近视患者瞳孔大小变化的研究

目的测量我国青年近视眼患者及正常青年在暗适应条件下的瞳孔大小,并探讨其异同。方法用红外线瞳孔测试仪测量150例近视眼患者(300眼,低、中、高度近视眼各100眼)及50例正常人(100眼)在暗适应条件下的瞳孔大小。检测对象年龄24.0岁±3.6岁(20～30岁),所有测试者在暗适应5分钟后由同一检查者进行检查,重复检查3次,各次检查间隔至少15分钟。取3次检查结果的平均值,分析所得数据。结果正常人瞳孔面积为(30.21±6.29)mm2,近视眼瞳孔面积(39.30±9.24)mm2;低、中、高度近视眼瞳孔面积分别为(33.65±7.31)mm2、(38.74±7.37)mm2、(45.61±9.08)mm2。统计分析显示,正常人与近视眼患者的瞳孔大小有显著统计学差异(P<0.01),正常人与低、中、高度近视眼患者的瞳孔大小均有统计学差异(P<0.01),低、中、高度近视眼患者间的瞳孔大小也有统计学差异(P<0.01)。结论青年近视眼患者的瞳孔比正常青年的瞳孔大,人的瞳孔面积随着近视度数的加深而增大。这对我们进一步认清近视发生发展的过程及其机理有一定的意义,对临床屈光手术前瞳孔的检查、手术面积的确定有一定的指导意义。     

非接触眼压计测量暗适应下瞳孔直径

目的 探讨应用TOPCON CT-80 computerized tonometer非接触眼压计测量暗适应下瞳孔直径的可重复性.方法 利用TOPCON CT-80 computerized tonometer非接触眼压计在不同日期不同时间重复测量57例正常人双眼暗适应下瞳孔水平直径3次,以重复测量数据的方差分析对样本进行显著性差异分析(F检验,α=0.05).结果 不同日期不同时间测量数据组间差异有统计学意义,不同日期相同时间测量数据组间差异无统计学意义.结论 应用TOPCON CT-80 computerized tonometer非接触眼压计测量暗适应下瞳孔直径有较好的可重复性.     

WaveScan波前像差仪测量暗适应下瞳孔的直径

目的:通过测量暗适应下瞳孔直径,探讨中青年近视患者暗适应下瞳孔直径的平均值及其与年龄及屈光度的联系。方法:选取2005-08/2006-05我院行LASIK矫正近视的患者276例552眼,利用WaveScan波前像差仪测量患者暗适应下瞳孔直径,进行统计学分析。结果:暗适应下男患者右眼瞳孔直径(7.22±0.96)mm大于左眼瞳孔直径(7.06±1.02)mm,差异有统计学意义(P<0.05),女患者左右瞳孔直径差异无统计学意义(P>0.05)。男患者右眼瞳孔直径(7.22±0.96)mm大于女患者右眼瞳孔直径(6.92±0.99)mm,而左眼瞳孔直径及左右眼瞳孔直径差值在不同性别患者间差异无统计学意义(P>0.05)。19例(6.9%)左右瞳孔直径差值>1mm,257例(93.1%)左右瞳孔直径差值≤1mm。不同屈光度组瞳孔直径差异无统计学意义(P>0.05)。瞳孔直径与年龄及屈光度的相关性分析结果表明,瞳孔直径与年龄成负相关(P<0.05),与屈光度无相关性(P>0.05)。结论:WaveScan波前像差仪测量暗适应下瞳孔直径可为角膜屈光手术的术前评估及手术方案的设计提供可靠依据。瞳孔直径与年龄成负相关,与屈光度无相关性。     

近视患者暗适应下瞳孔的临床观察与分析

目的:观察近视患者暗适应下瞳孔的大小,分析比较不同性别不同屈光度的近视患者暗适应下瞳孔大小的异同。方法:选择来我院接受准分子激光角膜屈光手术的近视患者337例(674眼),使用NIDEK全自动电脑验光仪(mod-el AR-710A)测量其暗适应下瞳孔的直径,分别按性别和屈光度分组,分析对比是否有统计学差异。结果:女性患者暗适应下瞳孔均值为6.2025mm,男性患者暗适应下瞳孔均值为6.0933mm,二者比较无统计学差异;三组不同屈光度患者暗适应下瞳孔大小经方差分析无显著差异。结论:不同性别不同屈光度的近视患者暗适应下瞳孔统计学分析未发现显著差异,近视患者暗适应下瞳孔的大小的测定已成为屈光手术术前评估和手术设计的一个重要步骤。     

正常人瞳孔及瞳孔对光反射的特征

目的探讨正常人瞳孔对光反射的特征,为神经眼科临床诊断和治疗提供参考依据。方法应用瞳孔自动测试仪检测100例正常人(200只眼)的瞳孔及瞳孔对光反射。检测对象年龄12~66岁,平均(31±2)岁,按10岁为1个年龄段分为5组,并对不同年龄组、性别、眼别间的左右眼参数值进行比较。结果正常人群随年龄增长,瞳孔面积减小,瞳孔对光反射的反应幅度降低、潜伏期延长,差异有统计学意义。性别、眼别间各参数差异无统计学意义。结论瞳孔对光反射检查是一种客观的视觉通路功能检查。瞳孔自动测试仪检查法可定量检测正常人瞳孔及瞳孔对光反射的各种参数值,为视神经病变的临床诊断和随访提供参考。     

红外线瞳孔测试仪检测原发性青光眼传入性瞳孔反应障碍的初步报告

传入性瞳孔反应障碍是视交叉前瞳孔对光反应传入纤维受损的共同特征。我们应用红外线瞳孔测试仪分别对６６例１３２只正常眼及８９例１５６只原发性青光眼及高眼压病人进行检测。结果表明，原发性青光眼患者瞳孔收缩反应的潜伏期Ｔ１延长（ｐ＜０．０１），瞳孔收缩与舒张的变化幅度Ｈ３变小（ｐ＜０．０１），提示青光眼性视神经损害有传入性瞳孔反应障碍。     

暗环境下瞳孔大小对对比度视力的影响

目的:探讨在暗环境下瞳孔大小对对比度视力的影响。方法:应用多功能电子视力测量仪(MFVA-100)及Allegroanalyzer波前像差仪测量42例84眼在暗环境中的对比度视力及瞳孔直径,以瞳孔直径的均值5.6mm为界分为两组,比较不同瞳孔大小范围时的对比度视力,并分析瞳孔大小与对比度视力的相关性。结果:在对比度25%和10%的情况下,瞳孔直径范围在(4.0～5.5)mm时的对比度视力分别为(0.158±0.097)及(0.374±0.099),优于范围为(5.6～7.2)mm时的对比度视力,差异有统计学意义(P<0.02),在对比度10%时的差异较对比度为25%时的差异小,在对比度100%和5%时,瞳孔直径范围为(4.0～5.5)mm与范围为(5.6～7.2)mm时两组间的对比度视力的差异无统计学意义;瞳孔直径范围为(4.0～5.5)mm和范围为(5.6～7.2)mm时,随直径的增加,各对比度下的对比度视力下降,瞳孔直径与对比度视力有明显的正相关(P<0.05)。结论:不同直径的瞳孔在一定条件下可明显影响对比度视力,从而影响夜间视觉质量,对术前暗环境下瞳孔大小的测量,是决定角膜屈光手术方式的重要指标之一。     

大小瞳孔状态下眼球表面麻醉的镇痛效果

目的 分析白内障超声乳化时,表面麻醉技术在两种瞳孔状态下,牵拉扩张与不牵拉扩张患者的疼痛感觉.方法 选择小瞳孔患者60例(60眼)及大瞳孔患者60例(60眼)为研究对象.所有患者术前滴0.5%盐酸丙氧苯卡因.按术中疼痛分级,评价麻醉剂的镇痛效果.结果 大小两种瞳孔状态下,小瞳孔组49例,大瞳孔组50例无疼痛感觉,无一例发生4～5级疼痛感觉.小瞳孔组1、2、3级疼痛发生例数分别为4例、3例、4例;大瞳孔组分别为5例、3例、2例,差异无统计学意义(P>0.05).结论 表面麻醉加小瞳孔扩张技术的超声乳化安全有效,镇痛效果好,值得推广.     

糖尿病患者的暗适应观察

糖尿病患者的暗适应观察金婉容张文芳糖尿病视网膜病变（ｄｉａｂｅｔｉｃｒｅｔｉｎｏｐａｔｈｙ，ＤＲ），是糖尿病过程中可致盲的严重眼部并发症。目前对ＤＲ的诊断，临床上主要依靠眼底荧光血管造影和眼底检查。近年来国内外学者较注重ＤＲ视功能的研究，我们对糖尿病...     

暗视下瞳孔直径测量方法及其评价

随着屈光手术的不断发展,暗视下瞳孔直径的测量越来越重要。本文介绍和比较暗视下瞳孔直径的三种测量手段：传统瞳孔直径测量工具、眼前节检测仪中内置的瞳孔测量功能和运用红外技术的瞳孔测量方法。传统瞳孔直径测量工具价格低廉,操作简单,但在暗视下应用有诸多不足;眼前节检测仪中内置的瞳TLN量功能,在测量的准确性和可重复性方面,介于传统测量方法和先进的红外技术测量方法之间,是国内的主流方法;运用红外技术的瞳孔测量方法最可靠,在国外科研和临床上应用广泛,但因价格昂贵等原因,国内应用较少。（国际跟科纵览,2012,36：314—317）     

Technical Note: Comparison of the wavefront aberrations between natural and pharmacological pupil dilations

Ocular wavefront aberrations were tested with the wavefront-supported corneal ablation (WASCA) aberrometer when the pupil was dilated naturally under scotopic illumination levels, and pharmacologically using tropicamide. Wavefront aberrations were measured across a 5-mm pupil in one eye of each of 58 subjects. There was a significant difference in the pupil diameter between the scotopic and cycloplegic conditions (p < 0.001). For higher order aberrations (HOAs), no significant difference was found in Zernike coefficients between the scotopic and cycloplegic conditions. There was no significant difference in the spherical equivalent refraction. Accommodation can be neglected during the wavefront aberration measurement with the WASCA aberrometer. In view of the shift of the pupil centre caused by pharmacological pupil dilation, obtaining measurements under natural conditions rather than using mydriatics is recommended for customized laser in situ keratomileusis (LASIK) surgery.     

LASIK术前和术后暗视下瞳孔变化的临床研究

目的 测量近视患者准分子激光原位角膜磨镶术(laser in situ keratomileusis,LASIK)术前及术后在不同光适应状态下的瞳孔大小,了解其瞳孔大小的变化.方法 应用计算机红外瞳孔测试仪的亮刺激和暗刺激模式分别测量120例(240眼)近视患者LASIK术前及术后的瞳孔大小,记录瞳孔面积,每个刺激模式测量3次,取平均值.按术前近视程度不同将240眼分为高度、中度、低度组,采用SPSS 13.0统计软件对各组术前及术后1个月瞳孔直径大小及面积进行比较.结果 亮刺激模式下测量的术前和术后瞳孔面积的平均值分别为(36.64±5.54)mm2(21.58～54.47 mm2)和(34.47±5.49) mm2(22.38～46.78 mm2),术前和术后瞳孔面积的差异有统计学意义(t=6.396,P＜0.01).术后1个月时各组瞳孔面积均数都较术前小,但低度近视组2者比较差异无统计学意义(P>0.05),而中、高度近视组2者有显著统计学意义(P＜0.01),并且术前屈光不正程度越高,术前和术后瞳孔面积的差值就越大.同样的趋势见于瞳孔直径的变化.结论 屈光状态可能在调节瞳孔大小方面起了一定的作用.同时我们的结果提示LASIK术前根据暗视下瞳孔大小设计手术切削区是安全、可靠的.     

三种瞳孔直径测量方法在不同测量状态下测量结果的比较和分析

目的比较三种瞳孔测量方法的不同,并分析不同测量状态对瞳孔大小的影响。方法对年龄为21～32岁的40例最佳矫正视力≥5．0的近视和正视志愿者分别采用照相机拍摄法、Pupillometer瞳孔测量仪和Rosebaum瞳孔尺三种方法测量瞳孔大小。瞳孔大小的测量在远距（5m）的双眼和单眼状态下以及近距（33cm）的清晰注视单个视标和阅读状态下进行。结果自然状态下的照相机拍摄法测得的瞳孔直径均小于Pupillometer瞳孔测量仪（P〈0．01）,远距瞳孔直径大于近距．近距清晰注视视标状态下的瞳孔直径大于近距阅读状态（随机区组方差分析,P〈0．05）。结论三种方法中．照相机拍摄法最为自然、精确。瞳孔近反应和阅读状态下的主动性导致了瞳孔大小的差异。     

Scotopic pupil size in a normal pediatric population using infrared pupillometry

Purpose To determine scotopic pupil diameter in a normal pediatric population.Methods Scotopic pupil size was measured in 166 eyes of 83 children with a mean age of 6.01±4.11 years (range 0.51–14.26 years) using the light and hand-held Colvard infrared pupillometer. Measurements were performed under dim illumination after 2 min of dark adaptation. The Colvard infrared pupillometer utilizes light amplification technology to determine scotopic pupil size.Results The mean scotopic pupil diameter was 6.06±0.95 mm (range 4.0–8.5 mm) in the right eyes (OD) and 6.11±1.02 mm (range 4.0–8.5 mm) in the left eyes (OS), and 6.09±0.98 mm (range 4.0–8.5 mm) for both eyes (OU). An increase in mean scotopic pupil size with age was detected, with a peak of 7.28±0.42 mm at the age of 10–11 years. The correlation coefficient for age and scotopic pupil diameter was 0.51 OU (OD 0.52, OS 0.51), and the correlation coefficient for objective refraction (spherical equivalent) and scotopic pupil diameter was 0.05 OU (OD 0.01, OS 0.08).Conclusions The scotopic pupil diameter in a pediatric population increases with age until the age of 11 years and then decreases again.Presented in part at the American Society of Cataract and Refractive Surgeons (ASCRS), Boston, USA, May 2000 and the Deutsche Ophthalmologische Gesellschaft (DOG), Berlin, Germany, September 2000The authors have no proprietary interest in any of the devices used in this study     

Scotopic versus photopic pattern onset-offset electroretinograms

We investigated the contribution of rods and cones to the human pattern electroretinogram to onset and offset checkerboards of different spatial frequency and wavelength in a 39° × 39° field. Under strictly scotopic conditions, there was a negative potential at onset and a positive potential at offset, whereas under photopic conditions, there was a positive potential at onset and a negative/positive potential at offset. Thus, the waveform to pattern onset (offset) was that of the luminance electroretinogram to decreasing (increasing) luminances. For pattern onset, the sensitivity difference 486–601 nm under scotopic and photopic conditions closely followed the luminosity function of rods and cones. The amplitude of the scotopic onset response increased with check size up to 3°30 and that of the photopic onset response, up to 30. With larger checks, the scotopic and photopic onset response markedly decreased. This indicates antagonistic center-surround organization of the receptive fields under both scotopic and photopic conditions. By contrast, the offset response monotonically increased with check size under scotopic and photopic conditions, which suggests a luminance component in the pattern electroretinogram. Consequently, the pattern electroretinogram to reversing checker-boards has to be regarded as a mixture of both pattern- (contrast) and luminance-specific components.     

Efficacy of a hinged pupil expansion device in small pupil cataract surgery

Purpose:To evaluate the efficacy and safety of a hinged pupil expansion device (PED) in eyes with small pupils undergoing phacoemulsification.Methods:In this prospective, multicenter, interventional case series of 57 eyes with suboptimal pharmacologic pupil dilation (<5 mm diameter), a hinged PED (I-Ring, Beaver-Visitec International, Waltham, MA) was applied to facilitate surgical visualization during cataract surgery. The pupil diameters (PD) were measured at different stages of the procedure and at the 1-month follow-up visit. Rate of successful intraoperative PED deployment, pupil size, and shape were assessed.Results:The mean patient age was 70.5 ± 12.1 years. The I-Ring PED was successfully applied in all eyes. The mean PD at various stages were 4.1 ± 1.1 mm (dilation with eye drops only preoperatively), 4.3 ± 1.1 mm (dilation after intracameral epinephrine and ophthalmic viscoelastic device), 6.80 ± 0.00 mm (with PED applied), and 5.7 ± 1.1 mm (end of surgery). A statistically significant difference (P < 0.001) was observed between the mean PD with intracameral medications and with PED application. Postoperative circular pupil was observed in 54 of 57 eyes (94.7%) and the mean eccentricity index (n = 57 eyes) was 0.11 ± 0.22. No significant adverse events were observed.Conclusion:The I-Ring PED safely and effectively provided and maintained adequate pupil expansion and surgical visualization in eyes with small pupils undergoing cataract surgery. Postoperatively 95% of eyes attained circular pupils. This hinged PED is an additional instrumentation option for the safe and effective expansion of inadequately sized pupils during cataract surgery.