影响近视眼角膜中央厚度的多因素探讨

目的:探讨影响近视眼患者角膜中央厚度的相关因素。方法:用超声角膜测厚仪检测630例(1260眼)近视及近视散光眼患者的中央角膜厚度,统计分析检测结果。结果:角膜中央厚度与眼内压呈正相关(r=0.416,P=0.01)。角膜中央厚度大约每增加28.8μm,眼内压上升1mmHg,角膜中央厚度与屈光度呈负相关(r=0.426,P<0.05)。角膜中央厚度与是否戴角膜接触镜有关,长期持续配戴软性角膜接触镜者平均中央角膜厚度为530.26±32.73μm,无角膜接触镜配戴史者平均中央角膜厚度为545.89±29.71μm,二者比较差异有显著性(P<0.05);散瞳前角膜中央厚度为532.77±32.21μm,散瞳后角膜中央厚度为539.97±31.31μm,二者比较差异有显著性(P=0.001)。结论:近视角膜中央厚度除与眼内压、屈光度及是否配戴软性角膜接触镜等因素有关,散瞳剂也是影响角膜中央厚度的因素之一。     

近视患者中央角膜厚度及其相关因素分析

目的:探讨与近视患者中央角膜厚度相关的因素。方法:近视及近视散光患者2217例(4398眼),用超声角膜测厚仪测量角膜中央厚度,电脑验光仪测量屈光度,非接触眼压计测量眼压,OrbscanⅡ眼前节分析仪查角膜地形图测量角膜曲率,并统计患者性别、年龄及配戴软性角膜接触镜情况。结果:近视患者平均中央角膜厚度为548.57±30.42μm,男女眼之间、左右眼之间、低龄与高龄眼之间平均中央角膜厚度均无统计学差异。中央角膜厚度与屈光度呈正相关(r=0.506,P=0.000)。中央角膜厚度与眼内压呈正相关(r=0.634,P=0.000)。中央角膜厚度与角膜曲率之间无相关性。中央角膜厚度与是否配戴软性角膜接触镜有关,长期持续配戴软性角膜接触镜患者与无角膜接触镜配戴史患者平均中央角膜厚度的差异有显著性(P=0.000)。结论:近视患者中央角膜厚度与屈光度、眼内压及配戴软性角膜接触镜情况等因素有相关性。     

LASIK手术前后角膜厚度的分析

目的　分析准分子激光原位角膜磨镶术(LASIK)前后角膜厚度的变化。方法　应用SP_3 0 0 0型超声角膜测厚仪测量64 1例(12 10眼)近视在施行LASIK手术前及术后1月、3月的中央角膜厚度;根据术前的屈光度分为4组,对各组所测得中央角膜厚度的数值进行分析。结果　-6 0 0D以上近视者的屈光度每增加1. 0 0D ,中央角膜厚度平均减少1 .3 1μm ;手术后1月及3月的实际角膜厚度与预计切削角膜厚度的差异非常显著(P <0 . 0 1) ,其差值与剩余屈光度±0 5 0D以内及±1 .0 0D以内的百分率呈负相关(r =-0 . 1及r =-0 . 3 ,P <0 . 0 1)。结论　高度及超高度近视的角膜厚度随着屈光度的增加而变薄。LASIK术后1月及3月的实际角膜厚度大于预计角膜厚度,实际与预计角膜厚度的差值与术后剩余屈光度呈正比。     

翼状胬肉大小与角膜地形图的相关性研究

目的 :研究翼状胬肉的长度、宽度及胬肉覆盖角膜的面积对角膜表面形态的影响以及术后的改善情况。方法 :对翼状胬肉 33例 ,4 5只眼患者术前进行检影验光及角膜地形图检查 ,术中测量翼状胬肉的宽度及长度 ,对翼状胬肉的宽度、长度及面积与角膜表面规则指数 (SRI)、不对称指数 (SAI)及角膜散光进行相关性研究 ;随访 2 3例 ,2 8只眼翼状胬肉患者进行术后的角膜地形图检查 ,观察各项指标的变化 ,从而找出最好的手术时机。结果 :术前翼状胬肉的长度与角膜散光 (r =0 30 4 ,P=0 0 4 2 ) ,SRI(r =0 4 78,P =0 0 0 1)和SAI(r =0 5 0 7,P <0 0 0 1)具有明显的相关性 ;翼状胬肉的宽度及面积与SRI(r =0 4 90 ,P =0 0 0 1;r =0 5 99,P <0 0 0 1)和SAI(r =0 5 0 8,P <0 0 0 1;r =0 5 83,P <0 0 0 1)有明显的相关性 ;而散光却与SRI及SAI(r=0 2 5 3,P =0 0 93;r=0 2 6 8,P =0 0 75 )无明显的相关性。术后只有角膜散光的改善具有显著性差异 (P =0 0 2 3) ,而SRI及SAI的改善无显著性差异 (P =0 4 2 3;P =0 14 3)。结论 :翼状胬肉的出现、生长及其手术切除对角膜的球面性、规则性以及散光均有影响 ,而有些影响是不能通过手术解除 ,所以本研究建议可适当地提前手术时机     

影响近视眼角膜屈光力多因素分析

目的:探讨影响近视眼角膜屈光力的相关因素。方法:分别测量227例(452眼)近视及近视散光患者角膜地形图、角膜中央厚度、眼压、A超及屈光度,将所得结果进行统计学分析。结果:①不同程度屈光度,角膜顶点屈光力低度近视组与中、高、重度近视组比较有显著性差异(P <0.05),角膜中央3mm屈光力,低、中度近视组与重度近视组比较有显著性差异(P <0.05),角膜中央5mm屈光力低度近视眼组与重度近视组比较有显著性差异(P <0.01),角膜中央7mm屈光力各组之间比较无显著性差异(P >0.05);②角膜中央3,5,7mm的屈光力与年龄、前房深度呈正相关(年龄:r分别为:0.398,0.387,0.342,P =0.000;前房深度:r分别为:0.277,0.310,0.288,P =0.000);③角膜中央3,5,7mm的屈光力均与等效球镜屈光度、眼轴、晶状体厚度呈负相关(等效球镜屈光度:r分别为-0.80,-0.782,-0.710,P =0.000;眼轴:r分别为:-0.670,-0.668,-0.598,P =0.000;晶状体厚度r分别为-0.318,-0.282,-0.232,P值分别为0.000,0.000,0.001);④将角膜不同区域屈光力为应变量,分别建立多元线性回归方程:Y 3=77.571-1.432X 1-0.554X 2 0.964X 3 0.067X 4-1.205X 5;(F =101.356,P =0.000);Y 5=76.538-1.424X 1-0.538X 2 1.063X 3 0.067X 4-1.122X 5;(F =92.395,P =0.000);Y 7=72.563-1.     

角膜塑型术临床疗效及其相关因素

目的 :分析第三代角膜塑型镜片在治疗近视中的作用及影响其疗效的相关因素。方法 :分析比较 14 1例 2 76眼角膜塑型术前后裸眼视力、屈光度、角膜屈光度等随时间变化的量及角膜形态因素、眼内压、角膜厚度等因素与疗效的关系。结果 :角膜塑型术后 1w患者即表现为角膜屈光度下降 (P <0 .0 5 ) ,总体屈光度下降 (P <0 .0 5 ) ,裸眼远视力明显提高 (P <0 .0 5 ) ;角膜屈光度、角膜非球面特性与角膜发生的屈光度改变相关 (P <0 .0 5 )。结论 :第三代角膜塑型术是一种快速可逆非根治性治疗近视的方法。角膜的屈光度、非球面特性与角膜可能发生的改变呈正相关。     

LASIK手术前后角膜中央厚度的测量及分析

目的　分析 L ASIK手术前后角膜厚度的变化。方法　应用 DGH- 40 0 0型超声角膜测厚仪分别测量6 37例 (12 10只眼 )近视患者在施行 L ASIK手术前及术后 1月、3月的角膜中央厚度 ;根据术前的屈光度分为 4组 ,对各组所测得角膜中央厚度的数值进行分析。结果　 >- 6 .0 0 DS近视患者的屈光度每增加 1.0 0 DS,角膜中央厚度平均减少 1.31μm ;手术后 1月及 3月的实际角膜厚度与预计切削角膜厚度的差异非常显著 (P <0 .0 1) ,其差值与剩余屈光度≤± 0 .5 0 DS及≤± 1.0 0 DS的百分率呈负相关 (r =- 0 .1及 r=- 0 .3,P <0 .0 1)。结论　高度及超高度近视的角膜厚度随着屈光度的增加而变薄。 L ASIK术后 1月及 3月的实际角膜厚度大于预计角膜厚度 ,实际与预计角膜厚度的差值与术后剩余屈光度呈正比。     

近视眼角膜中央厚度与眼压和屈光度的关系

目的 :探讨近视眼角膜中央厚度 (centralcornealthickness,CCT)与眼压 (IOP)、屈光度之间关系。方法 :10 0例193只眼行角膜中央厚度、眼压、屈光度、眼轴检查 ,并对所得数据行方差分析、直线回归分析。根据角膜中央厚度分四组 :1组 4 4 5 μm 相似文献   

角膜形态学因素对非接触式眼压计测量值的影响

目的　探讨角膜形态学指标和角膜中央厚度对非接触式眼压计测量值的影响。方法　选择屈光度 -0 75～ -2 5 0 0D的患眼 13 0 8眼 ,使用非接触式眼压计测量眼压 ,计算机辅助角膜地形图仪测量SimK1、SRI和SAI。采用多元线性回归分析的方法综合分析各自变量与眼压测量值之间的线性关系。结果　角膜中央厚度和SimK1与眼压测量值有明显的线性相关关系 (P <0 0 1) ,而SRI和SAI与眼压测量值无明显线性相关 (P >0 0 5 )。结论　近视眼患者角膜中央的规则性 (以SAI为代表 )和对称性 (以SRI为代表 )的变异 ,尚不致影响非接触式眼压计的测量结果。对眼压测量值构成影响的是角膜中央厚度和角膜屈光力 (以SimK1为代表 )。     

中青年复性近视散光角膜形态改变及其相关因素

目的探讨引起中青年复性近视散光角膜形态改变的相关因素。方法分别测量333例666眼18～46岁复性近视散光（-1．00DC以上）患者的角膜地形图、非接触眼压、角膜中央厚度（central corneal thickness，CCT），并进行散瞳检影验光、记录散光度数及轴位，将结果进行统计分析。结果角膜地形图的散光度与验光散光度呈正相关（r=0．68，P〈0．01），其回归方程Y=0．145±0．678X（F=569．7，P〈0．01）；角膜地形图的散光轴与验光散光轴呈正相关（r=0．229，P〈0．01）；CCT与眼压呈正相关（r=0．422．P〈0．01），其直线回归方程为Y=-3．479±0．037X（F=143．54．P〈0．01），角膜CCT大约每增加37μm，眼压上升1mmHg（1kPa=7．5mmHg）；CCT与屈光度无明显直线相关关系（r=0.003，P〉0.1）。结论中青年复性近视散光68％由角膜散光决定，对患者作出诊断及处理之前，应进行全面的眼科检查。     

Relationship Between Corneal Hysteresis and Corneal Resistance Factor with Other Ocular Parameters

Abstract

Purpose: To evaluate the relationship between corneal hysteresis (CH) and corneal resistance factor (CRF) with age, central corneal thickness (CCT), corneal curvature (KM), corneal volume (CV), and refractive error in naïve eyes. Methods: 105 healthy subjects (58 male and 47 female) were included in this study. The ages ranged from 19 to 82 years (mean 43.1?±?15.4 years) and refraction between ?11?D and +6?D (mean ?0.79?±?2.95?D). CH and CRF obtained with the Ocular Response Analyzer (ORA) were correlated with age, refractive error, Goldmann Applanation Tonometry (GAT), and with CCT, KM, CV obtained with the Pentacam, and with Corneal-Compensated Intraocular Pressure (IOPcc) and Goldmann-correlated intraocular pressure measurement (IOPg) obtained with ORA. A multivariable mixed effect model was used to evaluate associations among these parameters. Results: CH ranged from 6.9 to 14.6?mmHg (mean 10.26?±?1.49?mmHg); CRF ranged from 5.8 to 17?mmHg (mean 10.38?±?1.64?mmHg). Multivariate analysis showed a statistically significant correlation between CH with CCT (p?<?0.001), and KM (p?<?0.001), and between CRF with CCT (p?<?0.001) and GAT (p?<?0.001). Conclusions: Our findings support the hypothesis that CH and CRF are related to the corneal shape and thickness, and show a decrease of CH with age.     

A case of congenital corneal anesthesia with hypopyon in china

 PURPOSE: To report a case of congenital corneal anesthesia (CCA) associated with hypopyon and tactile hypoesthesia. METHODS: Case report. RESULTS: A 3-year-old girl presented with redness and mild photophobia in the left eye accompanied by corneal ulcer, hypopyon, and corneal neovascularization. Corneal sensation was reduced bilaterally. She exhibited an absence of normal response to painful stimuli. She also had extensive ulceration of the lateral borders and tip of the tongue. The left corneal biopsy revealed negative cultures for bacteria and fungi. She was treated with human amniotic membrane transplantation in the left eye. The response to treatment was good. CONCLUSION: This is the first case of CCA reported in China. CCA is often misdiagnosed as infectious keratitis. Amniotic membrane transplantation is effective in repairing the severe corneal ulcer which may be associated with CCA.     

Biomechanics and structure of the cornea: implications and association with corneal disorders

Recent studies have shown that alterations in corneal biomechanical properties are associated with corneal pathologies, particularly corneal ectasia. Moreover, these alterations may have implications with regard to the outcomes of therapeutic modalities and corneal refractive surgeries. We address corneal anatomy and its relevance to corneal biomechanical characteristics, as well as ocular and systemic conditions associated with changes in corneal biomechanics.     

A new multiple noncontinuous puncture (pointage) technique for corneal tattooing

AIM:To assess the safety and cosmetic efficacy of a new multiple noncontinuous transepithelial puncture technique for tattooing a decompensated cornea.METHODS:It was anon-comparative clinical case series study.The study examines 33 eyes in 33 patients with total corneal opacity due to corneal decompensation, which developed following intraocular surgery.Corneal tattooing was performed using the multiple noncontinuous transepithelial puncture technique (i.e. pointage). The safety of this new surgical strategy was assessed by occurrence of adverse events for the follow-up period. The cosmetic efficacy was determined by the patient’s cosmetic satisfaction and independent observer’s opinion about patient appearance.RESULTS:Seven women and 26 men were included in the study. The mean age was 46.4±17.5y (range:7-67). In total, 30 of 33 patients (91%) reported cosmetic satisfaction within the follow-up period. Only 3 patients (9%) required additional tattooing due to cosmetic unsatisfaction. Cosmetic outcomes were analyzed and classified as excellent or good in 13 (39%) and 17 (52%) patients, respectively. No serious adverse events developed, except delayed epithelial healing in 3 cases.CONCLUSION:The cosmetic outcomes of the multiple noncontinuous transepithelial puncture technique for corneal tattooing were good. The safety of this method is higher than conventional procedures. This new procedure also provides improved cost-effectiveness and safety over current corneal tattooing techniques.     

角膜基质透镜在角膜溃疡或穿孔修复中的应用

目的：研究由全飞秒激光SMILE手术所得的角膜基质透镜作为角膜移植材料治疗角膜溃疡的临床疗效。

方法：回顾性病例研究。收集本院2017-01/06角膜溃疡患者6例6眼,其中细菌性、真菌性、深层异物伴感染各1例1眼,角膜穿孔3例3眼。采用由全飞秒激光SMILE手术所得的角膜基质透镜作为角膜移植的材料进行修复手术,确保植片与角膜层间无空气间隙。术后随访1～6(平均3.71±1.56)mo,观察手术前后视力、角膜移植物存活情况及术后并发症发生情况等。

结果：所有患者均在控制感染下顺利完成手术,无术中并发症。术后所有角膜植片透明。末次随访时,患者最佳矫正视力(best corrected visual acuity,BCVA)较术前明显改善(0.48±0.12 vs 1.50±0.08),差异具有统计学意义(P<0.01)。

结论：来源于全飞秒激光屈光手术的角膜基质透镜用于角膜溃疡修复是安全有效的,但植片的远期疗效尚需进一步观察。     

Anterior amorphous corneal opacity and corneal thinning

PurposeTo present the clinical features of four cases with bilateral anterior amorphous corneal opacity.MethodsA retrospective study in four patients with bilateral anterior amorphous corneal opacity was conducted. Examinations included visual acuity, keratometry, slit-lamp biomicroscopy, confocal microscopy, anterior segment optical coherence topography, and histology.ResultsThree female and one male patients (mean age, 52.3 ± 8.9 years) showed bilaterally oval, amorphous sheetlike corneal opacities with central depression and thinning. Superior limbal opacities were observed in two of these patients. The best-corrected visual acuity ranged from 20/50 to 20/400, and the mean of the keratometry was 39.81 ± 3.97 D (diopters). They had mild dry eyes. The anterior segment optical coherence topography demonstrated hyporeflective abnormalities in the anterior depressed stroma in these four patients. Confocal microscopy revealed large round cells at the epithelial layer in one patient, and amorphous opacities with some strand-shaped opacities in the anterior stroma in all four patients. The mean of the corneal endothelial cells density in the eight eyes was 1521 ± 402 cells/mm². Central corneal stromalysis occurred in three patients, and descemetocele developed in two eyes. One patient received penetrating keratoplasty and two underwent lamellar keratoplasty. The histology of the corneal specimen revealed edematous basal epithelial cells, focal collagen disorganization in the thin stroma, and wartlike excrescences in a thickened Descemet's membrane.ConclusionAnterior amorphous corneal opacity is a rare keratopathy and may be one kind of rare corneal degeneration or dystrophy. Corneal stromalysis may occur in hyporefrective amorphous opacities and progress to descemetocele.     

过夜配戴角膜矫形镜(OK镜)后角膜曲率及厚度变化

目的了解过夜配戴角膜矫形镜(OK镜)后早期角膜曲率、角膜厚度及屈光度的变化.方法14个中低度近视患者(平均屈光度-3.89±1.26D)25眼,随机分成2组分别配戴Dk值不同的角膜矫形镜BE角膜矫形镜组(7人12眼,Dk≈140);E&E角膜矫形镜组(7人13眼,Dk＝58).采用夜戴方式,平均配戴时间10.76±1.27小时.用Orbscan角膜地形图系统检查配戴1晚后角膜曲率、角膜厚度的改变.同时记录裸眼视力及屈光度的改变.结果配戴1晚后所有患者的中央及周边的角膜均增厚(P＜0.05).Orbscan角膜地形图SimK值在垂直轴及水平轴均变平(垂直轴△SimK0.94±0.56D,P＜0.001;水平轴△SimK0.996=0.68D,P＜0.001).裸眼视力平均提高0.4±0.24(P＜0.001).屈光度平均减少-1.85±0.82D(P＜0.001).Dk值不同的2组之间中央及颞上方位点角膜增厚程度的差别有统计学意义.结论过夜配戴角膜矫形镜后减低近视屈光度的效果明显.初次过夜配戴角膜矫形镜可导致角膜厚度轻度增加.     

美容性角膜覆盖术疗效观察

目的:评价美容性角膜覆盖术治疗角膜(角巩膜)葡萄肿的临床效果。方法:对22例角膜(角巩膜)葡萄肿患者进行了美容性角膜覆盖术治疗。术后对所有病例的临床效果进行了随访观察。结果:22例均治愈,残留部分视力的2例的视力术后有所改善(2例2眼从术前手动/眼前到术后指数/眼前)。22例无1例发生排斥,角膜覆盖片的颜色除第1例因缺乏经验术眼的颜色明显深于对侧正常或正常人群眼的颜色外,其它无1例褪色。结论:应用角膜覆盖术治疗角膜(角巩膜)葡萄肿22例(22眼)临床证明疗效确实、安全可靠。     

Alcohol delamination of the corneal epithelium for recurrent corneal erosion syndrome

AIM: To evaluate the outcomes of alcohol delamination (ALD) of the corneal epithelium for the treatment of recurrent corneal erosion syndrome (RCES) and to implement a standardized treatment protocol for this condition utilizing evidence based practice and the findings of an internal audit. METHODS: A retrospective analysis of 42 eyes of 40 patients diagnosed with RCES who were treated with ALD between January 2006 and March 2016 was conducted. Patients had 20% alcohol applied to the cornea with the use of a well for 40s. Patients were reviewed one week later in the Outpatient Department. Outcome criteria were established based on standards from other studies in the medical literature. These included, a treatment success rate of at least 72% (defined as complete resolution of symptoms one month after treatment), a postoperative complication a rate of <5% (mainly infective keratitis, and subepithelial haze), and the absence of any detrimental effect on visual acuity in ≥95% of patients. RESULTS: The mean age at the time of ALD was 41.17±13.44y. Patients were followed for an average of 12.8±15.65mo. The majority were female (52.5%, n=21) and the majority of eyes treated with ALD were left eyes (62.9%, n=26). Trauma was the primary aetiology in our study population. Treatment was successful in 73.8% (n=31) of eyes and in 75% (n=30) of patients. Recurrence occurred in 26.2% of eyes at a mean of 10.41±12.63mo post treatment. CONCLUSION: ALD is an efficacious and cost-effective primary surgical intervention for RCES.