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1.
洪朝阳  王斌 《眼科新进展》2004,24(2):123-124
目的 研究 2次滴眼时间间隔对青少年验光和散瞳效果的影响。方法 在本院 2 0 0 1~ 2 0 0 2年门诊散瞳验光的青少年屈光不正患者中 ,随机抽取 73例 14 6眼 ,年龄 8~ 2 5岁 ,平均 14 4岁 ,滴 2次复方托吡卡胺之间间隔 1min或5min ,然后进行检影并记录瞳孔直径 ,1周后重复此过程 ,改变时间间隔。结果 滴 2次眼液的时间间隔对检影结果无显著性差异 (P >0 0 5 ) ,对散瞳效果也无显著性差异 (P >0 0 5 )。结论 间隔 1min滴 2滴复方托吡卡胺能达到与间隔5min滴眼同样的效果  相似文献   

2.
Purpose: To compare the mydriatic effect and safety between different concentrations of tropicamide and phenyle­phrine in preoperative mydriasis for phaco­emulsification. Methods: Two hundred and seventeen consecutive eyes in the same number of Chinese patients undergoing phaco­emulsification under local or topical anaesthesia in a university‐based eye hospital were analyzed. Patients were randomized into two groups by cluster randomization, each group receiving a different preoperative mydriatic regimen. Regimen A consisted of tropicamide 1.0% with phenylephrine 2.5%, and Regimen B consisted of tropicamide 0.5% with phenylephrine 0.5%. The main outcome measures were horizontal pupillary diameter, systolic, diastolic and pulse pressure and pulse rate. Results: The group who received Regimen A attained a mean horizontal pupillary diameter of 7.00 ± 1.06 mm. Their pupils were significantly larger than those receiving Regimen B (6.61 ± 1.03 mm, P = 0.007). No untoward cardiovascular effects were noted in either groups. Conclusion: Regimen A attained better preoperative mydriasis for phacoemulsification than Regimen B. Both regimens were safe with regard to their cardiovascular effects. The combination of tropicamide 1.0% and phenylephrine 2.5% is recommended as preoperative mydriatic for phacoemulsification in Chinese patients who have darkly pigmented irides.  相似文献   

3.

Purpose:

Phenylephrine hydrochloride (PHCl), a commonly used mydriatic agent, causes a small but significant deterioration of accommodation. The relative roles of pharmacology and optics in this deterioration, however, remain unascertained. The study determined the combined impact of PHCl concentration (pharmacology) and pupil size (optics) on the static and dynamic characteristics of accommodation.

Materials and Methods:

A total of 16 emmetropic Indian adults viewed a high-contrast visual target that switched between 67 and 33 cm viewing distance (1.5D stimulus) with their right eye (left eye occluded using infrared transmitting filter) through natural pupils and through 8, 6, 4, and 1 mm diameter artificial pupils. This protocol was repeated once without PHCl and once each with 2.5%, 5%, and 10% PHCl. Consensual accommodation of the left eye was recorded using infrared photorefraction (60 Hz).

Results:

Relative to no PHCl, the horizontal pupil diameter of left eye was significantly larger (P < 0.001) and the response magnitude and peak velocity of accommodation and disaccommodation were modestly but significantly smaller (P < 0.02 for all) for all concentrations of PHCl tested. There was no significant difference in these parameters across the three drug concentrations (P > 0.4 for all). The response magnitude and peak velocity also decreased significantly with pupil diameter, at similar rates for the no PHCl and the three PHCl conditions (P < 0.001 for all).

Conclusion:

The reduction in accommodative performance with all drug concentrations and with pupil diameter suggests independent roles of pharmacology and optics in determining accommodative performance with PHCl. The reduction in accommodative performance is, however, modest and may be clinically irrelevant in Indian eyes.  相似文献   

4.
Background: This study investigated the association of transient changes in intraocular pressure (IOP) with changes in the anterior chamber configuration in children after diagnostic mydriasis with 1% tropicamide. Methods: In this prospective case‐control study, 163 hospital clinic‐based samples of unrelated children with or without myopia were enrolled. Complete ophthalmological examinations, including visual acuities, cycloplegic refraction, slitlamp examination, fundus examination, IOP, axial length measurement and Pentacam examination were performed. Results: Lens thickness in emmetropic children was significantly greater than in myopic children of both genders, both before and after mydriasis. In a comparison of the biometric differences before and after mydriasis, IOP was not different, but the lens thickness after mydriasis was significantly less in myopic and emmetropic children of both genders. The mean anterior chamber angle, anterior chamber depth and anterior chamber volume significantly increased after mydriasis in myopic and emmetropic children of both genders. These parameters were not related to the changes of IOP under multiple regression analysis. There were no statistically significant differences between groups in either biometric parameters or anterior chamber configurations. Conclusion: While the present findings do not show a significant change in IOP following mydriasis, there was wide inter‐individual variation, with some children showing an increase in IOP of up to 8.0 mmHg and some showing a decrease of a similar amount. This variation suggests that IOP should be monitored when mydriatics or cycloplegics are used in children.  相似文献   

5.
Background: The slitlamp can be used to estimate the anterior chamber depth (ACD). The length of a slit object is increased until the corneal and iris/lens images appear to just touch. Multiplying the just‐touching‐slit‐length (JTSL) by a conversion factor gives an estimate of the ACD as measured by ultrasonography. The purpose of this study was to determine if central corneal thickness (CCT) affects the accuracy of this technique. Methods: The ACD of 50 subjects was measured by A‐scan ultrasonography and estimated by the slitlamp technique. CCT was measured by ultrasonic pachometry. The refractive error was determined subjectively. Results: The average ultrasonographic ACD for all subjects was 3.32 ± 0.65 mm. The average JTSL was 2.46 ± 0.38 mm. The conversion ratio between the ultrasonographic ACD and the average JTSL was 1.35. The predicted ACD using the regression equation of JTSL on the ultrasound anterior chamber depth (USACD) was 3.32 ± 0.54 mm. The corresponding value using the regression equation of JTSL and CCT on USACD was exactly the same, that is, 3.32 ± 0.54 mm. Conclusion: Incorporation of CCT into a regression equation does not improve the accuracy of the Smith technique.  相似文献   

6.
AIM: To evaluate the relationship between contrast sensitivity (CS) and corneal shape following overnight orthokeratology (OK). METHODS: We conducted a retrospective clinical study of 80 lens-wearing myopia patients, all of whom had undergone OK and had been evaluated by Orbscan II topography. We measured the surface irregularity index (SIRI) of corneal topography at 3 and 5 mm, the size of the flattened central corneal curvature of OK lens (zone A), the size of the cornea altered by OK lens (zone B), the size of the pupillary area at the corneal level (zone C), the area of crossover between zones A and C (zone AC), the area of crossover between zones B and C (BC), the ratio of BC to B (BC/B), and the ratio of AC to C (AC/C). CS was evaluated using the CSV-1000 with spatial frequencies of 3, 6, 12, and 18 cycles/degree (CPD). RESULTS: Multiple correlation analyses indicated significant negative correlations between CS, zone C, BC/B, and 3-mm SIRI (all P<0.01). There were no significant differences between CS, zone B, AC/A, or 5-mm SIRI (P=0.60, 0.94 and 0.11, respectively). Zone C was negatively correlated with 3, 6, 12, and 18 CPD. 5-mm SIRI were negatively correlated with 6, 12, and 18 CPD. BC/C was negatively correlated with 6 and 18 CPD. AC/C was positively correlated with 3 CPD. CONCLUSION: Zone C, 3-mm SIRI and BC/B affect the CS following overnight OK.  相似文献   

7.
8.
Mydrin-P散瞳前后中央角膜厚度的变化   总被引:4,自引:2,他引:2  
目的:比较使用Mydrin-P散瞳前后中央角膜厚度的变化。方法:将53例准备接受准分子激光角膜屈光手术的近视患者106眼纳入研究,用超声角膜测厚仪测量用Mydrin-P散瞳前后的中央角膜厚度。结果:用Mydrin-P散瞳后中央角膜厚度显著增加(P<0.001)。结论:Mydrin-P散瞳会对中央角膜厚度的测量产生影响。  相似文献   

9.
10.
目的 探讨年龄相关性白内障患者眼轴长度与角膜曲率、角膜散光、前房深度和眼压的关系.方法 本次研究对象为在武汉大学中南医院行白内障手术的年龄相关性白内障患者368例(368眼).患者的眼轴长度、角膜曲率、角膜散光和前房深度均应用IOL-Master(德国蔡司公司)进行测量,眼压采用iCare眼压计测量.使用随机抽样法从不同眼轴长度患者中随机抽出80例(80眼),分别为短眼轴组、中眼轴组和长眼轴组.各组间比较采用单因素方差分析.眼轴长度和角膜曲率、角膜散光、前房深度及眼压的关系采用Spearman相关分析.结果 眼轴长度与角膜曲率(r=-0.424,P<0.001)、眼轴长度与角膜散光(r=0.138,P=0.008)、眼轴长度与前房深度(r=0.561,P<0.001)均相关.其中,眼轴长度与角膜曲率呈负相关,与角膜散光和前房深度呈正相关,但与角膜散光相关性较弱,而与角膜曲率和前房深度中度相关.眼轴长度与眼压无相关性(r =0.064,P=0.326).中眼轴组和长眼轴组角膜曲率与短眼轴组比较,差异均有统计学意义(均为P<0.001);而中眼轴组与长眼轴组差异无统计学意义(P =0.438).中眼轴组与短眼轴组的角膜散光差异无统计学意义(P=0.333),同样中眼轴组与长眼轴组的角膜散光差异亦无统计学意义(P =0.718),但是短眼轴组与长眼轴组的角膜散光差异有统计学意义(P =0.042).短眼轴组的前房深度与中眼轴组(P=0.001)和长眼轴组(P<0.001)比较差异均有统计学意义,中眼轴组与长眼轴组的前房深度差异亦有统计学意义(P <0.001).3组眼压两两比较差异均无统计学意义(均为P>0.05).结论 角膜曲率与眼轴长度呈负相关;角膜散光与眼轴长度相关性弱,只有眼轴长度明显增长,才有可能表现出角膜散光度数增加;前房深度与眼轴长度中等相关,并随眼轴增长而加深;眼轴长度与眼压无相关性.  相似文献   

11.

Purpose:

To compare the efficacy in pupil dilatation between a mixture containing 0.75% tropicamide and 2.5% phenylephrine and the alternate application of 1% tropicamide and 10% phenylephrine eye drops.

Material and Methods:

Patients requiring pupil dilatation were randomized to receive one drop of the mixture every 10 min for four times or our standard application of one drop of 1% tropicamide alternating with one drop of 10% phenylephrine every 10 min for two cycles. Pupil size was measured under bright light with the pupil gauge before, and every 5 min after initial application for 40 min. Application of the drops was discontinued once the pupil diameter reached 7 mm. Blood pressure and pulse rate were monitored every 15 min.

Results:

Of 40 patients (age 57.3±10.9 years, range 35-70 years), 22 were randomized into the mixture group and 18 into the alternate drug group. Baseline pupil sizes were 1.7±0.5 mm in the mixture group and 1.8±0.4 mm in the alternate drug group. The pupils were successfully dilated to 7 mm within 40 min in 17 patients of the mixture group compared to seven patients in the alternate drug group (P=0.004, Log Rank test). The mean pupil sizes at 40 min were 6.6±0.8 and 6.0±0.9 mm in the mixture and alternate drug groups respectively (P=0.050, t-test). Blood pressure and pulse rate were stable and similar in both groups.

Conclusions:

The mixture of 0.75% tropicamide and 2.5% phenylephrine is superior to our standard application of 1% tropicamide alternating with 10% phenylephrine. It provides faster and more successful pupil dilatation within 40 min.  相似文献   

12.
目的:研究散瞳前后V4c有晶状体眼人工晶状体(ICL)植入术后患者拱高、前房深度(ACD)及前房角(ACA)的变化,探讨V4c ICL植入术的效果及术后患者散瞳的安全性。方法:前瞻性观察研究。 选取2018年2─9月于北京大学深圳医院眼科行V4c ICL植入术的近视患者31例(62)眼,在术前及 术后6个月时,分别测量裸眼视力(UCVA)、最佳矫正视力(BCVA)及屈光度。在术后6个月时,使用Sirius眼前节分析系统测量散瞳前后的拱高、ACD及ACA。采用配对t检验对数据进行分析。结 果:术前及术后6个月患者UCVA(LogMAR)分别为1.61±0.14、0.16±0.04,差异有统计学意义 (t=12.844,P<0.001)。术前及术后6个月患者BCVA(LogMAR)分别为0.02±0.05、0.01±0.03,差异 具有统计学意义(t=25.429,P<0.001)。散瞳前后拱高分别为(465±123)μm、(515±135)μm(t=-8.704, P<0.001),散瞳前后ACD分别为(2 966±83)μm、(3 009±89)μm(t=-9.899,P<0.001),差异均有 统计学意义。散瞳后3点位及9点位的ACA较散瞳前明显变宽,差异均具有统计学意义(t=-15.306, P<0.001;t=-15.163,P<0.001;)。结论:V4c ICL植入术是矫正近视的一种有效方法,术后散瞳会使拱高升高及ACD加深,同时ACA宽度增加,术后6个月时对V4c ICL植入患者执行术后散瞳是安全的。  相似文献   

13.
虞林丽  张向荣  蓝芹燕 《国际眼科》2017,10(11):2174-2176

目的: 探讨儿童和青少年眼轴长度(axial length,AL)、角膜厚度(center corneal thickness,CCT)、前房深度(anterior chamber depth,ACD)、晶状体厚度(lens thickness,LT)、白对白距离(white-to-white distance,WWD)和瞳孔直径(pupil diameter,PD)等眼球结构参数与年龄、性别的关系。

方法: 对2011-06/2013-10以来我院就诊的儿童和青少年患者413例826眼按照年龄分为3组:Ⅰ组≤5岁,Ⅱ组5~<10岁,Ⅲ组≥10岁以上; 按照性别分为两组:男200例400眼,女213例426眼; 采用Lenstar LS900 非接触式光学长度测量对受试者进行测量,取得AL、CCT、ACD、LT、WWD、PD值。用LSD-t法和SNK-q法进行比较年龄组和性别组间的差别, Pearson 相关系数评估儿童和青少年 AL、CCT、ACD、LT、WWD、PD相关参数的关系。

结果: CCT这项参数在不同年龄组间差异有统计学意义,年龄越大,CCT值越大,差异有统计学意义(P<0.05)。不同性别间的ACD和AL参数差异有统计学意义,男性较女性的ACD值和AL值大。CCT与WWD和PD存在正相关( r=0.208、0.167,P<0.05)。ACD与AL、WWD、PD存在正相关(r=0.620、0.238、0.192,P<0.05),LT与ACD、AL、WWD存在负相关(r=-0.271、-0.186、-0.227,P<0.05)。WWD与PD存在正相关(r=0.273,P<0.05)。

结论:CCT 随着年龄增长表现为逐渐变厚的趋势。男性较女性的ACD值和AL值大。CCT与WWD和PD存在正相关; ACD与AL、WWD、PD存在正相关,LT与ACD、AL、WWD存在负相关; WWD与PD存在正相关。  相似文献   


14.
目的 比较配戴软性及硬性角膜接触镜对角膜形态及前房深度的影响。方法 选取屈光不正患者60例(120眼),分别予以配戴软性角膜接触镜(softcontactlens,SCL)及透气性硬性角膜接触镜(rigidgaspermeablecontactlens,RGPCL),其中SCL组30例(60眼),RGPCL组30例(60眼),ObscanⅡ角膜地形图观察戴镜前及戴镜后1a、2a角膜屈光力、角膜前后表面Diff值、中央角膜厚度、前房深度的变化。结果 戴镜前RGPCL组角膜上下表面屈光力差值为(0.98±0.49)D,戴镜后1a为(0.66±0.43)D,戴镜后2a为(0.59±0.37)D,均较戴镜前减小(P<0.05);戴镜后1a、2a角膜前表面屈光力均较戴镜前降低,差异均有统计学意义(均为P<0.05)。SCL组戴镜后1a、2a角膜前后表面屈光力、I-S值、前后表面Diff值、前房深度与戴镜前比较,差异均无统计学意义(均为P>0.05);戴镜前中央角膜厚度为(549±26)μm,戴镜后1a为(527±29)μm,与戴镜前比较差异无统计学意义(P>0.05),戴镜后2a为(509±31)μm,与戴镜前比较差异有统计学意义(P<0.05)。结论 长期配戴RGPCL对角膜代谢和功能影响不明显,且能够提供更好的光学矫正效果。  相似文献   

15.
AIM: To evaluate the measurements of anterior segment parameters using three different non-contact optical devices in keratoconus patients.METHODS:A hundred and one eyes of 55 keratoconus patients were enrolled in this study. The mean age was 26.2±8.9 years. The inclusion criteria were keratoconus stage I to III according to the Amsler-Krumeich keratoconus classification. All the measurements were done by the same operator, under the mesopic light condition and repeated with three different optical methods; Visante , Orbscan and Pentacam. The evaluated anterior segment parameters were anterior chamber depth (ACD), central and thinnest corneal thickness (CCT and TCT) and pupil diameter (PD).RESULTS: The mean CCT measured by Visante, Orbscan and Pentacam were as follows:462.0±48.1μm, 463.9±60.9μm, 476.5±45.3μm, respectively (P=0.873). The mean ACD values were 3.34±0.33mm, 3.26±0.33mm, 3.49±0.40mm, respectively (P=0.118). The mean PD measurements were 5.11±1.14mm, 4.80±0.85mm, 3.80±1.38mm, respectively (P<0.001). The mean TCT measurements of Visante, Orbscan and Pentacam were 437.9±48.2μm, 447.6±60.6μm and 459.9±44.0μm, respectively (P=0.214). The Visante and Orbscan measured CCT similarly, while Pentacam measured CCT thicker than the other two. The Visante measured TCT thinner than the other two devices. In ACD measurements, Orbscan was the one giving the lowest values. PD was measured differently by the devices.CONCLUSION: Although TCT, CCT and ACD measurements acquired by Visante, Orbscan and Pentacam in keratoconus patients are similar, PD measurements show large differences among the devices.  相似文献   

16.
目的 通过复方托吡卡胺眼液对散瞳效果及角膜厚度影响的研究,为早产儿视网膜病变筛查提供更适宜的散瞳方法。方法 将进行RetCam3早产儿视网膜病变初次筛查并需进行复查的早产儿131人,按不同用药方法分为A、B、C、D四组,分别点入1、2、3、4次托吡卡胺眼液进行散瞳,在距最后一次散瞳15min、30min、45min时测量瞳孔直径和中央角膜厚度(cen-tralcornealthickness,CCT)。结果 瞳孔散大程度组内比较:A、B、C、D四组内各时间点两两比较差异均有统计学意义(均为P<0.05);组间比较:散瞳15min时,A组与D组、B组与D组、C组与D组差异均有统计学意义(均为P<0.05);散瞳30min和45min时,A组与B组、A组与C组、A组与D组、B组与D组、C组与D组差异均有统计学意义(均为P<0.05)。CCT组内比较:A、B、C、D四组内各时间点间两两比较,差异均有统计学意义(均为P<0.05);组间比较:散瞳30min和45min时,A组与C组、A组与D组、B组与C组、B组与D组CCT差异均有统计学意义(均为P<0.05)。结论 使用2次散瞳药,在距最后一次散瞳30min时进行RetCam3早产儿视网膜病变筛查为最佳散瞳方案。  相似文献   

17.
BACKGROUND: Anterior chamber configuration can be assessed via optical or ultrasonic techniques. Scheimpflug photography is a non-invasive method measuring the anterior segment. The Anterior Eye Segment analysis system, EAS-1000, utilises the Scheimpflug principle and was found to have good repeatability. Previous repeatability studies, however, have had limitations in their design. The current study investigated the intra-observer and interobserver repeatability of the EAS-1000. METHODS: Twenty-five healthy young subjects were recruited. The anterior chamber angles in different quadrants were measured by two examiners for interobserver analysis. The first examiner repeated the measurement at another session for intra-observer analysis. The 95% limits of agreement and intra-class correlation coefficient (ICC) were calculated. The anterior chamber depth was also measured and compared with ultrasound biometry. RESULTS: The anterior chamber angle assessment demonstrated good intra-observer (ICC ranging from 0.77 to 0.90 for different quadrants) and interobserver (ICC ranging from 0.68 to 0.81 for different quadrants) repeatability. The 95% intra-observer limits of agreement were within +/-5 degrees. The 95% interobserver limits of agreement were within +/-6 degrees. There was no significant difference between male and female subjects or among angles at different quadrants. The anterior chamber depth was found to be repeatable (ICC > 0.90) with 95% limits of agreement +/-0.1 mm. The anterior chamber depth was shallower than that obtained from ultrasound biometry. CONCLUSIONS: The EAS-100 is a non-invasive instrument which is repeatable for measuring the anterior chamber angle and depth. It provides quick results and is good for screening purposes. There is an under-estimation of anterior chamber depth, as previously reported.  相似文献   

18.
Background: The aim was to evaluate anterior segment parameters in patients with pseudoexfoliation syndrome (PXS) or pseudoexfoliative glaucoma (PXG) with the Pentacam‐Scheimpflug imaging system. Methods: Eighty eyes of 53 patients with PXS (Group 1), 80 eyes of 57 patients with PXG (Group 2) and 80 eyes of 45 control cases (Group 3) were included in the study. Anterior chamber depth, volume (ACV), angle (ACA) width, central corneal thickness (CCT), central 3.0, 5.0 and 7.0 mm corneal volumes and pupil diameters were compared between groups. Results: Although anterior chamber depths in the PXG group were significantly lower than the control group (p < 0.05), there was no statistically significant difference between the PXS group and the control group in means of anterior chamber depth values (p > 0.05). There were no statistically significant differences among PXS, PXG and the control group in mean values of ACV, ACA width, CCT, pupil diameters and central 3.0, 5.0 and 7.0 mm corneal volume (p > 0.05). Conclusions: The anterior chamber depths of PXG patients were lower than those of healthy individuals. Although the difference in anterior chamber depth between PXG patients and normal patients was statistically significant, this finding is unlikely to be of clinical significance. The anterior chamber depths of PXS patients were similar to those of healthy individuals. There were no significant differences in the means of ACV, ACA width, CCT, pupil diameter and corneal volume values on central 3.0, 5.0 and 7.0 mm among patients with PXS, PXG and healthy individuals.  相似文献   

19.
目的:探索一种临床实用的前房深度相对定量测量法,初步确定老年人前房深度的正常参考值。方法:裂隙灯光源外转45°,受检眼直视裂隙光,在6点时钟方向测量六个点的前房深度(ABCDEF),以角膜缘处的角膜厚度(CT值)为1计。A:角巩膜缘黑白交界处;B:A点上移1CT;C:B点上移1CT;D:虹膜最高点;E:瞳孔缘;F:晶状体前极。测量了50~75岁的正常老年人,229例229眼,采用双盲法对22例44眼进行了11次重复性检测。结果:女性组ABCDEF点的前房深度均值分别为0.38,0.58,0.89,2.10,2.65和3.26CT;男性组分别为0.71,1.02,1.43,2.37,2.90,3.41CT。女性组每个点的深度均比男性浅(P<0.05),越近周边部越显著。结论:前房深度六点相对定量测量法可重复性好,实用性强。  相似文献   

20.
目的:研究不同内径的前房维持器(anterior chamber maintainer,ACM)在兔眼实验性连续环形撕前囊(continuous curvilinear anterior capsulorhexis,CCC)中所创前房深度(anterior chamber depth,ACD)及眼压(intraocular pressure,IOP)的变化, 探讨ACM内径大小及灌注瓶高度(bottle height,BH)对ACD及IOP的影响。方法:将20只兔40眼随机分为4组,每组10眼,均在ACM维持前房下接受CCC。4个实验组所用ACM内径分别是0.4,0.5,0.6,0.7mm,BH由20cm阶梯式升至100cm,每10cm为一个提升高度,对术前及每个BH,应用A超测定ACD,应用Schiotz眼压计测定IOP,结果:内径为0.7,0.6,0.5mm的ACM在BH分别为50,60,70cm时使ACD较术前显著性加深,所提供IOP较术前较高,结论:内径较大的ACM形成前房及提高IOP迅速,所需BH相对较低,对于兔眼的CCC,内径为0.7,0.6,0.5mm的ACM均可提供理想的ACD及IOP,适宜的BH分别是50,60,70cm.  相似文献   

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