传导性角膜成形术后眼内压的变化

目的:探讨传导性角膜成形术(CK)对眼压测量可能影响。方法:在术前和术后第1wk,第4wk,分别用非接触式眼压计(NCT)、Goldmann眼压计(GAT)和Schiotz眼压计测量接受CK治疗的20例36眼的眼压,所得结果采用SPSS11.5软件进行统计分析。结果:和术前比较,CK术后NCT、GAT以及Schiotz眼压计测量值显著降低。眼压变化和年龄、性别、角膜曲率以及拟矫正屈光度无关。结论:CK术后压平式眼压计测量眼压值偏低。     

传导性角膜成形术后眼压及角膜内皮细胞的变化

目的 探讨传导性角膜成形术（CK）对眼压和角膜内皮细胞的影响。方法 对20例（36眼）接受CK治疗的患者，于术前和术后第4周分别用非接触式眼压计（NCT）和Goldmann眼压计（GAT）测量眼压，行角膜内皮镜检查，观察中央区角膜内皮细胞形态和密度的变化。结果 和术前比较，术后眼压显著降低。眼压变化和年龄、性别、角膜曲率以及拟矫正屈光度无关。角膜内皮细胞形态和密度无显著性改变。结论 CK手术对角膜内皮细胞无损伤，不会造成角膜内皮细胞形态改变和密度降低。但术后压平式眼压计和非接触式眼压计测量眼压值偏低。为避免CK术后青光眼的误诊，不能按传统的正常眼压值衡量术后结果。     

LASIK前后眼压测量方法选择

目的 比较四种常用眼压计在近视准分子激光原位角膜磨镶术(Laserin situ eratomileusis,LASIK)前后的应用,探讨LASIK手术前后眼压测量方式的选择,以做到术前高眼压患者筛查及术后患者青光眼的早期发现.方法 对71例接受LASIK手术近视眼患者按等效球镜分为三组,分别在术前和术后1个月和3个月采用Schiotz眼压计(Schiotztonometer,ST)、Goldmann眼压计(Goldmann applanationtonometry,GAT)、非接触眼压计(non-contacttonometer,NCT)和Tono-Pen眼压计(TP)测量眼压,同时记录手术前后角膜中央厚度.结果 各屈光度组间同时间点相同眼压计测量值差异无统计学意义,术前除GAT、TP外其他眼压计差异有统计学意义,术后各眼压计测量值均降低,TP受角膜变化影响较小,GAT及NCT受影响明显,三者均与术前GAT值相关.ST不受角膜变化影响但其测量值明显偏高且术后与术前GAT无相关关系.结论 术前采用TP或GAT均可,术后应用TP,而NCT可作为术前筛查辅助手段.ST的应用仍有待探讨.     

三种眼压计在准分子激光原位角膜磨镶术后的应用比较

目的评价三种不同眼压计在近视准分子激光原位角膜磨镶术后的应用。方法对近视33例66眼和LASIK术后43例86眼分别用非接触眼压计(non—contact tonometer NCT)，Goldmann压平眼压计(Godmann applanalion tonometer，GAT)和Tono-Pen压平眼压计测量眼压(Tono—Pen眼压计测量角膜中央和颞下距角膜缘1．5～2mm处的眼压)，同时测角膜中央及颞下方的厚度。结果用三种方法测得的近视眼LASIK术后的眼压测量值均明显低于正常近视眼。两组均为Tono—Pen和NCT、与GAT测量值呈正相关，LASIK术后中央Tbno—Pen眼压测量值与术前GAT呈正相关。眼压与角膜厚度的关系：近视眼组，NCT与角膜中央厚度呈正相关；GAT和Tono—Pen与角膜厚度无相关性。LASIK术后组，GAT和NCT与角膜厚度呈正相关；Tono-Pen与角膜中央厚度无相关性。结论LASIK术后眼压测量值下降。Tono—Pen测量IOP不受角膜厚度的影响，可应用于LASIK术后等角膜表面不平者。     

动态轮廓眼压计监测LASIK手术前后眼压变化

目的比较动态轮廓眼压计(DCT)、Goldmann压平式眼压计(GAT)及非接触式眼压计(NCT)测量接受准分子激光原位角膜磨镶术(LASIK)患者眼压值的差异。设计前瞻性临床试验研究。研究对象接受LASIK治疗的近视患者70例(140眼)。方法对上述患者于术前、术后1周,1、6个月用三种不同眼压计分别测量眼压,比较各时间点、各种眼压计之间的差异。同时记录手术前、后中央角膜厚度,取其两者差为角膜切削深度的值。主要指标眼压值(IOP)和角膜切削深度。结果术后1周,1、6个月DCT测量值(16.74±1.96mmHg、16.67±1.90mmHg、16.42±2.12mmHg)与其术前值(17.36±2.32mmHg)比较差异无统计学意义(F=1.346,P=0.06)。术后GAT和NCT测量值均呈下降趋势,与术前测量值比较差异有统计学意义(GAT:F=101.217,P=0.000;NCT:F=171.466,P=0.000),并且下降值与角膜切削深度成正相关关系(GAT:r=0.86,P=0.000;NCT:r=0.87,P=0.000),但术后三个时间段测量值比较差异无统计学意义(GAT术后三个时间点q值为0.216、0.677、0.461,P值分别为0.461、0.097、0.117;NCT术后三个时间点q值为0.215、0.585、0.370,P值分别为0.436、0.436、0.100)。结论LASIK术后GAT和NCT测量值明显下降,而DCT测量值无显著变化,其测量值较前两者更为可靠。(眼科,2007,16:344-347)     

中央角膜厚度、角膜曲率对Goldmann压平眼压计和非接触眼压计测量结果的影响

目的 探讨中央角膜厚度和角膜曲率对Goldmann压平眼压计(GAT)和非接触眼压计(NCT)测量结果 的影响.方法 比较性研究.选择120例门诊患者作为研究对象.应用超声角膜测厚仪测量患者中央角膜厚度,采用多功能验光仪测量角膜曲率,应用GAT和NCT测量受检者双眼眼压.应用SPSS 12.0统计学软件进行数据处理.采用直线回归法比较两种眼压计的测量结果 ,采用多重线性同归法分析中央角膜厚度、角膜曲率与两种眼压计所测眼压值的关系,应用Bland-Altman法比较NCT和GAT两种方法 对眼压测最结果 的影响.结果 GAT与NCT测量的平均眼压值分别为(18.4±4.0)mm Hg(1 mm Hg=0.133 kPa)和(17.0±4.6)mm Hg,差异有统计学意义(r=0.835,P=0.000).GAT和NCT测量的眼压值均受中央角膜厚度和角膜曲率的影响.中央角膜厚度每增加1μm,GAT测量眼压值增加0.039 mm Hg,而NCT测量眼压值增加0.064 mm Hg.角膜曲率半径每增加1 mm,GAT测最眼压值减少2.648 mm Hg,NCT测量眼压值减少3.190 nun Hg.中央角膜厚度对NCT测量眼压值的影响较其对于GAT测量眼压值的影响大.随着眼压的升高,NCT测最眼压值呈现出由低于GAT测量值到高于GAT测量值的逐渐变化趋势.结论 中央角膜厚度和角膜曲率均会影响NCT和GAT测量眼压值,而且中央角膜厚度对NCT测量眼压值的影响较其对GAT测量眼压值的影响大.     

动态轮廓眼压计与非接触式眼压计的比较

目的探讨中央角膜厚度和角膜曲率对轮廓动态眼压计以及非接触式眼压计眼压测量结果的影响。方法接受准分子激光原位角膜磨镶术(LASIK)的近视患者27例(54只眼),分别于术前和术后第4周使用非接触式眼压计(NCT)和动态轮廓眼压计(DCT)进行眼压测量。多元线性相关分析研究NCT、DCT测量值和角膜曲率及角膜中央厚度(CCT)之间的相关性。结果LASIK术后NCT测量值降低,而DCT测量值和术前比较差异则无统计学意义。角膜曲率、CCT和NCT读数呈线性相关,而与DCT读数无关。结论DCT测量眼压不受角膜曲率和中央角膜厚度影响,因此更适合于正常眼以及曾经接受角膜屈光手术眼的眼压测量。     

动态轮廓眼压计与压平眼压计的比较

目的:评价和比较动态轮廓眼压计和Goldmann压平眼压计测得的LASIK手术后眼压值。方法:接受准分子激光原位角膜磨镶术(LASIK)的近视患者34例68眼,分别于术前和术后3mo使用动态轮廓眼压计(Pascal dynamic contour tonometer,PDCT)和Goldmann压平眼压计(the Goldmann applanation tonometer,GAT)进行眼压测量。比较手术前后两种测量方法测得的眼压值的差异。多元线性相关分析研究GAT,PDCT测量值和角膜曲率及角膜中央厚度(CCT)之间的相关性。结果:LASIK手术后GAT测量值较术前低,而PDCT值和术前比较差异则无统计学意义。角膜曲率、CCT和GAT读数呈线性相关,而与PDCT读数无关。结论:GAT测量得到的眼压低于实际值。PDCT测眼压不受角膜曲率和中央角膜厚度影响。     

动态轮廓眼压计与Goldmann压平眼压计及非接触眼压计测量眼压的对比研究

目的探讨动态轮廓眼压计(DCT)与Goldmann压平眼压计(GAT)及非接触眼压计(NCT)测量眼压的准确性,并比较三种眼压计测量结果与中央角膜厚度(CCT)的相关性。设计前瞻性、比较性病例系列。研究对象连续选取90例(90眼)10~76岁正常人。方法采用KONAN非接触式角膜内皮镜测量CCT后,对所有入选者单眼以随机顺序采用Pascal型DCT、GAT及Topcon型NCT测量眼压。测量结果两两比较,并将眼压值与CCT进行直线回归分析。主要指标眼压值,Pearson相关系数。结果 90例正常人DCT眼压平均值(17.33±2.71 mm Hg)明显高于GAT(14.27±2.81 mm Hg)(P=0.000)及NCT(14.67±2.93 mm Hg)(P=0.000),平均差异分别为(3.06±2.01)mm Hg和(2.67±2.20)mm Hg;GAT与NCT之间平均差异为(-0.39±2.29)mm Hg(P=0.105)。DCT与GAT眼压值之间相关系数r=0.736(P=0.000);与NCT眼压值之间相关系数r=0.699(P=0.000)。GAT、NCT眼压值与CCT均明显相关(r=0.370,P=0.000;r=0.508,P=0.000);DCT眼压值与CCT无明显相关性(r=0.051,P=0.639)。DCT和GAT的差值与年龄无明显相关性(r=0.064,P=0.052)。结论 DCT测量的眼压值虽高于GAT及NCT,但不受CCT的影响,可能较GAT和NCT测量的眼压值更接近真实值。     

轮廓动态眼压计测量准分子激光原位角膜磨镶术后眼压

目的通过与Goldmann眼压计(goldmann appla-nation tonometer,GAT)的比较,评价轮廓动态眼压计(dynamiccontour tonometer,DCT)在准分子激光原位角膜磨镶术(laser insitu keratomileusis,LASIK)前和术后眼压测量中的应用价值。方法在术前以及术后第1周和第4周,分别用GAT和DCT测量30例60眼的眼压,对所得结果采用SPSS 11.5统计分析软件进行统计学处理。结果中央角膜厚度(centralcorneal thickness,CCT)和GAT读数相关,而与DCT读数无关。术前眼压和术后第1周、第4周的眼压比较,GAT读数分别下降(5.00±1.12)mmHg和(5.45±1.13)mmHg,DCT则无显著性差异。结论LASIK导致的CCT变化可影响GAT测量结果的准确性,但对DCT无影响,因此,DCT更适用于正常眼以及曾接受LASIK手术眼的眼压测量。     

角膜厚度对三种不同眼压计测量的影响

目的:比较采用Goldmann压平眼压计(Goldmann applanation tonometer,GAT)、非接触眼压计(non-contact tonometer,NCT)和Schiotz眼压计(Schiotz tonometer,ST)的眼压(intraoeular pressure,IOP)测量,评估角膜中央厚度(central corneal thickness,CCT)对读数的影响。方法:使用GAT、NCT和ST对所有患者的右眼进行眼压测量。超声角膜厚度测量法测定CCT。所有IOP及CCT测量由同一检查者进行。计算CCT25%(Q1)百分位数和75%(Q3)百分位数值,并通过这种方法将该组分为薄、中、厚角膜亚组。使用Statplus软件进行统计分析。结果:全系列144眼,GAT测量平均IOP为17.4±4.9mmHg,NCT为16.0±5.8mmHg,ST为14.0±4.0mmHg(Friedman方差分析P<0.01)。IOP水平和CCT之间的相关系数NCT为0.787(P<0.01),GAT为0.630(P<0.01),ST为0.565(P<0.01)。ST测量中,纠正的IOP误差和CCT之间的相关性在厚角膜明显弱(r=0.381,P=0.022)。结论:NCT是最易受不同CCT影响的设备。ST读数似乎比GAT和NCT读数受CCT的影响小。特别是在厚角膜,与NCT和GAT相比,ST可以被认为是一个更可靠的仪器。     

A clinical evaluation of XPERTtm NCTtm (Reichert) for glaucoma screening by optometrists

XPERT^tm NCT^tm advanced logic pneumotonometer (Reichert) was studied for its reliability and use in glaucoma screening. The evaluated 2400 NCT measurements on 300 eyes were compared to the results of Goldmann applanation tonometry (GAT) from the same eyes. Repeated NCT tonometry had no significant effect on IOP. Local anesthesia reduced mean NCT-GAT difference and standard deviation significantly (p < 0.05), i.e. feeling due to the diminished air pulse force provided by the instrument had still considerable influence on IOP. NCT-GAT regression was significant (p < 0.01). Mean IOP readings provided by NCT were four mmHg higher than GAT values. Although accuracy was not satisfactory for exact measuring, it was satisfactory for screening. The results suggested that four mmHg less than the mean IOP value seen on the display is acceptable for screening when the difference between the minimal and maximal individual readings on the display is less than 2SD i.e. six mmHg. In the case of a greater difference, the maximal value is to be replaced, as NCT tends to read higher values than GAT.Abbreviations GAT Goldmann applanation tonometer - NCT XPERT NCT tonometer - IOP in-traocular pressure     

眼球内气体对眼压测量的影响

目的研究NCT和Schiotz眼压计在含气眼的眼压测量中有何差异。方法用NCT和Schiotz眼压计对53例53眼患视网膜脱离经玻璃体切割环扎注气（C3F8）术后进行眼压测量。患者另眼为健眼，用作空白对照组。同期57例57眼患视网膜脱离经环扎加压术后眼作环扎对照组。所有的眼压测量均在术后3～4天内进行。结果注气组NCT值为25．3mmHg，Schiotz值为14．8mmHg；环扎组NCT值为14．3mmHg，Schiotz值为7．1mmHg；空白组NCT值为19．0mmHg，Schiotz值为15．5mmHg。注气组织内分层分析发现在高眼压状态下NCT与Schiotz眼压计的差值增大。结论NCT在玻璃体视网膜手术后，尤其在含气眼的眼压测量中比Schiotz眼压计准确。     

非接触眼压计的测量值探讨

比较眼压测量结果的不同取值方法 ,探讨非接触眼压计测量眼压的准确性。方法 :用非接触眼压计和压平眼压计测量 2 6 4例患者 ( 5 2 8只眼 )眼压 ,取非接触眼压计第一次测量值、三次均值和三次中的低值与压平眼压计比较。结果 :非接触眼压计测量眼压值与压平眼压计测得值密切相关 ,其中非接触眼压计三次测得值中的最低值与压平眼压计测得值最接近。结论 :非接触眼压计测量眼压应采用三次测量值的低值。     

Misleading Goldmann applanation tonometry in a post-LASIK eye with interface fluid syndrome

A 21-year-old myope presented with decreased vision and corneal edema following vitreoretinal surgery for retinal detachment. While intraocular pressure (IOP) measurement with Goldmann applanation tonometer (GAT) was low, the digital tonometry indicated raised pressures. An interface fluid syndrome (IFS) was suspected and confirmed by clinical exam and optical coherence tomography. A tonopen used to measure IOP through the peripheral cornea revealed elevated IOP which was the cause of the interface fluid. Treatment with IOP-lowering agents resulted in complete resolution of the interface fluid. This case is being reported to highlight the fact that IFS should be suspected when there is LASIK flap edema and IOP readings using GAT are low and that GAT is not an optimal method to measure IOP in this condition. Alternative methods like tonopen or Schiotz tonometry can be used.     

Effects of corneal thickness on intraocular pressure measured with three different tonometers

Purpose: To compare intraocular pressure (IOP) measured by a Goldmann applanation tonometer (GAT), a noncontact tonometer (NCT), and a portable noncontact tonometer (PNCT) in eyes of healthy volunteers, and to determine if a significant correlation exists between the IOP and the central corneal thickness (CCT). Methods: A total of 144 healthy participants were randomly assigned to one of two groups; in the first group, IOP was measured first with the NCT and then with the GAT. In the second group, IOP was measured first with the PNCT and then with the GAT. Subsequently, the CCT of all subjects was measured with an ultrasonic pachymeter. Results: The IOPs determined by the GAT and NCT and were strongly correlated, as were those determined by the GAT and PNCT, in both groups. However, a Bland-Altman plot showed that the correlations between the GAT and NCT and between the GAT and the PNCT measurements were not significant. With all three instruments, the IOP readings varied with the CCT. The mean IOPs obtained with the GAT increased by 0.23 mmHg with each 10-μm increase in CCT (0.23 mmHg/10 μm). The comparable value for the NCT was 0.29 mmHg/10 μm, and that for the PNCT was 0.31 mmHg/10 μm. Conclusions: For measurements of IOP in normal eyes, the GAT is the tonometer least affected by the CCT, compared with the PNCT and NCT. A PNCT is more likely to be affected by variations in CCT than the GAT.     

Goldmann压平眼压计与非接触式眼压计测量眼压的对比研究

目的:比较Goldmann压平眼压计(Goldmannapplanationtonometer,GAT)与非接触眼压计(non-contacttonometer,NCT)测量眼压的差异,以评价NCT与GAT测量的相关性。方法:对265例志愿者(529眼)分别采用Goldmann压平眼压计与非接触眼压计测量眼压。结果:非接触眼压计的测量结果低于Goldmann压平眼压计,且差异有显著性(19.13vs23.43,t=22.644,P<0.01),随眼压值的升高,两者相差幅度增大,差异在眼压〉30mmHg时更为明显,但相关系数逐渐变小。结论:非接触眼压计眼压测量值较Goldmann眼压测量值偏低,非接触眼压计眼压值为临界眼压时,需应用Gold-mann压平眼压计校正,以便及时发现病理性眼压升高,避免青光眼的漏诊和失治。