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1.
目的: 评价改良的巩膜隧道切口不缝合白内障超声乳化技术的疗效。方法: 对91 例老年性白内障行超声乳化并植入光学部为6m m 的 P M M A 人工晶体, 外切口距角膜缘05~10m m , 内切口位于角膜缘内 20m m 的透明角膜处。结果: 术后一周内裸眼视力高于 05 者达 93% 。术前及术后一天、一周、一月、三月的角膜散光值分别为 079±029 D、119±058 D、108±048 D、106±056 D和 107±063 D。结论: 改良的巩膜隧道切口不缝合超声乳化技术, 术后早期获得良好的裸眼视力, 角膜散光小, 可植入 P M M A 人工晶体, 降低手术费用。  相似文献   

2.
目的:观察基质内角膜环(ICR)植入术的安全性及有效性。方法:60只兔眼随机植入不同厚度的ICR,分别于术前及术后1,3天,1,2周,1,3,6月作裂隙灯检查及角膜生物测量。结果:术后各术眼角膜屈光力均出现不同程度的降低,ICR厚度与角膜屈光力变化之间存在直线相关(Y=1.4353-32.87X)。术后角膜屈光力稳定。角膜切口愈合良好,中央角膜保持透明。结论:ICR植入术是一种安全、有效、预测性好、屈光效果稳定的角膜屈光手术。  相似文献   

3.
目的 探讨后房型有晶状体眼人工矫正晶状体(intraocularcorrectivelens,ICL)植入术治疗超高度近视后患者的视觉质量。方法 收集2010年2月至2012年12月就诊于我院的-10.0D以上的接受后房型有晶状体眼ICL植入术治疗高度近视患者38例(76眼)为观察组,选取同期就诊于我院的-10.0D以上的接受角膜屈光手术的患者31例(62眼)作为对照组。术前2组患者最佳矫正视力、对比敏感度、屈光状态等指标比较,差异均无统计学意义(均为P>0.05)。比较2组术前及术后10d、1个月、3个月、6个月及12个月裸眼远近视力、最佳矫正视力、屈光度、波阵面相差及对比敏感度等。结果 术后观察组患者各时间点随访的裸眼视力均超过术前最佳矫正视力,术后1个月及3个月2组裸眼视力比较均无统计学差异(均为P>005),术后12个月观察组裸眼视力为1.03±0.18、对照组裸眼视力为0.96±0.24,2组比较差异有统计学意义(t=2.040,P=0.025);观察组最佳矫正视力为1.05±0.17、对照组最佳矫正视力为1.06±0.17,2组差异无统计学意义(t=-0.341,P=0970)。观察组术后高阶像差为(0.515±0.122)μm,与术前(0.400±0.060)μm相比差异无统计学意义(t=-7.825,P=0128),对照组术后高阶像差为(0.818±0.151)μm,与术前(0.399±0049)μm相比差异有统计学意义(t=22.580,P=0037),2组术后高阶像差相比差异有统计学意义(t=13.049,P=0.005)。观察组术后1个月对比敏感度恢复到术前水平,对照组对比敏感度始终低于术前,各时间点观察组对比敏感度均优于对照组,差异均有显著统计学意义。结论 ICL植入术对于超高度近视的矫正较准分子激光原位角膜磨镶术更安全、稳定、有效。  相似文献   

4.
超声乳化白内障摘除及人工晶体植入术后早期眼压改变   总被引:15,自引:1,他引:14  
Wu X  Zhu S 《中华眼科杂志》1998,34(5):339-341
目的探讨超声乳化白内障摘除及人工晶体植入术后早期的眼压变化。方法对49例(53只眼)白内障患者进行手术前及术后定期眼压测量。结果发现无论术毕对切口缝合与否,术后10~12小时眼压均较术前明显升高;缝合切口组眼压的升高程度明显高于不缝合切口组(t分别为4.41和3.32,P分别为0.0001和0.0020)。术后16只眼眼压>3.00kPa(1kPa=7.5mmHg),其中缝合切口组10只眼(10/20,50.0%),不缝合切口组6只眼(6/33,18.2%),两组间的差异有显著性(χ2=5.9820,P=0.014)。术后22~24小时眼压已明显降低,46~48小时已降至术前水平。结论超声乳化白内障摘除及人工晶体植入术后早期眼压有不同程度升高,缝合切口者眼压升高更为显著,应于术后注意测量眼压,以便及时作相应处理,提高手术疗效。  相似文献   

5.
目的 探讨无巩膜瓣经巩膜缝线固定后房折叠型人工晶状体植入术的手术方法及效果。方法 对22例(22眼)行无巩膜瓣经巩膜固定后房折叠型人工晶状体植入术,记录术前和术后的裸眼视力及最佳矫正视力并随访超过12个月,探讨该手术方法的技巧,观察手术效果及术后并发症。结果 22眼术前最佳矫正视力为0.58±024,术后视力均有提高。术后1周裸眼视力0.52±0.27,与术前最佳矫正视力相比,差异无统计学意义(t=0.742,P>005)。术后1个月最佳矫正视力0.61±023,与术后1周相比,差异无统计学意义(t=0.814,P>0.05)。术后1眼出现眼压升高,1d后降至正常;1眼出现角膜水肿, 3d内逐渐消退。未见人工晶状体移位、脱位及倾斜,无缝线脱落及暴露,无虹膜粘连、黄斑水肿等并发症发生。结论 无巩膜瓣经巩膜固定后房型人工晶状体植入术具有视力恢复良好、术后并发症发生率低等优势,对于无后囊或后囊支撑力不足的无晶状体眼的屈光矫正是安全有效的。  相似文献   

6.
透明角膜小切口折叠人工晶体植入术   总被引:5,自引:1,他引:4  
目的评价透明角膜小切口折叠人工晶体植入术的效果。方法经3.5mm小切口完成41例45眼。分别观察视力、角膜地形图及角膜内皮细胞丢失率。结果术后d1,裸眼视力≥0.5占82.35%,≥1.0占50%;术后1个月时≥0.5占100%,≥1.0占75.32%。角膜地形图显示角膜切口附近较为平坦,但术后1月时可恢复至术前状态。角膜内皮丢失率术后1周为9.37%±4.12。结论透明角膜小切口折叠人工晶体植入术反应轻,散光小,视力恢复快。  相似文献   

7.
影响准分子激光屈光性角膜切削术后眼压的因素   总被引:10,自引:0,他引:10  
Zhang X  Pan C  Li L  Ding J 《中华眼科杂志》1998,34(5):385-387
目的分析影响准分子激光屈光性角膜切削术(excimerlaserphotorefractivekeratectomy,PRK)术后眼压的因素。方法采用非接触式眼压计(noncontacttonometry,NCT)测量眼压,对PRK前、后随访半年以上86例(150只眼)患者眼压差与角膜切削厚度、术前术后角膜曲率差之间进行多元回归分析。结果术前眼压明显高于PRK术后1周、3及6个月的眼压,差异有非常显著性(t检验,P<0.01),与术后1个月时眼压比差异无显著性(P>0.05)。术后1个月时的眼压高于术后其他时间眼压(P<0.01)。PRK后眼压降低与角膜厚度减少及角膜前表面曲率的降低有关(r=0.361,P<0.01;r=0.188,P<0.05),建立二元回归方程如下:Y=-0.059-0.038X1+0.009X2。Y:术前术后眼压差(kPa),X1:术前术后角膜曲率差(D),X2:角膜切削厚度(μm)。结论PRK后NCT测量眼压低于术前,术后眼压与氟甲脱氧泼尼松龙(fluorometholone)的用药次数和时间、角膜切削厚度、角膜曲率有关。  相似文献   

8.
目的 探讨飞秒激光辅助的角膜基质透镜植入术矫正远视的早期安全性及疗效。方法 前瞻性研究。对7例9眼远视患者行飞秒激光辅助的角膜基质透镜植入术,术后随访6个月。观察术后裸眼远视力、裸眼近视力、最佳矫正远视力、等效球镜度数、眼压、角膜曲率、角膜一般情况及神经生长情况等。结果 所有患者手术均顺利完成,仅1例(1眼)术后4个月发生角膜排斥反应。术后早期角膜基质水肿,术后1个月、3个月水肿消失;术后6个月,透镜与周边组织完全融合,无法识别边界。术后各时间点裸眼近视力、裸眼远视力、等效球镜度数均较术前改善,角膜平坦轴曲率、角膜陡峭轴曲率、中央角膜厚度均较术前明显增加。术后角膜平均曲率及眼压与术前比较变化不大,差异均无统计学意义(均为P>0.05)。术后角膜OCT检查显示(除发生角膜排斥反应的1眼外)角膜表面光滑,基质透镜透明、在位。术后角膜激光共聚焦显微镜检查:术后1周,角膜组织水肿,透镜组织及角膜基质层均可见活化的角膜基质细胞,随时间延长,角膜水肿消退,基质细胞逐渐呈静止状态,并可见神经纤维。结论 飞秒激光辅助的角膜基质透镜植入术矫正远视早期是安全有效的,但其可预测性有待提高,远期疗效还需进一步随访观察。  相似文献   

9.
经角膜切口行白内障摘除和人工晶体植入术   总被引:22,自引:3,他引:19  
目的介绍经角膜切口行白内障囊外摘除和人工晶体植入的方法及疗效观察。方法用可调钻石刀在上方角膜缘内1.0~1.5mm处做梯形切口,行白内障囊外摘除和人工晶体植入手术,观察术后眼压、角膜内皮细胞及角膜性散光变化。结果45只眼的眼压术前及术后对比,无统计学差异(P>0.05),角膜内皮细胞损失率为12.55%,术后平均循规性角膜散光0.96DC。结论经角膜切口治疗青光眼小梁切除术后并发白内障、陈旧性葡萄膜炎瞳孔闭锁并发白内障及严重的糖尿病性白内障等,其疗效安全、可靠。  相似文献   

10.
白内障超声乳化吸除术的不同切口对角膜散光的影响   总被引:14,自引:0,他引:14  
为探讨超声乳化白内障吸除术不同大小切口对术后视力和手术源性角膜散光的影响,对白内障超声乳化32mm水平切口、60mm反眉状切口的69只眼对照白内障囊外摘除术12mm切口的96只眼,在术后1周至3个月进行视力和角膜散光的测定和评价。结果:超声乳化32mm切口组和60mm组术后1周至1个月的视力明显高于囊外摘除12mm切口组(P<005),术后1周至3个月时超声乳化组角膜散光明显低于囊外摘除组(P<001)。结论:采用6mm反眉状巩膜隧道切口水平缝合一针,同样有效减少术后角膜散光并早期获得良好视力,术后1个月时的视力和角膜散光比较32mm切口组无明显差异。  相似文献   

11.
In a prospective study we used the change in central and peripheral (12 o'clock position) corneal thickness after two cataract surgery techniques as a parameter of tissue trauma. We looked at whether our findings indicated a difference in corneal thickness in the two groups and thus, as postulated in the literature, in the prospective endothelial cell loss. In 32 eyes (Group A) we performed small incision surgery (3.5 mm to 4.0 mm scleral-step incision) with hydrogel intraocular lenses implanted in the bag. In 30 eyes (Group B) we performed a 7.0 mm scleral-step incision with in-the-bag implantation of conventional poly(methyl methacrylate) intraocular lenses. Increases in corneal thickness (centrally and peripherally) were correlated after different postoperative periods. After 48 hours Group B showed a slightly higher increase in corneal thickness than Group A. Similar findings were observed at five days. In Group B the peripheral thickness did not show as high an increase as the central thickness after 48 hours. In all other cases the peripheral thickness increased more than the central thickness. After one month all eyes regained their preoperative thickness. We did not find a statistically significant difference in central and peripheral corneal thickness between the two groups. The results show that neither of the two surgical techniques greatly influenced the increase in corneal thickness and, consequently, the prospective endothelial cell loss.  相似文献   

12.
PURPOSE: To evaluate the change of intraocular pressure (IOP) after implantation of Intacs (KeraVision) corneal ring segments using Goldmann applanation tonometry (GAT). SETTING: Multicenter clinical trial for U.S. Food and Drug Administration application conducted at 10 U.S. sites. METHODS: One-year follow-up data from a phase III clinical trial (n = 359) were reviewed. Intraocular pressure was measured by GAT preoperatively and 1 week and 1, 3, 6, and 12 months after Intacs implantation. The untreated fellow eyes were controls. Change from baseline (preoperative) IOP was calculated and tested for correlation with age and change from baseline in mean keratometry, manifest refraction spherical equivalent (MRSE), and pachymetry (central corneal thickness). Mean IOP in treated and control groups was compared through month 6. RESULTS: At all postoperative examinations, mean IOP in the Intacs eyes was significantly lower (-0.39 to -1.75 mm Hg; all P 相似文献   

13.
目的 通过傅里叶频域光学相干断层扫描(FD-OCT)对VisuMax飞秒激光制作角膜帽的早期临床观察,评价帽厚度的精确性、重复性、均一性及规整性,并研究SMILE术后不同方向不同时间帽厚度变化及其角膜上皮等可能的影响因素。方法 回顾性研究。选取44例(87眼)拟行SMILE术的近视患者,采用FD-OCT测量术后1周、1个月角膜6 mm直径范围内水平和垂直子午线方向的角膜帽厚度。应用RVe软件工具在每个截面图上特定的7个点标定角膜帽的厚度。采用配对样本t检验分析术后帽厚度预期值与实际值差异及术后不同时间帽厚度差异,术后角膜帽厚度与术前参数等相关性采用Pearson线性相关分析。结果 精确性:术后实际角膜帽厚度均较理论值厚,差异均有统计学意义(均为P<0.05);重复性:术后1周、1个月水平方向帽厚度标准差分别为2.64 μm、3.41 μm,术后1周、1个月垂直方向帽厚度标准差分别为3.36 μm、3.10 μm;均一性:术后1周水平方向各位点的帽厚度差异有统计学意义(t=3.246,P=0.004)、术后1个月水平方向各位点的帽厚度差异也有统计学意义(t=2.295,P=0.034);术后1周、1个月垂直方向各位点帽厚度差异均无统计学意义(均为P>0.05)。术后不同时间帽厚度相关影响因素:中央角膜厚度(CCT)与术后1周、1个月角膜帽厚度均存在正相关性(r=0.438、0.360,P<0.001、0.001),术前角膜中央区上皮厚度与术后1周、1个月角膜帽厚度均存在正相关性(r=0.323、0.296,P=0.002、0.005),且CCT对术后角膜帽厚度的影响较大。多元线性回归方程结果显示:术后1周角膜帽厚度=96.226+0.032×CCT+0.212×术前角膜中央区上皮厚度,术后1个月角膜帽厚度=97.022+0.029×CCT+0.219×术前角膜中央区上皮厚度。结论 飞秒激光制帽早期可有良好的可重复性,且角膜帽形态均一、规整。随着术前CCT及角膜中央区上皮厚度的增厚,术后帽厚度较预设帽厚度厚,影响制帽的精确性。其中术前角膜CCT是影响角膜帽厚度的主要因素。  相似文献   

14.
PURPOSE: To evaluate changes in corneal thickness after laser in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK) in eyes with the same preoperative refraction, correlate these changes to postoperative refractive outcomes, and compare corneal healing process in a standardized subset of patients. METHODS: Central corneal thickness was measured by contact ultrasound pachymetry in 14 eyes of 8 patients with preoperative myopia of -6.00 D who had LASIK, and in 14 eyes of 8 patients with the same preoperative refractive error who had PRK. Measurements were taken preoperatively, and 1 week, 3, and 6 months after surgery. Data were evaluated and compared using the paired Student t-test and Pearson correlation coefficient. RESULTS: Mean preoperative central corneal thickness in the LASIK group was 549.14 +/- 37.4 microm, and in the PRK group, 552.64 +/- 34.9 microm. At 1-week postoperatively, mean central corneal thickness in the LASIK eyes was 467.28 +/- 29 microm and in the PRK eyes, 473.85 +/- 39.2 microm; at 6 months, central corneal thickness had increased in both groups compared to the 1-week values; LASIK eyes had a mean central corneal thickness of 481.42 +/- 23.0 microm and PRK, 481.50 +/- 35.3 microm. Mean postoperative refraction after 6 months was -0.48 +/- 0.30 D in the LASIK group and -0.67 +/- 0.35 D in the PRK group. CONCLUSION: Increase in central corneal thickness between 1 week and 6 months postoperatively occurred in both LASIK and PRK eyes, but differences were not statistically significant. No statistically significant differences were found in myopic regression between the two patient groups.  相似文献   

15.
华焱军  ;王勤美  ;黄锦海 《眼科》2014,23(5):308-312
目的 评估Pentacam HR测量角膜屈光术后眼角膜参数的可重复性并比较用Pentacam HR角膜参数计算未手术眼和角膜屈光术后眼角膜屈光指数的差异。设计 前瞻性研究。研究对象 接受角膜屈光手术术前及术后检查者,分为两组:A组为接受常规术前检查者207例207眼;B组为接受常规术前检查且术后3个月(LASIK)或6个月(PRK)以上复查者67例133眼。方法 A组受试眼行主觉验光和Pentacam HR检查;B组受试眼手术前后分别行主觉验光和Pentacam HR检查。两组中Pentacam HR检查均获得三次有效结果。主要指标  变异系数(CVw)、组内标准差(Sw)和组内相关系数(ICC)评估Pentacam HR获得的未手术眼(A组)和角膜屈光术后眼(B组)的角膜中央前表面3 mm范围内平均曲率半径(Ra)、角膜中央后表面3 mm范围内平均曲率半径(Rp)和中央角膜厚度(CCT)的可重复性。独立样本t检验分别分析A组和B组中计算获得的角膜屈光指数的差异。结果 A组中Pentacam HR获得的Ra、Rp和CCT分别为(7.780±0.235)mm、(6.341±0.225)mm和(541.67±31.79)μm; B组中Pentacam HR获得的Ra、Rp和CCT分别为(8.625±0.412)mm、(6.379±0.237)mm和(461.89±34.70)μm,均具有很好的可重复性(CVw均<1%,ICC均≥0.99)。基于Pentacam HR获得的参数计算角膜屈光指数,A组为(1.3278 ± 0.0008);B组为(1.3227±0.0019)(t=34.634,P=0.000)。结论 Pentacam HR获得的未手术眼和角膜屈光术后眼角膜中央前、后表面3 mm范围内曲率半径和中央角膜厚度均具有很好的可重复性。基于Pentacam HR获得的角膜屈光术后眼的角膜屈光指数小于未手术眼的角膜屈光指数。(眼科, 2014, 23: 308-312)  相似文献   

16.
目的  评估3.2 mm透明角膜切口超声乳化术治疗放射状角膜切开术(radial keratotomy,RK)后白内障的效果与安全性。设计  回顾性病例系列。研究对象  既往有RK手术史的白内障患者8例13眼,其中RK角膜瘢痕为8刀者2例4眼,12刀者3例4眼,16刀者3例5眼。方法  由同一手术医师进行3.2 mm透明角膜切口超声乳化人工晶状体植入术。8刀RK组中,角膜主切口位于相邻两条放射状角膜瘢痕之间,未与瘢痕接触;12刀RK组中,主切口跨越1条角膜瘢痕;16刀RK组中,主切口跨越2条角膜瘢痕。于术后1天,1周,1、3、6个月,1、2、3年进行随访,观察角膜RK瘢痕情况、并发症处理及术后视力恢复情况。主要指标 有无RK瘢痕裂开、术后最佳矫正视力、角膜散光、角膜内皮细胞密度。结果  8刀RK组和12刀RK组术中均未发生角膜RK瘢痕裂开,术毕切口密闭良好;16刀RK组中,2眼发生术中角膜瘢痕裂开,1眼采用前房注气封闭切口,另1眼采用主切口下注入黏弹剂,侧切口前房注气封闭切口。随访过程中,所有13眼术后角膜切口密闭良好,均未出现新发角膜瘢痕裂开。最后1次复查时,最佳矫正视力为(0.67±0.18)较术前(0.29±0.20)提高(t=-6.077,P=0.000),角膜散光(1.69±1.23 D)较术前(1.28±0.78 D)无明显变化(t=-0.758,P=0.470),角膜内皮细胞密度(1716.95±906.79/mm2)较术前(2383.97±833.39/mm2)降低(t=2.995,P=0.012)。结论  8刀、12刀RK术后白内障患者行超声乳化手术时采用3.2 mm透明角膜切口是安全的,16刀者术中易发生角膜瘢痕裂开,对此应采用更小的角膜切口或采用传统的角巩膜隧道切口。  相似文献   

17.
目的 探讨同轴微切口超声乳化白内障吸出术对角膜内皮细胞的损伤及其修复特点。方法 选取2011年1月至2013年12月我院收治的100例(100眼)年龄相关性白内障患者为研究对象,根据手术方式不同分为常规切口组和微切口组,分别行常规3.0mm切口白内障超声乳化术和1.8mm同轴微切口超声乳化白内障手术,使用角膜内皮显微镜于术前、术后1d、1周、1个月、3个月检查角膜内皮细胞密度和形态,对两组结果进行观察比较。结果 两组术前角膜内皮细胞密度组间比较差异无统计学意义(P>0.05);两组术后不同时间角膜内皮细胞密度均低于术前,差异均有统计学意义(均为P<0.05);两组术后不同时间点组间比较,差异均无统计学意义(均为P>0.05)。两组术前六角形细胞比例组间比较,差异无统计学意义(P>0.05);两组术后不同时间六角形细胞比例均低于术前,差异均有统计学意义(均为P<0.05);两组术后不同时间点组间比较,差异均无统计学意义(均为P>0.05)。两组术前角膜内皮细胞变异系数组间比较,差异无统计学意义(P>0.05);两组术后不同时间角膜内皮细胞变异系数均高于术前,差异均有统计学意义(均为P<0.05);两组术后不同时间点组间比较,差异均无统计学意义(均为P>0.05)。两组术后1d、1周中央角膜厚度增加明显,均高于术前,差异均有统计学意义(均为P<0.05),术后1个月、3个月逐渐恢复至术前水平,与术后1d、1周比较,差异均有统计学意义(均为P<0.05);两组术前及术后不同时间点中央角膜厚度组间比较差异均无统计学意义(均为P>0.05)。结论 同轴微切口白内障超声乳化手术进一步缩小了手术切口,术后恢复更快,是一种安全有效的手术方式。  相似文献   

18.
In a prospective study we used the change of central and peripheral (12 o'clock-position) corneal thickness (CT) after no-stitch small incision cataract surgery as a parameter of tissue traumatisation (33 eyes) and compared the values to a series of cases (32 eyes) with conventional 3.5 mm scleral step incision. In both groups the peripheral measurements showed a higher increase in corneal thickness than the central. After 1 month all eyes regained their central preoperative thickness. Increase in corneal thickness (ACTc, ACTp) after the different postoperative periods were correlated. The values of the central cornea showed no significant difference between the two groups. 1, 7 and 30 days after surgery the increase of peripheral CT was significantly higher in the no-stitch group. This fact was underlined by the clinical aspect at the slit lamp and is due to the anatomical and surgical characteristic of this procedure. One month postoperatively there was no increased endothelial cell loss in the no-stitch group (3%). No-stitch cataract surgery surgery provides a lot of intra- and postoperative advantages. The problem of increased swelling of the peripheral corneal entry seems to be a secondary one as corneal thickness decreases with time. Concerning the prospective endothelial cell loss it is mandatory to study the long term results.  相似文献   

19.
AIM:To assess the early surgical outcomes ofquick-chop phacoemulsification technique in patients with high myopia.METHODS: The data of patients with high myopia who underwent quick-chop phacoemulsification were reviewed retrospectively. There were 42 eyes of 31 patients. The axial length was more than 26 mm in all eyes. All eyes underwent quick-chop phacoemulsification surgery with the placement of an intraocular lens (IOL) in the capsular bag. Postoperative visits were performed at 1, 3d; 2wk, 1mo. Early postoperative best corrected visual acuity (BCVA), preoperative and postoperative corneal endothelial cell density (ECD), central corneal thickness (CCT) and postoperative complications were assessed. Paired sample t-test or Wilcoxon tests were used to compare data between preoperative and postoperative data.RESULTS:There was no statistically significant difference between preoperative and postoperative ECD and CCT. Retinal detachment was developed in one eye at postoperative first day. There was an iris prolapsus from side port insicion.CONCLUSION: Quick-chop phacoemulsification technique is a safe surgical technique. However we can encounter some complications in high myopic eyes due to histopathological differences. Both side port and clear corneal tunnel insicion size is crucial for preventing postoperative complications. If any persistent leakage is noticed, suture should be placed.  相似文献   

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