences with respect to the other tests. Characteristics and administration procedures of tests, such us uni- or bilateral, sitting or standing, measuring with or without box, parallel or V position, and hip position influence thoracic and lumbar postures.     

MTT比色法检测兔膜上皮细胞活性

目的：建立一种定量检测角膜上皮细胞活性的方法,方法：造成兔角膜碱烧伤和激光烧伤模型,分别于伤后1,2,3周钻取板层角膜,37℃孵育1h,加MTT孵育4h,加DMSO充分溶解,于酶联免疫仪上490nm御测定D值,结果：经MTT比色法测定,碱烧伤和激光烧伤后不同时间点的兔角膜上皮细胞活性均明显低于正常对照组（P＜0．010,结论：MTT比色法可用于定量检测角膜上皮细胞活性,此方法可作为眼药效学定量评价指标之一。     

角膜穿通伤合并海水浸泡致房水肿瘤坏死因子-α含量变化的实验研究

目的 观察爆炸致兔角膜穿通伤合并海水浸泡的房水肿瘤坏死因子-α(TNF-α)含量的变化及意义.方法 成年健康灰兔10只,单支鞭炮致兔角膜爆炸伤.于角膜中周部作长3 mm的全层切口.右眼为实验眼,左眼为对照眼.通过角膜切口将海水注入实验跟前房,海水持续灌注眼表30 min.对照眼使用生理盐水灌注相同时间.造模后第1、2、3、5、7天采用双抗体夹心ELISA法测定房水中TNF-α含量.结果 实验眼造模后第1、2、3天房水中TNF-α含量分别是190.338、156.107、117.018 ng/L,与对照眼相比差异有统计学意义(P<0.01).其中第1天TNF-α含量最高.结论 爆炸导致的兔角膜穿通伤合并海水浸泡后早期房水TNF-α含量明显高于对照眼,提示TNF-α参与这一病理改变并发挥重要作用.     

Interrelation between parameters of thickness of cornea in its optical part and thickness of nerve fibre layer of amphiblestrodes in case of primary open angle glaucoma

61 patient was checked-up (113 eyes) with the help of optical coherence tomography for the purpose of determination of the interrelation between thickness of cornea in its optical part and thickness of nerve fibre layer of amphiblestrodes in case of primary open angle glaucoma. The average age of patients was 63,9 +/- 10,4 years. Direct moderate interrelation between parameters of thickness of cornea in its central zone and thickness of nerve fibre layer of amphiblestrodes in its temporal part discus nervi optici (r=0,46 u r=0,26, p<0,05) was determined in patients with suspicion on glaucoma. Direct moderate interrelation between parameters of thickness of cornea in its central zone and thickness of nerve fibre layer of amphiblestrodes in its upper part of discus nervi optici (r=0,35 u r=0,43, p<0,05) is determined in patients with progressive glaucoma. Direct interrelation between parameters of thickness of cornea in its central zone and average thickness of nerve fibre layer of amphiblestrodes (r=0,25, p<0,05) is determined in patients with advanced glaucoma. Determined interrelation of figures proves the possibility of fast progression of glaucomic optic neuropathy in patients with progressive glaucoma.     

空军招飞学生角膜屈光力调查及应用价值探讨

目的 通过观察招飞体检中受检学生角膜屈光力及角膜散光的分布状况,探讨角膜屈光力检测在空军招飞体检中的应用价值. 方法 采用佳能RK F1型全自动验光/角膜曲率仪,测量参加招飞定选的2 586名高中毕业生5 172眼角膜水平及垂直子午线屈光力,计算平均角膜屈光力、角膜散光度、散光轴向及双眼角膜屈光力差值,描述其频数分布状况,比较双眼角膜散光度差异.结果 招飞学生平均角膜屈光力（42.64±1.23）D（范围：37.95～47.31 D）;同一个体双眼角膜屈光力差值的绝对值（0.20＋0.18）D（范围：0.00～2.53 D）;角膜教光度（0.98±0.45）D（范围：0.00～4.25 D）;角膜散光轴位：顺规性散光占总体的96.83％,逆规性散光占1.16％,斜向散光占2.01％;左眼角膜散光度为（1.00±0.46）D,较右眼（0.96±0.45）D稍大,差异有统计学意义（Z=-6.517,P＜0.05）. 结论 在空军招飞体检中,全自动验光/角膜曲率仪所采集的角膜屈光力作为筛查线索之一用于筛查角膜屈光,矫治后角膜和圆锥角膜需要其他筛查手段协助完成筛查和鉴别.16～20岁健康男性角膜散光以顺规散光为主.同一个体双眼角膜屈光力及散光在一定程度上具有对称性.     

中国汉族成人额叶体积的高分辨率MRI测量

目的 测量中国汉族正常成人大脑额叶体积,为建立中国成人数字标准脑提供基础数据.方法 采用全国多中心临床研究形式,选取18～70岁健康志愿者200名,按照年龄18～30、31～40、41～50、51～60、61～70岁进行分组,每组男、女各20名.所有受试者均行3D磁化强度预备梯度回波序列T1WI采集额叶体积,通过人工勾画ROI法分别测量志愿者左、右侧额叶体积,并对测量数据进行统计学分析.男、女性别间比较采用独立样本t检验;左、右侧别间比较采用配对样本t检验;年龄与额叶体积进行相关与回归分析.结果 200名志愿者大脑额叶总体积为(563±73)cm3.100名男性左、右侧额叶体积值分别为(288±42)、(292±41)cm3;100名女性左、右侧额叶体积值分别为(273±30)、(274±30)cm3.大脑额叶总体积男、女性别间差异有统计学意义(t=3.334,P<0.05).男性左、右侧额叶体积差异有统计学意义(t=-3.09,P<0.05),女性左、右侧额叶体积差异无统计学意义(t=-1.304,P>0.05).男性及女性大脑额叶总体积均与年龄呈负相关(r值分别为-0.586、-0.498,P值均<0.01).结论 健康国人男性额叶总体积大于女性.男性右侧额叶体积大于左侧,而女性双侧额叶体积差异无统计学意义.随着年龄的增长,男性及女性的额叶总体积均呈现逐渐缩小的趋势,男性额叶缩小的趋势比女性明显.     

Reproducibility of renal blood flow estimation in the miniature pig using 99Tcm-DTPA: introducing semiautomatic processing.

This study examines the reproducibility of renal blood flow measurement (RBF) in nine miniature pigs using 99Tcm-DTPA renography, and introduces a new algorithm useful in data processing. Renal blood flow can be estimated using three arterial regions of interest (ROI), the left ventricle (LV), the right lung (RL) and the aorta. Using the LV ROI, left kidney RBF was 9.08 (S.D. 1.69) and right RBF was 10.87 (S.D. 2.26). Reproducibility was assessed by performing renograms on successive days in nine pigs and was found to be best for LV [S.D. of change 0.32 for the left kidney (LK) and 0.74 for the right kidney (RK)] followed by RL (0.77 for LK and 0.75 for RK) and worst for aorta (1.47 for LK and 1.78 for RK).     

Asymmetry in cerebral blood flow velocity with processing of facial images during head-down rest

INTRODUCTION: Ability to interpret facial expression is crucial for non-verbal communication among humans, and could be affected by changes in cerebral circulation during exposure to microgravity or its simulation. METHODS: There were 16 subjects (8 men and 8 women) who were exposed to 24 h of -6 degrees head-down rest (HDR). Transcranial Doppler ultrasonography was used to monitor mean blood flow velocity (MBFV) in the middle cerebral arteries bilaterally during processing of facial images before, at 6 and 24 h of HDR, and after HDR (Pre-, 6H-, 24H-, and Post-HDR, respectively). The laterality index was assessed as side-to-side differences in MBFV relative to Pre-HDR for each condition. RESULTS: For Pre-HDR, both objects and faces were right lateralized in men (p < 0.001) and showed a left lateralization tendency in women (p > 0.05). At 6H-HDR, both object and faces were left lateralized in men (p < 0.05), but right lateralized in women (p < 0.001). At 24H-HDR, both men and women were left lateralized (p < 0.05). For Post-HDR, both remained left lateralized for all tasks (p < 0.05). DISCUSSION: HDR alters cerebral lateralization for object and facial stimuli, with opposing tendencies in men and women. The gender differences may reflect peculiarities in processing strategy for object and faces between men and women. Men use a right hemisphere processing strategy for faces and women a left hemisphere strategy. The superiority of processing of faces by women compared with men has been attributed to left hemisphere based strategy. HDR alters lateralization patterns and may thus alter processing strategies for faces.