国产A型眼科超声诊断仪在眼轴测量中的评价

目的 评价国产YZ54 A型眼科超声诊断仪在白内障术前眼轴测量中的准确性和安全性.方法 随机检测白内障患者84例(84眼),分别用NIDEKU US-1800型眼科超声诊断仪(进口A超组)和YZ54A型眼科超声诊断仪(国产A超组)行眼轴测量.结果 84例(84眼)白内障患者眼轴测量均顺利完成,无并发症发生.根据测得眼轴长度分为3组:短眼轴组(眼轴＜23 mm)共23眼、正常眼轴组(眼轴≥23 mm和≤25 mm)共27眼和长眼轴组(眼轴＞25 mm)共34眼.各组中进口A超组眼轴长度、中央前房深度、晶状体厚度、玻璃体腔长度和国产A超组相比差异均无统计学意义(P＞0.05).结论 YZ54 A型眼科超声诊断仪眼轴测量的准确性和安全性达到进口A超组产品的性能水平,能满足临床测量要求.     

硅油充填眼A超眼轴测定的临床意义

目的:探讨硅油充填眼A超眼轴测定的临床意义。方法:采用A超仪器,经同一操作者分别对86例患者测定硅油充填前、硅油充填时及硅油取出后的眼轴长度,了解A超眼轴测定在硅油充填前后的变化。结果:硅油充填前86例患者眼轴平均长度23.6±2.2mm,硅油充填后眼轴平均长度33.4±5.8mm,硅油取出后平均长度23.4±1.9mm;硅油充填前后眼轴平均相差9.8±5.7mm,硅油充填前后眼轴变化呈显著改变(P<0.01),硅油充填前与硅油取出后眼轴变化无显著差异(P>0.05)。结论:硅油充填前后A超眼轴长度变化约9.61±0.16mm,对硅油眼并发性白内障的人工晶状体测量有一定指导意义。     

A超分段测量法在硅油填充眼生物测量中的应用

目的 评价应用A超分段测量法对硅油填充眼进行生物测量的准确性.方法 前瞻性选取2008年1月至12月间在我院行硅油取出术的硅油填充眼患者29例(29眼),在术前、术后3个月均用眼科A超测量眼轴长度并进行比较;其中硅油填充眼的A超分段测量法采用仰卧位接触法测量,硅油泡长度采用1 532 m·s-1的声速值测得表观长度后乘以0.644,得到硅油泡的实际长度,并考虑到硅油泡下水层的厚度,即计算公式为:硅油填充眼的眼轴长度=前房深度+晶状体厚度+0.644×硅油泡的表观长度+硅油泡下水层的厚度.结果 用眼科A超分段测量法测得术前、术后的眼轴长度平均为(26.11±2.85)mm、(26.06±2.80)mm;同一患眼术前、术后眼轴长度的差值平均为(0.06±0.27)mm,术前、术后测得结果高度相关,相关系数为0.995,差异无统计学意义(P=0.283＞0.05);患眼术后与对侧眼眼轴长度的差值水平为(1.69±2.28)mm,双眼眼轴长度相关性差,相关系数为0.549,差异无统计学意义(P=0.816＞0.05).结论 A超分段测量法可对硅油填充眼进行准确可靠的生物测量.     

A超测量硅油填充眼眼轴准确性研究

目的:探讨A超在硅油填充眼眼轴测量中的准确性。方法:由于硅油与玻璃体的屈光指数不同,超声波在硅油中的传播速度发生变化,从而可导致眼轴的测量值出现偏差,采用实验的方法对超声波在硅油中的传播速度进行测量,进而对眼轴值进行修正。选取24例行玻璃体切割伴硅油填充术的患者,应用A超分别对患眼、健眼进行眼轴测量,并对所测得患眼眼轴值进行修正,应用IOL-Master对患眼眼轴进行测量,对各眼轴长度进行比较。结果:A超测得患眼眼轴为31.97±6.07mm,修正后患眼眼轴为23.94±4.17mm,健眼眼轴为23.74±1.40mm,IOL-Master测量的眼轴长度为24.77±0.82mm。结论:A超经修正后可准确测量硅油眼的眼轴长度,可以应用于IOL-Master不能测量的病例。     

IOL-Master测量硅油眼轴长精确性的研究

目的:比较IOL-Master与A超测量硅油填充眼轴长的准确性,探讨两种临床应用特点。方法:分析14例玻璃切割术后硅油填充眼分别采取A超和IOL-Master测量眼轴长度。结果:A超测得硅油眼轴长分别为仰卧位22.48±5.19mm,坐位25.10±4.19mm;IOL-Master测得硅油眼轴长为26.32±4.16mm。不同体位A超测量硅油眼轴长度有显著差异(t=-6.27,P<0.01),用IOL-Master和A超两种方法测量硅油眼眼轴长度有显著统计学差异(t=-6.08,P<0.01)。结论:A超和IOL-Master用于正常眼轴长的测量都具有精确性高的特点,IOL-Master采用非接触方法更为简便;对硅油填充眼测量时A超受体位及屈光介质声学性质影响而差异显著,而IOL-Master可克服声学测量缺陷,对于硅油填充眼轴长测量更为准确。因此临床上应根据个体情况选择不同的测量方法以准确测量眼轴长度。     

IOL Master与A超测量硅油眼眼轴的对比研究

目的:比较评估A超及IOL Master在硅油眼患者眼轴长度测量的精确性,探讨IOL Master在硅油眼人工晶状体度数计算中的临床应用价值。方法:分析我院2012-06/12间收治的硅油眼白内障手术患者30例30眼,分别用接触式A超及IOL Master测量术前、术后眼轴长度比较两者之间差异。并将术前IOL Master测量自动获取IOL度数后预估患眼屈光状态与术后1mo复查患者屈光状态(等效球镜度数)行统计学分析。结果:A超与术前IOL Master测量眼轴有显著性差异,使用IOL Master测量术前、术后眼轴无显著差异,术后使用A超及IOL Master测量眼轴之间无显著性差异。采用IOL Master术前测量眼轴所得人工晶状体度数植入人工晶状体术后屈光状态与术前预估无明显差异。结论:IOL Master测量眼轴较A超有明显优越性,但对于某些不能使用IOL Master测量的病例仍需结合A超等其他测量方法辅助测量。     

A超分段测量法及IOL Master在硅油填充眼生物测量中的应用

目的 评价应用A超分段测量法及光学相干生物测量仪(IOLMaster)对硅油填充眼进行生物测量的准确性.方法 前瞻性选取2008年1月至12月拟行硅油取出术的患者总共29例29眼,手术前、后使用眼科A/B超及IOL Master两种方式测量眼轴,并分别进行比较;A超分段测量法计算公式为:硅油填充眼的眼轴长度=前房深度+晶状体厚度+0.644×硅油泡的表观长度(声速值1532m/s)+硅油泡下水层的厚度.结果 用眼科A超分段测量法测得手术前、后的眼轴长为(26.11±2.85)mm、(26.06±2.80)mm,其差值为(0.06±0.27)mm(P =0.226);IOLMater测得手术前、后的眼轴长为(26.37±2.80)mm、(26.29±2.77)mm,其差值为(-0.04±0.15)mm(P=0.315);IOLMaster测得的术前和术后眼轴长与术后A超眼轴长差值分别为(0.18±0.17)mm(P ＜0.01)、-0.23±0.13 mm(P＜0.01).两种方法在术前术后测得的眼轴长度结果均显示高度相关(相关系数＞0.99).结论 A超分段测量法及IOL Master均可对硅油填充眼进行准确可靠的眼轴测量.     

不同体位A超测量难测眼眼轴的对比研究

目的：通过比较患者难测眼的坐位、卧位A超和晶星900(Lenstar,LS900)三种方法测量眼轴长度的差异,为更准确进行难测眼眼轴测量提供指导。

方法：临床病例对照研究。对2019-05/2020-09在郑州市第二人民医院就诊的合并硅油眼、玻璃体积血或视网膜脱离的白内障患者及晶状体或人工晶状体脱位的患者102例102眼分别行LS900及坐位、卧位A超检查测量眼轴长度,并对三种方法测量结果进行统计学分析。

结果：LS900与A超眼轴测量检出率分别为83%和100%; A超坐位和卧位及LS900三种方法测量眼轴长度整体、硅油组、晶状体脱位组、玻璃体积血组比较均有差异(P<0.001),整体卧位、硅油组卧位、晶状体脱位组卧位、玻璃体积血组卧位与LS900测量值眼轴长度均值比较有差异(均P<0.05),而整体坐位和各难测眼组坐位与LS900测量眼轴长度比较均无差异; 三种测量方法所测值在95%一致性范围内一致性良好,A超坐位测量结果更接近LS900。

结论：在难测眼A超眼轴测量中,特别是眼部组织结构发生改变的疾病,改变常规卧位为坐位可提高测量结果的准确性,为临床医生制定治疗方案提供更可信的指导。     

IOL-Master测量硅油填充眼眼轴长度的临床评价

目的 探讨IOL-Master测量硅油填充眼眼轴长度可行性以及其计算晶状体度数的精确性.方法 选择2007年6月至2008年12月间在本院行玻璃体切割联合眼内硅油填充术3～6个月后,行白内障摘除人工晶状体植入联合硅油取出术的患者,共78例,83只眼.术前行IOL-Master测量眼轴长度,并将测量值用SRK/Ⅱ公式计算出人工晶状体度数.术后1周行接触式A超,术后3个月行IOL-Master复测眼轴长度.术后3月综合验光仪行主觉验光.结果 眼轴长度测量结果术前IOL-Master与术后A超及IOL-Master分别比较,差异无统计学意义(P=0.505,0.065),但是术后A超与IOL-Master测量结果差异有统计学意义(P=0.012).术后3个月绝对屈光误差≤0.5D共73只眼,占88.0%;>0.5D共10只眼,占12.0%.结论 IOL-Master对于硅油填充眼的眼轴长度测量具有较好可信性,其计算人工晶状体度数预测性高.     

A超分段测量法在硅油填充眼并发白内障三联手术中应用

目的 评价A超分段测量法对硅油填充眼进行生物测量的准确性,以及“白内障超乳摘除、硅油取出联合人工晶状体植入术”治疗硅油填充眼并发白内障的安全性及手术效果.方法 临床病例系列研究.对2009年1月至2010年12月在襄阳市第一人民医院眼科选取硅油填充眼并发性白内障患者11例11只眼,术前使用A超分段测量法进行生物测量.术中经巩膜隧道切口行白内障超乳摘除,经睫状体平坦部穿刺口置入20G套管针抽吸出玻璃体腔内硅油,囊袋内植入PMMA或丙烯酸酯折叠人工晶状体.随诊至术后6个月.结果 术前硅油填充眼眼轴长度为22.17 ～ 29.38 mm,平均(25.46±2.20) mm.所有患者手术经过顺利,人工晶状体植入囊袋,随访至术后6月无特殊并发症发生.裸眼视力0.1～0.3者8例8只眼,0.4～0.6者3例3只眼.屈光状态(等效球镜度)介于-1.5 ～+0.25 D之间,与目标屈光状态的平均绝对屈光误差值为(0.77±0.32)D(0.25～1.25D).结论 “三联手术”治疗硅油填充眼并发白内障安全、可靠,效果良好,“A超分段测量法”可对并发白内障的硅油填充眼进行准确的生物测量,并计算出合适的人工晶状体度数.     

硅油填充眼A超眼轴测算及人工晶状体度数计算

目的:评价声速调整法测量硅油眼眼轴、测算人工晶状体度数的准确性。方法:对2003/2008年于我院治疗的24例硅油填充术后并发性白内障患者,采取坐位眼轴测量并改变硅油眼中超声波的传播速度来修正眼轴长度,再将计算所得眼轴长度代入SRKII公式计算拟植入的人工晶状体度数。行硅油取出术联合白内障摘除+人工晶状体植入术。术后3mo测量眼轴及屈光状态。对手术前后眼轴长度进行对比,将术后屈光状态与术前预期值比较。结果:硅油取出术前平均眼轴长度为25.25±0.65mm,术后平均眼轴长度为24.80±0.67mm,取油前后眼轴长度均值差异无统计学意义。手术后屈光度与术前预期值差值平均为1.50±0.40D,差异无统计学意义。结论:通过坐位测量并调整超声波在硅油中的传导速度,可准确测量硅油填充眼眼轴,较传统方法测算人工晶状体度数准确率更高。     

Measurement of axial length of eyes with incomplete filling of silicone oil in the vitreous cavity using x ray computed tomography.

AIMS: To establish a reliable method for measuring the axial length of the eye with incomplete filling of silicone oil in the vitreous cavity in order to determine the IOL power before executing combined cataract surgery and silicone oil removal. METHODS: 12 eyes of 12 patients undergoing combined cataract extraction and silicone oil removal between October 1998 and June 2000 were entered prospectively into this study. All eyes were examined using an x ray computed tomography (CT) scanner. Each axial length of a silicone oil injected eye was measured on the best CT slice among eyeball cuts, which showed both the insertions of the medial and lateral rectus muscle, the thickest slice of the lens, and the optic nerve. The IOL power for the eyes was determined using the SRK/T formula based on the CT data. The deviation of postoperative refraction from the goal refraction was evaluated for each eye. RESULTS: The CT slices demonstrated that the vitreous cavity was not completely filled with the oil in all of the silicone oil injected eyes. The deviation of postoperative refraction from the goal refraction was less than 1 dioptre (D) error in six of 12 eyes (50%), and was less than 2 D error in nine eyes (75%). In the other three eyes having more than 2 D error, the axial length was 27 mm or more. CONCLUSION: The CT measurement of axial eye length for determining IOL might be a useful method for evaluating silicone oil injected eyes before combined cataract surgery and silicone oil removal.     

Intraoperative biometry for intraocular lens (IOL) power calculation at silicone oil removal

PURPOSE: Cataract development is common following retinal detachment surgery that necessitates silicone oil injection. Intraocular lens (IOL) power calculation in the presence of silicone oil is challenging for many reasons. The authors evaluated the accuracy of intraoperative biometry during cataract surgery in silicone-filled eyes. METHODS: Twelve cases of cataract in eyes filled with silicone oil after retinal detachment surgery were included. Preoperatively, keratometric readings were documented. Intraoperative axial length was measured following removal of silicone oil using a sterile probe of the Nidek Echoscan US800 unit. IOL power calculation was computed using the SRK/T formula. This was followed by phacoemulsification and foldable lens implantation. Postoperative refraction allowed evaluation of the accuracy of intraoperative biometry. The predictability of three different formulas was also compared (Holladay, SRK/T, and SRK II). RESULTS: Seven men and five women with a mean age of 50.2 years were included in the study. The mean postoperative spherical equivalent using the described technique was 6.77 +/- 0.43 diopters. SRK/T and Holladay formula had the best predictability for high axial length eyes, whereas the three studied formulas showed no significant differences in predictability in eyes with normal axial length. CONCLUSIONS: Intraoperative biometry proved to have good predictability for the absolute postoperative refractive error in cataract surgery for eyes at the time of silicone oil removal. This predictability was accurate independent of axial length.     

Accuracy of segmented measurement of axial length in ultra-high myopia filled with silicone oil using immersion B-scan ultrasonography

AIM: To evaluate the accuracy of segmented measurement of axial length (AL) in high myopia filled with silicone oil by immersion B-scan ultrasonography (immersion B-scan). METHODS: From June 2016 to June 2020, a total of 67 ultra-high myopia inpatients (67 eyes) who underwent silicone oil removal combined with cataract extraction and intraocular lens (IOL) implantation were retrospectively enrolled. The preoperative axial length (AL) of 31 patients with severe cataract were segmented measured using immersion B-scan (B-scan group) and another 36 patients with mild or moderate cataract were measured using IOLMaster 500 (IOLMaster group). The post-operative ALs in two groups were both measured using IOLMaster 500. The IOL power was calculated with Haigis formula. The differences in ALs between pre- and post-surgery, as well as the postoperative refractive spherical equivalent, absolute refractive error, the prediction deviation of postoperative refraction and best corrected visual acuity (BCVA) were compared. RESULTS: The pre- and post-operative ALs were 30.46±1.63 mm (range 28.09-33.51 mm) and 30.42±1.70 mm (range 28.03-33.90 mm) in B-scan group (t=0.644, P=0.542) and 30.51±1.21 mm (range 28.03-33.90 mm) and 30.43±1.27mm (range 28.54-33.50 mm) in IOLMaster group (t=1.843, P=0.074), respectively. Three months after surgery, BCVA were 0.45±0.13 (range 0.3-0.9) and 0.44±0.20 (range 0.2-1.0) in B-scan and IOLMaster group respectively (t=0.086, P=0.932). There was no significant difference of the postoperative spherical equivalent (-3.11±0.65 D vs -3.21±0.51 D, t=0.671, P=0.505) and the absolute refractive error (0.589±0.340 vs 0.470±0.245 D, t=1.615, P=0.112) between two groups. In B-scan group, absolute refractive error within ±0.50 D was found in 18 eyes (58.1%), within ±1.00 D in 26 eyes (83.9%), and within ±1.50 D in 31 eyes (100%). In IOLMaster group, absolute refractive error within ±0.50 D was found in 23 eyes (63.9%), within ±1.00 D in 34 eyes (94.4%), and within ±1.50 D in 36 eyes (Z=0.757, P=0.449). CONCLUSION: The segmented measurement of ALs by immersion B-scan shows comparable measurement accuracy with that of IOLMaster 500 in ultra-high myopia patients with severe cataract secondary to silicone oil filling and can obtain an ideal postoperative refractive state.     

Reliability of the IOLMaster in axial length evaluation in silicone oil-filled eyes

PURPOSE: To assess the reliability of IOLMaster in axial length (AL) measurement in phakic silicone oil-filled vs pseudophakic saline-filled eyes. METHODS: Ten eyes of 10 patients, vitrectomized with silicone oil tamponade and scleral buckled with significant lens opacity were enrolled. Optical biometry with IOLMaster (Carl Zeiss Meditec AG, Germany) was performed 1 day before and 1 week after silicone oil removal and phacoemulsification with artificial intraocular lens (IOL) implantation in order to assess changes in AL measurements. RESULTS: Mean AL was 26.16+/-1.23 mm (range 24.64-28.8 mm) and 26.27+/-1.46 mm (range 25.26-29.6 mm), respectively, the day before and 1 week after silicone oil removal and cataract surgery, and the difference was not statistically significant (P=0.2). CONCLUSIONS: Presence vs absence of silicone oil tamponade as well as phakic vs pseudophakic status in buckled and vitrectomized eyes did not influence the AL measurement by means of no-contact optical biometry, suggesting that such eyes might be candidate for silicone oil removal and cataract surgery at one time.     

Signal quality of biometry in silicone oil-filled eyes using partial coherence laser interferometry

PURPOSE: To assess the practical feasibility and signal quality of axial length measurements by partial coherence laser interferometry in silicone oil-filled eyes with previous complicated vitreoretinal surgery. SETTINGS: Department of Ophthalmology, University Cologne, Cologne, Germany. METHODS: Using a Zeiss IOLMaster, axial length measurements and signal-to-noise ratios of optical biometry in silicone oil-filled eyes (n=45) and contralateral eyes without tamponade (n=41) were analyzed. RESULTS: Axial length measurements with signal-to-noise ratio > or =2 were feasible in 41 of 45 silicone oil-filled eyes (91%) and 37 of 41 eyes without tamponade (90%). Cataract, central retinal detachment, vitreous hemorrhage, and emulsified oil droplets attached to the intraocular lens were reasons for failure of partial coherence laser interferometry. The signal-to-noise ratio of the first 2 measurements was significantly smaller (P=.04) in silicone-filled eyes (4.4 +/- 2.0) than in eyes without tamponade (5.5 +/- 3.0). Axial lengths of the oil-filled eye and the contralateral eye showed a significant intraindividual correlation (P<.0001, Spearman r=0.84). CONCLUSIONS: Partial coherence laser interferometry shows good clinical practicability in silicone oil-filled eyes with previous complicated vitreoretinal surgery. Further studies are needed to assess the reliability of these measurements with regard to postoperative refraction after combined oil removal and cataract surgery.     

后囊膜切开在糖尿病视网膜病变硅油取出联合白内障术中的应用

目的：探讨后囊膜切开在糖尿病视网膜病变硅油取出联合白内障术中的临床疗效。

方法：收集我院2019-01/2020-02诊治的糖尿病视网膜病变硅油填充眼合并白内障患者83例83眼的临床资料进行回顾性分析。根据手术方式不同分为试验组(硅油取出同期行后囊膜切开联合白内障手术)41眼,对照组(硅油取出联合白内障手术)42眼。术后6mo对两组的最佳矫正视力、后发性白内障的发生、眼前黑影飘动等项目进行评估,以证实后囊膜切开在糖尿病视网膜病变硅油取出联合白内障手术中的优势。

结果：术后6mo,最佳矫正视力试验组优于对照组(P<0.05); 后发性白内障的发生、眼前黑影飘动试验组低于对照组(P<0.05); 两组眼压、术后视网膜脱离、玻璃体积血、人工晶状体偏位比较均无差异(P>0.05)。

结论：后囊膜切开在糖尿病视网膜病变硅油取出联合白内障手术中的应用安全可靠,可有效地避免后发性白内障的发生。