青少年近视眼屈光度与角膜屈光力的相关性研究

目的 研究青少年近视眼屈光度与角膜屈光力的相关性。方法 使用角膜地形图仪和角膜曲率仪对年龄在8～22岁的近视患者,336例共672只眼的屈光度和角膜屈光力进行测定分析。结果 青少年中、低度近视眼垂直径角膜屈光力明显大于水平径角膜屈光力(P<0.001),垂直径角膜屈光力与屈光度呈正相关,并且随近视屈光度增加有明显增高的趋势(P<0.05);而在高度近视眼与中度近视眼组之间,垂直角膜屈光力的增加无显著差异(P>0.05)。结论 垂直径角膜屈光力的增高是青少年中、低度近视眼形成的主要原因。     

近视眼患者379例角膜曲率的多因素分析

目的:探讨近视眼患者角膜曲率及其相关影响因素。方法:近视眼患者379例746眼,分别做角膜地形图检查获取角膜曲率、测量近视屈光度、中央角膜厚度和非接触眼压,将所得结果进行统计分析。结果:近视眼患者角膜曲率(轻度43.0±1.3D,中度43.3±1.6D,高度44.1±1.2D)比较有明显统计学意义(F=30.90,P=0.000);角膜厚度(轻度546±41μm,中度541±32μm,高度535±30μm)轻度与高度近视组差别有统计学意义(P=0.002);眼压(轻度14.3±2.6mmHg,中度14.0±2.4mmHg,高度14.0±2.2mmHg)3组间比较差别无统计学意义。男、女之间角膜曲率(男43.1±1.3D,女44.0±1.5D)、中央角膜厚度(男546±34μm,女534±32μm)、眼压(男14.7±2.5mmHg,女13.4±2.1mmHg)等比较差别均有明显统计学意义(均P=0.000)。角膜曲率(Y)与近视屈光度(X1)、角膜厚度(X2)、眼压(X3)之间均有高度相关性(Y=46.462+0.114X1-0.0051X2-0.0597X3)。近视屈光度与角膜厚度、眼压之间无相关性;而角膜厚度(X)与眼压(Y)之间有高度相关性(Y=0.036X-5.437)。结论:近视眼患者角膜曲率与性别、近视屈光度、角膜厚度和眼压等因素均存在显著相关性。     

影响近视患者屈光度的相关因素分析

目的:探讨近视眼患者屈光度与眼轴长度、角膜屈光力、眼压及角膜厚度的相关关系及各因素对近视屈光度的影响。方法:随机抽取行LASIK手术的近视患者430例,分为3组:低度近视组140例(≤-3.00D);中度近视组177例(>-3.00D,≤-6.00D),高度近视组113例(>-6.00D)。测量患者眼的屈光度、眼压、角膜厚度、角膜屈光力及眼轴。结果:低度、中度、高度近视组眼轴长度分别为:24.33±0.86mm,25.45±0.78mm,26.12±1.05mm。各近视组之间比较差异具有统计学意义(P<0.05);各组屈光力分别为:42.96±1.40D,44.09±1.32D,43.59±1.33D。中、高度近视组与低度近视组比较差异具有统计学意义(r=0.096,0.0062,P<0.05);各组眼压分别为:15.71±2.51mmHg,16.04±2.48mmHg,16.89±2.31mmHg。眼压与屈光度呈正相关关系(r=0.185,0.192,P<0.05);各组角膜厚度分别为:604.66±51.47μm,531.17±37.06μm,533.03±35.61μm。中度、高度近视的角膜厚度与低度近视的角膜厚度有显著差异(r=0.506,0.613,P<0.05)。结论:在近视性屈光不正的影响因素中,眼轴长度是影响近视程度的主要因素,随屈光度的增加,眼轴长度增加;眼压也是近视发生、发展过程中不可忽视的因素,眼压随眼轴长度和屈光度增加而增加;中、高度近视除眼轴增长外,角膜屈光力也是重要影响因素,而对在低度近视的作用甚微。角膜厚度与屈光度有直接相关关系,还与长期配戴角膜接触镜等因素有关。     

角膜厚度、眼压和屈光度对LASIK治疗近视疗效的影响

目的　了解角膜厚度、眼压、术前屈光度及性别对 L ASIK治疗中高度近视疗效的影响。方法　将 2 98例 (5 90只眼 )近视患者 ,根据术前角膜中央厚度 (CT)与术前眼压 (IOP)的比值进行分组 ,观察术后视力与角膜厚度、眼压、屈光度及性别之间的关系。结果　近视眼屈光度数高低与术前角膜中心厚度无统计学相关 ;角膜中心厚度男、女性患者基本接近 ,差异无统计学意义 ;术前角膜厚度与眼压比值 (CT/ IOP)小于 30 ,术后视力较差。角膜厚度与非接触式眼压进行相关分析 ,为中度相关 ,相关系数 r =0 .36 6 4 ,F值 =31.4 9,P <0 .0 0 0 1,相关具有高度统计学意义 ;术后视力与术前的屈光度存在负相关关系 ,Y=1.4 772 - 0 .0 6 13X(屈光度 )。结论　矫正高度或超高度近视 ,应适度控制激光切削深度和切削量 ,必要时采取部分矫正屈光力的方法 ,剩余屈光度日后配戴低度眼镜 ,以确保手术安全 ,避免出现术后并发症及屈光回退     

影响近视眼眼内压的多因素分析

目的：通过对影响近视眼眼内压的多因素分析，探讨近视眼与原发性开角型青光眼的内在联系。方法：随机选取非青光眼性近视眼患者198例(354眼)，按屈光程度分为低、中、高、超高度近视四组，常规眼外、眼底、扩瞳检影，视野检查，Go1denann压平式眼压计测眼压，同时测角膜中央厚度、角膜屈力、眼轴长度，将所得数据应用统计学方法处理，分析其影响眼压的因素。结果：1．不同程度近视眼患者的眼压、眼轴长度均值有非常显著性差异(P＜0．001)。2．近视眼患者的眼压与性别、年龄、角膜屈力无关，与角膜中央厚度、眼轴长度呈正相关(r＝0．204，P＜0．01；r＝0．138，P＜0．01)，与屈光度呈负相关(r＝—0．201，P＜0．001)，3．建立多元回归方程：Y＝17．752—0．314X1 0．0135X2—0．423X3(P＜0．002)。Y：眼压(mmHg)，X1：屈光度(D)，X2角膜中央厚度(μm)，X3：眼轴长度(mm)。结论：影响近视眼眼压的主要因素是屈光度、眼轴长度、角膜中央厚度，对有近视眼的原发性开角型青光眼的诊断时应特别注意这些因素对眼压值的影响。     

准分子激光角膜屈光手术后角膜厚度改变对近视眼眼压读数的影响

目的 评价准分子激光角膜屈光手术对低中度和高度近视眼压测量的不同影响,探讨角膜屈光术后眼压计读数的“正常值”。方法 38例72眼近视眼患者分为低中度近视和高度近视2组,分别于术前、术后测量眼压、角膜中央厚度和角膜前表面屈光力,并比较2组眼压计读数改变的差异及其与角膜中央厚度及角膜前表面屈光力的关系。所有数据用配对t检验和相关与回归分析进行统计学处理。结果 低中度组和高度组术前眼压值分别为15.19±2.89mmHg(1mmHg=0.133kPa)和16.32±2.54mmHg,术后为10.16±2.17mmHg和10.17±2.61mmHg,二者眼压值差异无统计学意义(P>0.05);2组术前、术后眼压计读数下降值分别为5.02±2.10mmHg和6.15±1.96mmHg;术后2组残留角膜中央厚度分别为445—557μm和490±30μm,差异均无统计学显著性意义(P>0.05);术后角膜前表面屈光力分别为39.18±1.60D和37.56±1.61D,差异显著,有统计学意义(P=0.001)。眼压计读数改变只在低中度组与角膜中央厚度有依存关系,其回归方程为:术后眼压计读数=-3.207 2.667×术后角膜中央厚度。结论 在一定范围内,准分子激光角膜屈光术后眼压计读数随角膜中央厚度的减少而降低;角膜中央厚度的改变是影响眼压测量准确性的主要因素;术后残留的角膜中央厚度相同,则眼压计读数亦基本相似     

青少年近视眼屈光度与角膜屈光力的相关性研究

目的 研究青少年近视眼屈光度与角膜屈光力的相关性。方法 使用角膜地形图仪和角膜曲率仪对年龄在8－22岁的近视患，336例共672只眼的屈光度和角膜屈光力与屈光度呈正相关，并且随近视屈光度增加有明显增高的趋势（P＜0.05)；而在高度近视眼与中度近视眼组之间，垂直角膜屈光力的增加无显差异（P＞0.05)。结论 垂直径角膜屈光力的增高是青少年中、低度近视眼形成的主要原因。     

影响近视眼角膜屈光力多因素分析

目的:探讨影响近视眼角膜屈光力的相关因素。方法:分别测量227例(452眼)近视及近视散光患者角膜地形图、角膜中央厚度、眼压、A超及屈光度,将所得结果进行统计学分析。结果:①不同程度屈光度,角膜顶点屈光力低度近视组与中、高、重度近视组比较有显著性差异(P <0.05),角膜中央3mm屈光力,低、中度近视组与重度近视组比较有显著性差异(P <0.05),角膜中央5mm屈光力低度近视眼组与重度近视组比较有显著性差异(P <0.01),角膜中央7mm屈光力各组之间比较无显著性差异(P >0.05);②角膜中央3,5,7mm的屈光力与年龄、前房深度呈正相关(年龄:r分别为:0.398,0.387,0.342,P =0.000;前房深度:r分别为:0.277,0.310,0.288,P =0.000);③角膜中央3,5,7mm的屈光力均与等效球镜屈光度、眼轴、晶状体厚度呈负相关(等效球镜屈光度:r分别为-0.80,-0.782,-0.710,P =0.000;眼轴:r分别为:-0.670,-0.668,-0.598,P =0.000;晶状体厚度r分别为-0.318,-0.282,-0.232,P值分别为0.000,0.000,0.001);④将角膜不同区域屈光力为应变量,分别建立多元线性回归方程:Y 3=77.571-1.432X 1-0.554X 2 0.964X 3 0.067X 4-1.205X 5;(F =101.356,P =0.000);Y 5=76.538-1.424X 1-0.538X 2 1.063X 3 0.067X 4-1.122X 5;(F =92.395,P =0.000);Y 7=72.563-1.     

青壮年近视患者的眼压变化及其规律探讨

目的 :探讨青壮年近视患者的眼压变化及其变化规律。方法 :对 46 6例 ( 891眼 )年龄在 16岁～ 46岁、屈光度从 -0 5 0D～ -2 3 5 0D的近视患者的眼压及其相关因素进行统计分析并与非近视组对照。结果 :近视患者眼压水平随屈光度增加而升高 (P <0 0 0 5 ) ;近视组平均眼压较非近视组高约 0 9mmHg ( 1mmHg =0 133kPa) ,高度近视组较非近视组高约 1 3mmHg ;不论中、低度近视还是高度或超高度近视其平均眼压水平均高于非近视组 (P <0 0 5 ) ;在近视组内 ,中、低度近视的平均眼压与高度或超高度近视之间有显著性差异 (P <0 0 5 ) ,但中度与低度近视之间、高度与超高度近视之间无明显差异。屈光度从 0D增加到 >8D时 ,眼压均值上升辐度大 ,净升值高达 1 2 7mmHg ,屈光度从 -8D上升到 -12D时 ,眼压均值升辐小 ,净升值低 ,仅 0 14mmHg。近视男性眼压高于女性 (P =0 0 0 0 1)。近视眼压与年龄及眼别无显著相关性。结论 :平均眼压随屈光度增加而升高 ,应加强对近视患者的眼压监测 ,对男性患者更为重要 ,降低眼内压也许是控制近视发展的一个重要手段     

近视眼中央角膜厚度的测量及与多因素之间的分析

目的:测量近视眼中央角膜厚度,探讨中央角膜厚度、屈光度、眼压和角膜曲率之间的关系。方法:近视眼552例(1104眼),用超声角膜测厚仪、电脑验光仪、非接触眼压计和角膜地形图分别测量其数据。结果:平均中央角膜厚度为556.57±32.42(451～645)μm,男女眼之间、左右眼之间平均CCT无统计学差异;屈光度为-5.68±2.32(-0.5～-13.75)D;眼压16.75±2.63(10～21)mmHg(1mmHg=0.133kPa);角膜曲率44.65±1.45(38.24～48.67)D。除眼压与中央角膜厚度之间有显著的正相关性(t=0.506,P=0.000)外,其余因素之间均无相关性。结论:近视眼的眼压与中央角膜厚度之间有显著的正相关性。     

Strabisme Alternant - Etude clinique - traitement

The author defines motor and sensory alternation: the term alternation should not be used in isolation, it should always be accompanied by the name of the parameter concerned. Sensory alternation is always found together with motor alternation but the reverse is not true.The examining criteria for a diagnosis of sensory alternation are given, sensory alternation must not be confused with alternating inhibition. Working from clinical observations of cases of motor alternating strabismus, the author selects 2 types of binocular sensory relations which allow one to differentiate between:- cases of primary alternating strabismus- cases of secondary alternating strabismusThese forms will develop in different ways; in both cases a cure is possible providing that the right treatment is prescribed and once prescribed carefully followed, etc. It is always a case of serious forms of strabismus whose developmental period is spread over several years.According to the authors, the frequency of cases of true primary strabismus is from 1–3%, the frequency of cases of secondary alternating strabismus varies according to the type of therapy practised on cases of monocular strabismus with amblyopia. These latter will become cases of alternating strabismus under the influence of certain types of therapy carried out over several years (penalization, rocking, alternated occlusion, etc...).Experimental data on kittens confirm clinical data; kittens placed in abnormal environments during the sensitive period will show modification in the distribution of cortical cells and the absence of binocular cells (either because the excitation of the two eyes was not simultaneous, or not identical: artificial strabismus, occlusion, opaque glasses). This disturbances become irreversible after a certain period of exposure (a function of age, length of exposure, etc...).It is thus necessary to bear in mind: 1) the iatrogenic risks of certain orthoptic treatments, 2) the necessity for a binocular form of treatment as soon as possible, as once a certain stage is passed, cortical plasticity diminishes and the elaboration of normal binocular relations becomes impossible.

---

     

Effects of Adenosine Agonists on Intraocular Pressure and Aqueous Humor Dynamics in Cynomolgus Monkeys

The effects of single or multiple topical doses of the relatively selective A₁adenosine receptor agonists (R)-phenylisopropyladenosine (R-PIA) and N⁶-cyclohexyladenosine (CHA) on intraocular pressure (IOP), aqueous humor flow (AHF) and outflow facility were investigated in ocular normotensive cynomolgus monkeys. IOP and AHF were determined, under ketamine anesthesia, by Goldmann applanation tonometry and fluorophotometry, respectively. Total outflow facility was determined by anterior chamber perfusion under pentobarbital anesthesia. A single unilateral topical application of R-PIA (20–250 μg) or CHA (20–500 μg) produced ocular hypertension (maximum rise=4.9 or 3.5 mmHg) within 30 min, followed by ocular hypotension (maximum fall=2.1 or 3.6 mmHg) from 2–6 hr. The relatively selective adenosine A₂antagonist 3,7-dimethyl-1-propargylxanthine (DMPX, 320 μg) inhibited the early hypertension, without influencing the hypotension. Neither 100 μg R-PIA nor 500 μg CHA clearly altered AHF. Total outflow facility was increased by 71% 3 hr after 100 μg R-PIA. In conclusion, the early ocular hypertension produced by topical adenosine agonists in cynomolgus monkeys is associated with the activation of adenosine A₂receptors, while the subsequent hypotension appears to be mediated by adenosine A₁receptors and results primarily from increased outflow facility.