两种显微角膜板层刀制作角膜瓣厚度的对比分析

目的:对Hansatome自动旋转式显微角膜刀及AmadeusⅡ自动平推式显微角膜刀制作准分子激光原位角膜磨镶术(LASIK)角膜瓣厚度进行对比分析。方法:对来我院行LASIK的患者50例100眼,随机分成两组,一组用Hansatome显微角膜刀160μm刀头制作角膜瓣,另一组用AmadeusⅡ显微角膜刀140μm刀头制作角膜瓣。对所有患者进行术前中央角膜厚度测量及术中角膜基质床厚度测量,从而计算角膜瓣厚度。所有的患者均先行右眼手术再行左眼。对两组患者实际切削的角膜瓣厚度进行对比,同时对两种显微角膜板层刀制作角膜瓣厚度左右眼之间进行对比分析。结果:Hansatome组实际角膜瓣厚度67～158(平均98.70±18.04)μm;AmadeusⅡ组实际角膜瓣厚度69～171(平均110.60±16.47)μm,两种角膜刀制作角膜瓣厚度差异有统计学意义(P=0.001)。Hansatome组右眼104.40±18.78μm,左眼93.00±15.61μm,两眼角膜瓣厚度差异有统计学意义(P=0.01);AmadeusⅡ组右眼115.12±18.74μm,左眼105.20±12.29μm,P=0.024,患者左眼角膜瓣均比右眼要薄,差异有统计学意义。结论:在LASIK术中角膜板层刀制作的角膜瓣厚度与预计值有一定的偏差,术中测量角膜瓣厚度有重要的参考价值。     

准分子激光原位角膜磨镶术二次使用角膜刀制作角膜瓣厚度分析

目的 分析准分子激光原位角膜磨镶术(laser in situ keratomileusis,LASIK)中二次使用角膜刀制作角膜瓣的厚度.方法 应用MoriaM2显微角膜刀制作角膜瓣,每位患者用同一角膜刀制作双眼角膜瓣,手术顺序为先右眼后左眼,角膜瓣厚度为手术前角膜厚度减去角膜瓣下激光切削前角膜基质厚度.按手术顺序分为首次刀片使用组(右眼组)和二次刀片使用组(左眼组),对角膜瓣厚度进行统计学分析.结果 首次刀片使用组角膜瓣厚度平均(144.46±20.25)μm,二次刀片使用组角膜瓣厚度平均(131.64 ±20.46)μm,差异有统计学意义(P<0.01).两组角膜瓣厚度均比角膜瓣厚度标识值(160 μm)薄,差异有统计学意义(P<0.01).结论 首次使用角膜刀组(右眼组)角膜瓣厚度比二次使用角膜刀组(左眼组)厚.MoriaM2显微角膜刀所做角膜瓣比预测值薄,角膜瓣厚度在一定范围内变化.     

Moria M290一次性微型板层角膜刀制作角膜瓣的临床研究

目的：探讨Moria M290一次性微型板层角膜刀制作角膜瓣的可预测性及其影响因素。方法共入选104例（208只眼）拟行准分子激光原位角膜磨镶术（LASIK）患者参加此研究。术中使用Moria M290一次性微型板层角膜刀制作角膜瓣,所有患者均使用全新刀头,先右眼制瓣,然后左眼制瓣。制瓣前及制瓣后均使用超声角膜测厚仪测量术眼中央角膜厚度,同时测量角膜瓣直径及蒂长。结果平均角膜瓣厚度为（113．26±12．12）μm,其中右眼平均角膜瓣厚度为（121．42±12．08）μm,左眼平均角膜瓣厚度为（107．24±12．24）μm,两者比较有显著统计学差异（P ＜0．01）。右眼平均角膜瓣直径（9．46±0．15）mm,平均蒂长（5．16±0．25）mm;左眼平均角膜瓣直径（9．39±0．19）mm,平均蒂长（5．09±0．24）mm,两者比较均无显著性差异（P ＝0．08和P ＝0．95）。角膜瓣厚度与患者年龄,术前屈光度,术前角膜曲率及角膜直径均无明显相关性（分别P ＝0．56,P ＝0．50,P ＝0．19,P ＝0.42）,与术前中央角膜厚度呈正相关性（r ＝0．448,P ＜0．01）。结论 Moria M290一次性微型板层角膜刀制作角膜瓣预测性良好,角膜瓣厚度与术前中央角膜厚度呈正相关性。     

M2抛弃型显微角膜刀头制作角膜瓣可预测性分析

目的分析M2抛弃型130及90显微角膜刀头制作角膜瓣的可预测性。设计前瞻性随机对照临床试验。研究对象双眼同时行近视激光原位角膜磨镶术(LASIK)的患者77例154眼(130刀头50例100眼,90刀头27例54眼)。方法使用M2抛弃型130及90显微角膜刀头制作LASIK角膜瓣,术中用A超角膜测厚仪进行角膜厚度测量,计算角膜瓣厚度。同时测量角膜基质床面的水平径及角膜瓣蒂宽度。主要指标角膜瓣厚度、角膜基质床面水平径、角膜瓣蒂宽度。结果130刀头组:右眼角膜瓣厚度为(161.1±13.6)μm;左眼角膜瓣厚度为(156.9±14.6)μm;两者差异有显著统计学意义(P=0.009)。右眼角膜瓣床面水平直径为(9.1±0.2)mm,蒂宽(5.2±0.5)mm;左眼角膜瓣床面水平直径为(9.1±0.2)mm,蒂宽(5.3±0.4)mm。90刀头组:右眼角膜瓣厚度为(130.9±14.9)μm;左眼(第二次切削)角膜瓣厚度为(123.4±12.5)μm;两者差异有显著统计学意义(P=0.0004)。右眼角膜瓣床面水平直径为(9.0±0.1)mm,蒂宽(5.0±0.3)mm;左眼角膜瓣床面水平直径为(8.9±0.2)mm,蒂宽(5.0±0.3)mm。结论M2抛弃型130及90显微角膜刀头制作的实际角膜瓣厚度大于预计(标称)值,个体间存在一定的可预测偏差,对于角膜瓣大小及角膜瓣蒂宽度具有良好的可预测性。     

应用眼前节相干光断层扫描仪测量机械板层角膜刀所制准分子激光原位角膜磨镶术后的角膜瓣厚度

目的 探讨准分子激光原位角膜磨镶术(LASIK)中使用不同厚度的微型板层角膜刀(90、110、130刀头)制作角膜瓣的可预测性、均匀性及其影响因素.方法 对照病例研究.选择LASIK术后87例(174只眼)患者,其中手术中使用MoriaⅡ微型角膜刀90刀头组26例(52只眼),110刀头组29例(58只眼),130刀头组32例(64只眼).应用眼前节相干光断层扫描仪(OCT)测量患者角膜上0.、45.、90.及135.共4条子午线所在截面的角膜瓣厚度,先在每条子午线所在截面选取5个点,再于每个角膜瓣上测量20个点的角膜瓣厚度.3种刀头所制角膜瓣偏差情况采用线性混合效应模型分析,以P＜0.05作为差异有统计学意义.结果 MoriaⅡ微型角膜刀90、110、130刀头组制作的角膜瓣中央区厚度均值分别为(119.23±15.65)、(140.42±12.26)及(165.92±17.00)μm.3种刀头所制角膜瓣皆为中间薄、周边厚,形状近似一凹透镜.其中角膜瓣中央部厚度变异小,而旁中央和周边部厚度变异较大,差异有统计学意义(F=212.419,P＜0.05).右眼角膜瓣厚度均值(19.58±0.44)μm,高于左眼(16.55±0.44)μm;入刀侧角膜瓣厚度差值均值(21.30±0.55)μm,高于出刀侧差值均值(14.36±0.64)μm,差异均有统计学意义(F=25.341,44.461;P＜0.05).结论 3种刀头所制角膜瓣中央区厚度预测性均较好.角膜瓣厚度并非均匀一致,预计值越厚的角膜瓣其厚度变异越大,因手术顺序所致右眼角膜瓣比左眼角膜瓣厚,入刀侧角膜瓣厚于出刀侧角膜瓣.     

高度近视VisuMax飞秒激光制作超薄角膜瓣预测性研究

目的探讨VisuMax飞秒激光制作超薄角膜瓣应用于高度近视的可预测性及其影响因素。方法前瞻性临床研究。连续选取11例（21眼）欲行飞秒激光原位角膜磨镶术高度近视患者．使用VisuMax飞秒激光制作预计瓣厚度为85μm的超薄角膜瓣,制瓣前、后分别使用A型超声测厚仪测量术眼中央角膜厚度和中央基质床厚度,相减得出实际瓣厚度,采用Pearson相关分析实际角膜瓣厚度与术前眼压、等效球镜度、角膜曲率、水平角膜直径和角膜厚度的相关性。结果平均术中角膜瓣厚度为（96．0±10．5）μm,角膜瓣厚度与术前眼压、等效球镜度、角膜曲率及水平角膜直径的相关性无统计学意义,与术前中央角膜厚度呈正相关（r=0．512,P=0．018）。结论VisuMax飞秒激光制作超薄角膜瓣应用于高度近视的预测性良好,制作85μm瓣的实际瓣厚度与术前中央角膜厚度相关。     

准分子激光原位角膜磨镶术后角膜瓣丢失1例

患者男性,20岁,于2008年7月在我院行准分子激光原位角膜磨镶术手术.术前查屈光度：右眼-4.75 DS-0.75 DC×16°→1.0;左眼-5.0 DS-0.5 DC×159°→1.0.角膜厚度：右眼575μm,左眼582μm.角膜曲率：右眼K1 40.5 D,K2 39.4 D,左眼K1 40.9 D,K2 40.3 D.手术使用博士伦Z217型准分子激光治疗仪,采用Hansatome角膜板层刀制作角膜瓣,角膜瓣厚度110μm,蒂位于角膜上方,患者手术一切顺利,无游离角膜瓣及其他瓣的并发症.     

板层角膜刀制作前弹力层下角膜磨镶术中角膜瓣的临床评估

目的:观察前弹力层下角膜磨镶术(sub-Bowman’s keratomileusis,SBK)术中应用板层角膜刀制作的角膜瓣特点及相关影响因素。方法:用Moria One Use-Plus SBK板层角膜刀对98例196眼进行手术,预设角膜瓣厚度为100μm,术中用A型超声测量角膜瓣厚度,分析角膜瓣的均匀性、稳定性及相应的瓣并发症,并与预设角膜瓣厚度进行差异性分析,与术前等效球镜、角膜直径、角膜厚度、角膜中央最大K值等进行相关性分析。结果:实际角膜瓣平均厚度为100.96±5.35μm,先做眼(左眼)平均角膜瓣厚度103.56±5.22μm,后做眼(右眼)平均角膜瓣厚度98.12±5.50μm,两组差异有统计学意义(t=2.36,P<0.05)。角膜瓣的均匀性良好,各眼角膜中心、鼻侧、颞侧和上下方距中心3mm处角膜厚度无统计学差异(F=0.438,P>0.05)。实际角膜瓣厚度与患者术前中央角膜厚度(r=0.312,P<0.05)、角膜中央最大K值(r=0.452,P<0.01)呈正相关,与术前等效球镜、角膜直径等无明显相关性。常见制瓣并发症为上方瓣缘出血(34眼)、根部瓣缘粗糙(38眼)以及微小皱褶(25眼),未见其他严重并发症。结论:SBK术中机械板层角膜刀制作角膜瓣厚度均匀,预测性好,瓣相关并发症少,角膜瓣厚度与术前中央角膜厚度及角膜中央最大K值呈正相关。     

Moria OUP-SBK microkeratome制作LASIK角膜瓣特点及因素分析

目的 观察LASIK术中应用Moria One Use-Plus SBK板层角膜刀制作角膜瓣的特点及相关因素.方法 LASIK手术113例(226眼)预设角膜瓣厚度为100μm.术后1周使用美国Optovue公司的RTVue-100傅立叶域光学相干断层扫描仪(OCT)测量角膜瓣厚度,与预设角膜瓣厚度进行差异性分析,与术前等效球镜,角膜直径,角膜厚度,角膜中央最大K值等进行相关性分析.结果 实际角膜瓣平均厚度为( 106.37±3.72)μm.右眼角膜瓣平均厚度为(107.17±4.28) μm,左眼角膜瓣平均厚度为(105.58±2.89)μm,两组差异有统计学意义(t=2.429,P＜0.05).实际角膜瓣厚度与术前角膜中央最大K值呈正相关( RK=0.302,PK＜0.05),与术前等效球镜、角膜直径、角膜厚度均无明显相关性.结论 Moria One Use-Plus SBK板层角膜刀制作角膜瓣预测性好,厚度均匀,角膜瓣厚度与术前角膜屈光力呈正相关.     

飞秒激光制作的角膜瓣形态及其厚度的相关影响因素

目的探讨应用飞秒激光制作的角膜瓣的形态及其厚度的相关影响因素。设计前瞻性病例系列。研究对象北京同仁医院的36例（72眼）应用IntraLa。seFS60飞秒激光制作角膜瓣后行LASIK手术患者。方法术前所有患者均进行常规检查并记录相关资料，包括角膜曲率、角膜厚度、角膜直径等。术后1个月应用VisanteOCT测量角膜上0°、45°、90°和135°四条经线所在截面上特定5个点的角膜瓣厚度，中央角膜瓣厚度与术前角膜曲率等参数进行线性相关分析。主要指标不同测量点的角膜瓣厚度值及相关系数。结果术后1个月，每个角膜上20个测量点对应的角膜瓣厚度均值分散在预计值110μm周围，其中20个对应测量点中最大最小标准差变异分别为9μm和5μm。实际角膜瓣厚度与预计值差值≤5μm的测量点占到全部测量点的55．07％。中心、旁中心、周边区域角膜瓣厚度分别为（110．72±3．76）μm、（110．99±3．52）μm和（110．00±3．62）μm；4条经线所在截面角膜瓣厚度分别为（109．80±4．02）μm、（110．82±3．98）μm、（110．78±4．01）μm和（110．79±3．54）μm；右眼、左眼中央区角膜瓣厚度分别为（110．47＋4．29）μm和（110．97±3．16）μm（P均〉0．05）。术后中央角膜瓣厚度与术前患者角膜曲率、角膜厚度、角膜直径、年龄均无显著相关性（P均〉0．05）。结论应用IntraLaseFS60飞秒激光制作的LASIK角膜瓣形态均一规整，受术前个体差异及环境因素影响小。     

超声角膜测厚仪和Orbscan测量LASIK术后角膜厚度的比较

目的　比较不同的方法测量LASIK术后角膜厚度的差异及其相关性。方法　分别用美国DGH 40 0 0型超声角膜测厚仪和Orbscan Ⅰ眼前节系统测量LASIK术后 3个月以上的患眼角膜厚度 ,各测量 3次 ,取其平均值并进行比较。结果　超声角膜测厚仪测量值平均为 (4 4 5 66± 3 2 16) μm ,Orbscan测量值平均为 (3 95 5 0± 3 8 5 0 ) μm ,两者相差(5 0 17± 15 2 7) μm ,在统计学上有显著性差异 (P <0 0 1)。将两种方法测量结果作相关性分析 (r =0 92 2 ,P <0 0 1) ,呈显著正相关。回归方程如下 :超声角膜测厚仪测量值 (μm ) =14 1 0 3 3 1+ [0 770 2×Orbscan测量值 (μm ) ]。 讨论　Orbscan的软件设计是引起两种检测方法差异的主要原因之一 ,LASIK术后角膜的改变也可影响测量结果。对于外伤性角膜疾病及屈光手术后角膜厚度的测量 ,应将两种方法互为参照     

健康青少年视网膜厚度的定量化测量

目的旨在建立温州地区健康青少年视网膜厚度的正常数值范围,并同国内外相关研究进行分析比较,以指导临床实践。方法使用视网膜厚度分析仪(retinal thick-ness analyzer,RTA)的视网膜厚度模式对健康青少年120只眼的后极部(21°×21°)视网膜厚度进行测量。对5位受检者进行可重复性评估。结果后极部平均视网膜厚度为(172±16)μm,中心凹平均视网膜厚度为(148±18)μm。同一天测量得到同一被测者检查可重复性的误差为±5%,相当于±9μm。结论后极部视网膜厚度地形图与解剖学结构相吻合。视网膜厚度最大值出现在中央凹旁区,并从视盘到中央凹的上下方呈“C”字型变化。采用RTA进行视网膜厚度测量的可重复性好,证明该设备对于黄斑疾病的视网膜厚度改变的检测有价值。这种检查对于早期、准确诊断和监测黄斑水肿以及其他视网膜疾病,评价临床的疗效有较大意义。本结果与以往活体和组织学研究的成人后极部视网膜厚度的结果相符合,提示人眼视网膜厚度发育较早完成。     

正常青少年黄斑区活体测量及分析

目的:应用视网膜厚度分析仪(RTA)对青少年正常眼黄斑区视网膜厚度进行测定,以确定国人参考值范围及正常地形图的特点。方法:对100眼经眼科检查确认的正常眼按同一方法进行黄斑区RTA图像采集,使用随机软件对其厚度进行测量,并按照青少年黄斑地形图特点,人工测量不同黄斑分区距中心小凹的跨度,计算黄斑不同分区的范围及视网膜厚度的平均值。对结果应用多元回归方法探讨年龄、性别、眼别对视网膜厚度的影响。结果:黄斑区可分为中心小凹区、中心凹区、旁中心凹区,中心小凹直径为428±165μm,中心凹平均直径为1356±277μm,旁中心区平均直径为1450±226μm;黄斑部视网膜平均厚度168±14.3μm,黄斑各部位测量所得数值为:中心小凹区为128±22μm,中心凹区为138±17.6μm,旁中心凹区为169±15μm,不同分区视网膜厚度有明显差异(P <0.05),年龄对中心凹区和中心小凹区平均厚度影响最大(P <0.05);不同性别、眼别对视网膜厚度无影响(P >0.05)。我国青少年不同分区视网膜平均厚度低于RTA软件的正常参考值,差异有显著性(P <0.01)。结论:RTA能够对活体视网膜厚度进行精确的量化测定,青少年黄斑区厚度测定值可作为我国正常青少年人群黄斑视网膜厚度的正常值参考。     

Choroidal and Retinal Thickness and Axial Eye Elongation in Chinese Junior Students

PurposeTo explore the associations between macular choroidal and retinal thickness and axial elongation in non-myopic and myopic junior students.MethodsIn this school-based longitudinal observational study, axial length was measured by optical low-coherence reflectometry, and choroidal thickness and retinal thickness were measured by spectral-domain optical coherence tomography. Myopia was defined as non-cycloplegic objective spherical equivalent refraction ≤ −0.50 diopters. Structural equation modeling and multiple linear regression models were used to analyze the associations between baseline choroidal and retinal thickness with axial elongation.ResultsOut of 1307 students examined at baseline in 2017, 1197 (91.58%) returned for follow-up examination in 2018, with a median age of 12.00 years (interquartile range [IQR], 1.00) and included 667 boys (55.72%). Within a 1-year period, the median axial elongation of right eyes was 230 µm (IQR, 180) in boys and 200 µm (IQR, 160) in girls (P = 0.032). The thinner temporal choroidal thickness was associated with greater 1-year axial elongation only in myopic students (β, −0.20; 95% confidence interval [CI], −0.37, −0.03), the thinner temporal retinal thickness was associated with greater 1-year axial elongation in both non-myopic (β, −2.67; 95% CI, −4.52, −0.82) and myopic (β, −0.99; 95% CI, −1.68, −0.30) students, after adjustment for sex, age, and height. Subfoveal and nasal choroidal and retinal thickness were not significantly associated with axial elongation in either non-myopic or myopic students.ConclusionsA thinner temporal choroid at age 12 years may predict greater 1-year axial elongation in myopic students, and a thinner temporal retina may predict greater 1-year axial elongation in both non-myopic and myopic students. This finding may help to identify children at risk and control axial elongation with potential preventive strategies.     

影响LASIK术后角膜后表面稳定性的相关因素

目的：探讨影响准分子激光原位角膜磨镶术( laser in situ keratomileusis,LASIK )术后角膜后表面稳定性的相关因素。
　　方法：对来我院行LASIK手术的患者64例64眼分析术后6mo后表面变化与制瓣方式、角膜瓣厚度( flap thickness, FT)、切削厚度( ablation thickness,AT)、术后剩余基质厚度( postoperative residual corneal stroma thickness, RCST )、术前角膜最薄点厚度( preoperative thinnest corneal thickness,CT)、角膜瓣厚度/术前角膜最薄点厚度( flap thickness/ preoperative thinnest corneal thickness, FT/CT )、切削厚度/术前角膜最薄点厚度( ablation thickness/preoperative thinnest corneal thickness, AT/CT )、剩余基质厚度/术前角膜最薄点厚度( postoperative residual corneal stroma thickness /preoperative thinnest corneal thickness, RCST/CT)、术前角膜地形图(前表面高度、后表面高度、后表面diff值)和术前眼压的相关性。
　　结果：本研究表明手术前后角膜后表面diff差值与屈光度(r=0.419,P=0.014),AT(r=0.394,P=0.023),AT/CT(r=0.501,P=0.004),术前角膜后表面diff值(r=0.501,P=0.004),RCST(r=-0.385,P=0.033)和RCST/CT(r=-0.401, P=0.025)相关。手术前后角膜后表面高度差值与屈光度(r=0.520,P=0.002),AT(r=0.504,P=0.003),AT/CT(r=0.442,P=0.013),角膜后表面diff值(r=0.624,P=0.000)和RCST/CT(r=-0.394,P=0.028)相关。
　　结论：AT,RCST,AT/CT,RCST/CT和术前角膜地形图后表面diff值应作为预测术后角膜后表面稳定性的关键性指标,但具体安全限度值有待进一步研究。     

Corneal and corneal epithelial thickness distribution characteristics in healthy North Indian eyes using spectral domain optical coherence tomography

Purpose:To determine the pattern of corneal thickness and epithelial thickness distribution in healthy North Indian eyes by using spectral domain optical coherence tomography (SD-OCT).Methods:The observational study measured total corneal and epithelial thickness in the central 2 mm zone and eight sectors each in paracentral 2–5 mm (ring 1) and midperipheral 5–7 mm (ring 2) zones on SD-OCT.Results:The study included 67 eyes of 67 subjects with a male:female ratio of 32:35 and mean age of 25.04 ± 4.54 years. The mean central corneal and epithelial thicknesses were 505.97 ± 30.12 mm and 60.48 ± 8.37 mm, respectively. The epithelium of inferior and infero-nasal sectors in ring 1 and inferior sector in ring 2 was significantly thicker than the radially opposite sectors of the respective rings (P = 0.001; P = 0.01 and P = 0.02, respectively). Sector-wise analysis did not reveal any significant correlation between the total corneal thickness and epithelial thickness (all P > 0.05) except in the outer superior sector where there was a weak positive correlation (r = 0.28, P = 0.02). Central epithelial thickness in males (60.59 ± 9.28 mm) and females (60.37 ± 7.58 mm) was comparable (P = 0.91). Pachymetry was thinnest in the inferior, inferonasal, and inferotemporal sectors in 44.79% of eyes (n = 30), while thinnest epithelium was seen in the superior, superonasal, and superotemporal quadrants in 50.75% of eyes (n = 34)Conclusion:The epithelial thickness distribution in this sample of topographically normal healthy North Indian eyes was nonuniform and independent of the underlying corneal thickness. Epithelium was thinner in the superior cornea, whereas total corneal thickness was minimum in the inferior part.     

The Effect of Pseudoexfoliation Syndrome on the Retinal Nerve Fiber Layer and Choroid Thickness

Purpose: To investigate thickness of the retinal nerve fiber layer (RNFL) and choroid thickness in patients with pseudoexfoliation syndrome (PEX) and pseudoexfoliation glaucoma (PXG) compared to healthy volunteers. Methods: This cross-sectional, prospective study included 43 patients with PXG, 45 patients with PEX syndrome, and 48 healthy volunteers. The RNFL and macular thickness were analyzed with standard OCT protocol while choroidal thickness was analyzed with EDI protocol in all subjects. Results: The RNFL thickness was higher in the PEX and control groups compared to the PXG group (p<0.001). The choroid thickness was significantly higher in the control group compared to the PXG and PEX groups (p<0.05). No significant difference was detected between the both groups. Conclusions: PEX might weaken choroid circulation by accumulating in choroid vessels. The thinner choroid in the PXG group suggests that ischemia affects the duration of PEX and has a role in the development of glaucoma.     

近视眼中央角膜厚度和最薄角膜厚度的关系

目的 研究近视患者中央角膜厚度和最薄角膜厚度的大小、位置关系,以及近视程度对角膜厚度的影响.方法 回顾性病例对照研究.以接受近视性屈光手术的150例(300眼)为研究对象,根据等效球镜分为低、中、高近视3组,提取他们的术前Pentacam检查资料.左右眼参数的相关性和差异分别采用Pearson相关分析和配对t检验,多组比较采用方差分析,同一侧眼不同参数差异采用独立样本t检验.结果 左眼平均中央角膜厚度和最薄角膜厚度分别为(555.83±31.83)μm和(552.88±31.48)μm,右眼平均中央角膜厚度和最薄角膜厚度分别为(554.10±31.47) μm和(549.26±31.25)μm.左眼角膜最薄点72.00％(108/150)位于颞下方;右眼角膜最薄点70.67％(106/150)位于颞下方.不同程度近视组间的角膜厚度差异无统计学意义.结论 最薄角膜厚度与中央角膜厚度并不一致,双眼角膜最薄点均主要位于颞下方,其次在鼻下方.角膜厚度与近视程度无关.     

Changes in Choroidal Thickness after Cataract Surgery

Objective: The aim of this study is to compare subfoveal choroidal thickness (SFCT) before and after uneventful phacoemulsification using enhanced depth imaging optical coherence tomography (EDI-OCT).Background: Cataract is a major cause of visual impairment in the elderly. Cataract surgery is the most common ophthalmic surgery and is performed simultaneously with glaucoma or vitreous surgery in many cases. However, according to the results in epidemiology studies, cataract surgery is associated with the onset of age-related macular degeneration (AMD) and cataract surgery increases visual acuity in these patients without an increased risk of progression to exudative AMD. Methods: A prospective study was conducted on 53 eyes of 53 patients who had phacoemulsification. Measurements of SFCT were performed preoperatively, 7 days (D7), 1 month (M1), and 3 months (M3) postoperative using the EDI-OCT technique. Central retinal thickness was also measured at the same time. Results: Twenty-seven male (50.9%) and 26 female (49.1%) with a mean age of 56.43 years ± 10.34 (SD) were analyzed. The mean choroidal thickness was 199.9 ± 60.74 µm. It significantly increased to 228.42 ± 59.77 µm at D7, then decreased to 210.78 ± 59.59 µm at M1, and then decreased to 200.63 ± 61 µm at M3. The mean retinal thickness was 260.79 ± 6.12 µm. It significantly increased to 294.09 ± 7.20 µm at D7 and then decreased to 274.70 ± 6.00 µm at M1 and 258.92 ± 5.89 µm at M3. Conclusion: Mean SFCT increased after cataract surgery. The changes in SFCT return to near the baseline after 3 months.     

Relationship between the Lamina Cribrosa,Outer Retina,and Choroidal Thickness as Assessed Using Spectral Domain Optical Coherence Tomography

Purpose

To evaluate the characteristics and relationship between peripapillary choroidal thickness (pCT), lamina cribrosa thickness (LCT), and peripapillary outer retinal layer thickness (pORT) as determined using spectral domain optical coherence tomography (SD-OCT) enhanced depth imaging (EDI).

Methods

In total, 255 participants were included (87 healthy subjects, 87 glaucoma suspects (GS), and 81 glaucoma cases). The pORT, defined as the thickness between the posterior outer plexiform layer and the retinal pigment epithelium (RPE) interface, and the pCT, between the outer margin of the RPE and the choroidal-scleral interface, were manually measured using EDI scanning of the circumpapillary retinal nerve fiber layer (RNFL). LCT was determined by EDI scanning of the optic nerve head (ONH). Baseline characteristics, including axial length (AXL) and the SD-OCT measurements of the participants, were compared among the three groups. The correlation between putative factors and pCT was determined using univariate and multivariate linear regression analyses.

Results

In all three groups, both pORT and pCT were thinnest in the inferior area among the four quadrants. In the healthy group, the mean peripapillary RNFL, pORT, and LCT were significantly greater in comparison with those of the GS and glaucoma groups (p < 0.001, p < 0.038, and p < 0.001, respectively). The pCT demonstrated no significant differences among the three groups (p = 0.083). Only age and AXL were associated with pCT by multivariate analysis.

Conclusions

The pCT is substantially thinner in the inferior area of the ONH. In addition, the pCT demonstrates the strongest correlation with age and AXL, but was not associated with glaucoma or LCT.