老视前期近视患者LASIK术后调节功能变化

2008年3—10月,我们采用准分子激光角膜原位磨镶术（LASIK）治疗老视前期近视患者37例,疗效满意。现报告如下。     

Q值引导的个体化LASIK治疗近视86例效果观察

同期行准分子激光原位角膜磨镶术（LASIK）手术86例（172眼）,其中右眼（观察组）行Q值引导一个体化LASIK切削程序,左眼（对照组）行标准LASIK切削程序,术后随访时间〉6个月,观察两组术后裸眼视力、Q值及视觉生活质量满意度。结果两组术后裸眼视力无显著差异,观察组术后Q值显著低于对照组,视觉生活质量满意度显著高于对照组,P均〈0．05。认为Q值引导的个体化LASIK治疗近视具有安全稳定、预测性强、患者视觉质量较好等优点。     

LASIK治疗近视220例疗效观察及护理

自1998年7月以来，我院开展了准分子激光角膜磨镶术（LASIK），现对220例术后随访达5a以上患者的疗效观察结果及护理体会报告如下。     

常规LASIK术后早期近视患者波前像差变化研究

目的 探讨常规LASIK术后早期近视患者波前像差变化规律.方法 抽取2008-03～07在广西视光中心接受常规LASIK手术的35例近视患者,其中男18例,女17例,年龄16～36岁;屈光度-0.50～-10.50 DS(等效球镜).采用美国VISX公司生产的WaveScan波前像差仪对所有患者进行波前像差检测,收集每位患者术前、术后1天、1周、1个月、3个月和6个月共六个时间点的波前像差数据.将波前像差数据按检测时间分组后,使用SPSS13.0统计软件采用One-way ANOVA单因素方差分析,Game-Howell方法(方差不齐)或LSD法(方差齐性)比较六组间波前像差成份的差异.结果 总像差:(1)术前与术后各时间点均不相同(P=0.000);(2)术后各时间点两两比较均无统计学差异(P＞0.05).彗差:(1)术前与术后1 d无差异;术后1周、1个月、3个月、6个月间两两比较均无差异;(2)术前及术后1 d分别与术后其他时间点两两比较差异均有统计学显著意义(P＜0.05).球差:(1)术前与术后1天、1周、6个月无差异;术后1周、1个月、3个月,6个月两两间比较均无差异;(2)术前与术后1个月、3个月比较差异均有统计学显著意义(P＜0.05),术后1 d与术后其他时间点比较差异均有统计学显著意义(P＜0.05).总高阶像差、三叶草像差在术前、术后各时间点均无统计学差异(P＞0.05).结论 常规LASIK可明显减少总像差,但术后早期近视患者的总像差维持相对稳定,仅球差和彗差有所波动.     

单眼视LASIK术治疗远视眼老视远期疗效观察

目的 评价Monovision(单眼视)LASIK术矫正远视眼老视的远期疗效. 方法 远视眼老视患者共38例(76眼),术前屈光度( 2.1±1.0)D.采用LASIK手术,依据单眼视原理(优势眼远视力矫正至最佳,非优势眼矫正至一定度数的近视)施术. 结果 术后双眼远视力与术前最佳矫正视力相比,P>0.05;术后双眼近视力均达J 2以上;优势眼与非优势眼实际矫正屈光度与目标屈光度的差别分别为(0.52±0.69)、(0.77±0.85)D;术后43.6%的患者有不同程度的夜间视物困扰,37%有眩光等不适. 结论 单眼视LASIK术治疗远视眼老视远期疗效好,但仍存在一定的不足.     

近视眼LASIK术后非球面性研究

目的 探讨近视眼LASIK术后早期角膜非球面参数的变化规律.方法 抽取2008-03～07来广西视光中心接受常规LASIK手术的25例近视患者(共49只眼),其中男13例,女12例;年龄19～36岁;屈光度-0.50～-10.50 DS(等效球镜).采用美国BausE-Lomb公司生产的Orbscan-Ⅱz角膜地形图对所有患者进行角膜地形图检测,收集每位患者常规LASIK术前、术后1周、1个月的角膜前表面Q值.将Q值按检测时间分组后,使用SPSS13.0统计软件,采用OnE-way ANOVA单因素方差分析,Games-Howell法比较三组间Q值的差异.结果 近视患者LASIK术后1周的Q值与1个月的比较差异无统计学显著意义(P＞0.05),但术前Q值与术后1周、1个月比较差异均有统计学极显著意义(P＜0.01).结论 LASIK手术可使近视患者的角膜前表面发生明显改变.     

巩膜扩张术治疗兔老视的安全性和有效性

目的探讨巩膜扩张术治疗老视的安全性和有效性及其可能作用机制。方法对选择健康有色家兔30只随机分为正常组和实验组,正常组6只进行正常值测定,实验组随机分为3组,第1组行标准巩膜扩张术(SRP),第2组行水平前睫状巩膜切开术(ACS),第3组行放射前睫状巩膜切开术(ACS),测定术前,术后1 d、1 w、1个月的屈光度、调节幅度及巩膜扩张程度,术后1个月进行术区巩膜的病理检查。结果手术前后实验各组屈光度均有不同程度下降(P<0.01);缩瞳前与缩瞳后的屈光度改变有显著性差异(P<0.01);在术后的不同时期内,各组的屈光度变化无显著差异(P>0.05)。术后各组的调节幅度均明显高于术前(P<0.01)。实验各组术后的巩膜扩张程度与调节幅度变化均无明显的线性关系。结论SRP和ACS均使兔眼向近视方向发展的趋势;本实验中的3种手术方法均能显著提高兔眼的调节幅度;SRP中可以用硅胶替代PMMA作为巩膜扩张带;ACS采用水平状切口较放射状切口术后调节力的提高更明显、更稳定,因此水平前睫状巩膜切开术可以替代经典的ACS。     

针刺治疗青少年近视123例临床分析

近年来,青少年近视问题已经成为社会关注的热点问题.2003～2007年我院采用针刺治疗青少年近视123例,取得较好的效果.现报告如下. 临床资料:123例近视青少年患者中,男61例、女62例,年龄9～15岁,病史为3个月～3 a.视力均在4.9以下,其中视力在4.8～4.9者32眼,4.7～4.6者75眼,4.5～4.3者62眼,4.2以下67眼.     

老视的巩膜手术研究进展

<正>老视俗称老花眼,传统的理论认为老视是由于晶状体随年龄的增加逐渐变硬,睫状肌收缩减弱,造成睫状肌调节晶状体聚焦的能力下降,是一种自然的老化现象。然而,最近的研究表明,随着眼睛的老化,眼睛的其他组织如玻璃体膜、外周的脉络膜、睫状肌、巩膜结缔组织和睫状小带等都有许多变化,这可能导致调节功能障碍[1,2]。老视发病的平均年龄是42岁,此后20年会出现显著、渐进下降。青少年约有13屈光度(D)的主观调节,40岁平均只保留6 D,50岁为2 D     

患者心理素质对评价LASIK疗效满意程度的影响

准分子激光原位角膜磨镶术 ( LASIK)是目前治疗近视的主要方法之一 ,其疗效肯定[1～ 3] 。本文就患者对疗效满意程度与自身心理素质相关因素进行探讨 ,以了解患者手术前后的心理变化 ,而给予适当的心理支持 ,提高患者对疗效的满意程度。1　资料与方法1 .1　一般资料　本组 1 38例患者 ( 2 72眼 )中 ,男 71例 ( 1 39眼 ) ,女 67例 ( 1 33眼 ) ;年龄 1 8～ 40岁 ,平均 2 3.44± 3.1 0岁。术前屈光度 (球镜等量 ,下同 )- 3.0 0～ - 2 2 .0 0 D,散光 0～ - 2 .5 0 D,近视屈光度基本稳定 2年以上。根据焦虑自评量表 ( SAS) [4 ] 分为两组 :A…     

LASIK治疗老视眼初步临床研究

为探讨利用准分子激光角膜原位磨镶技术(LASIK)治疗老视眼的可行性，对9例(10眼)老视眼先采用微型角膜刀制作角膜瓣，然后应用准分子激光在角膜周边做光区大于5．5mm的远视切削，紧接着在角膜中央做光区为4．0mm的近视切削，以重塑角膜形状使之形成双焦点。结果所有患者手术后的近视力均有不同程度的提高，与手术前相比有权显著性差异(P＜0．001)；而远视力手术前后则无明显变化(P＞0．05)。提示LASIK治疗老视眼安全、有效。     

Anticipation of presbyopia in Portuguese familial amyloidosis ATTR V30M

The aim of this study was to evaluate if Portuguese patients with familial amyloidosis, liver transplanted and not, have an earlier development of presbyopia compared with a normal population and its relation with the presence or the absence of anterior capsule opacification of the lens. This study was performed to evaluate if Portuguese patients with familial amyloidosis and in a blood donors population (control group). Three hundred and fifty-six subjects, 144 amyloidotic patients and 212 healthy individuals, were evaluated for the need of plus lenses for normal near reading (Jaeger chart 1 at 33?cm). In familial amyloidosis patients, the value of the add-power was related to age, liver transplantation status, and presence of visible anterior capsule opacification of the lens. In both groups, the value of add-power was positively correlated with age (r?=?0.91; P?<?0.005). Familial amyloidosis patients require more add-power than control individuals of similar age, and need to use reading glasses at earlier ages. The age of onset of presbyopia in familial amyloidosis patients was significantly lower than in control individuals (32 years vs. 42 years). Adjusting for age, no significant difference was observed in add-power values between liver transplanted and not transplanted amyloidotic patients, suggesting that liver transplantation has no influence on presbyopia evolution in these patients. Familial amyloidosis patients had an earlier onset of presbyopia, probably related to amyloid deposition on the anterior capsule of the lens, which is not halted by liver transplantation.     

准分子激光原位角膜磨镶术治疗中低度近视及散光临床效果分析

对366例667眼中、低度近视及散光患者行准分子激光原位角膜磨镶术(LASIK)治疗.术前屈光度球镜-3.86±1.27D(-1.50～-6.00D),散光-1.13±0.72D(-0.25～-2.50D).术后对患者的视力、屈光度、角膜屈光力K值、角膜中央厚度及眼内压随访观察6个月.结果98.50%眼裸眼视力≥1.0,100%眼最佳矫正视力与术前相同;屈光度球镜+0.49±0.31D(-0.25～+1.00D),散光-0.45±0.21D(0～-0.75D);角膜屈光力K值较术前平均下降4.23±1.85D;角膜中央厚度比术前平均薄38.51±19.32μm;眼内压读数较术前平均下降0.52±0.12kPa.术中无严重并发症.术后3个月屈光度稳定.认为LASIK是治疗中低度近视及散光的安全、有效方法.     

博士伦217z准分子激光治疗近视250例疗效分析

为评价博士伦Technolas 217z准分子激光治疗近视、散光的疗效,采用Technolas 217z治疗近视、散光250例,角膜刀采用Hansatome。观察术后6个月内的屈光度、视力变化情况。结果显示,患者术后视力恢复很快,术后1天裸眼视力达1.0者占91％,6个月时屈光度稳定,并发症少,可以妥善处理。认为博士伦Technolas217z准分子激光治疗近视安全、可靠,治疗效果稳定。     

Correlation between central corneal thickness and myopia in Taiwan

The aim of the study was to explore the correlation between central corneal thickness (CCT) and the degree of myopia in Taiwanese adults. A total of 528 individuals were enrolled to undergo myopic laser refractive surgery from January 2004 to December 2006. Preoperative CCT was measured using the Orbscan corneal topography system and refractive status was determined by cycloplegic spherical equivalent. The relationship between CCT and refractive error was investigated by interindividual and intraindividual analyses. Participants had a mean age of 34.8 ± 7.3 years, and 79.9% were female. The mean refractive error was ?7.27 ± 2.96 diopters and the mean CCT measurement was 560 ± 35 μm. CCT revealed that there was no association with age. However, CCT was significantly (p = 0.012) less in females than in males. The CCT also showed no significant association with refractive error (p = 0.49). Among the 67 participants with myopic anisometropia, the mean difference between both eyes was 3.09 ± 1.06 diopters. There was no association between the intereye CCT difference and refractive error (p = 0.57). The results remained the same after adjusting for age and sex. In conclusion, there was no correlation between CCT and the degree of myopia among adults in Taiwan. These data might contribute to the ongoing discussion about the role of CCT in the higher incidence of development and progression of glaucoma in myopic individuals.     

调节灵活度训练对儿童近视发展影响的研究

目的：观察使用Flipper镜训练调节灵活度对儿童近视发展的影响。方法选择6～12岁的近视儿童患者62例（117眼）,根据近视程度分为三组：Ⅰ组（＜-3.00 D）;Ⅱ组（-3.00～-6.00 D）;Ⅲ组（＞-6.00 D）,观察进行Flipper镜调节灵活度训练6个月后的近视增长幅度的变化。结果同原近视增长幅度比较,Flipper镜训练后近视增幅显著减缓（ P＜0.05）;不同近视程度组间比较差异有统计学意义（ P＜0.05）。结论 Flipper镜训练调节灵活度能有效延缓近视儿童屈光度的发展,尤其对低中度近视患者控制的效果更为明显。     

角膜塑形镜对青少年近视眼调节参数的影响

目的观察分析角膜塑形镜对青少年近视调节各参数的影响及临床意义。方法选取在视光门诊规范验配、随诊、配戴角膜塑形镜的8~16岁青少年近视患者31例(62眼),其中男16例,女15例,平均等效球镜(-3.71±0.90)D。在配戴角膜塑形镜前后,应用综合验光仪对近视患者测定调节参数,包括正相对调节量、负相对调节量、调节幅度、调节反应(调节滞后量)及梯度性AC/A;对配戴前后的相关数据进行配对t检验。结果配戴角膜塑形镜前后调节幅度(AMP)分别为(+7.94±1.44)D和(+7.06±1.19)D(t=7.94,P0.05);调节滞后量(FCC法)分别为(+0.90±0.21)D和(+0.15±0.26)D(t=13.79,P0.05);梯度性AC/A分别为(4.05±0.83)和(3.03±0.63)(t=8.07,P0.05)。结论青少年近视眼配戴角膜塑形镜后调节参数趋于正常,配戴后调节滞后量减少,AC/A值降低,患者的调节与集合的关系更加协调,为延缓近视的进展提供了一定依据。     

Transient myopia with severe chemosis as an initial manifestation of systemic lupus erythematosus

A 24-year-old woman suffered from blurred vision and periorbital edema with remittent fever. She was diagnosed as having systemic lupus erythematosus (SLE), complicated with myopia and retinopathy and severe chemosis. Antiphospholipid syndrome (APS), hemophagocytic syndrome, and liver involvement were also proven. We considered that APS might cause chemosis as a result of thrombosis-induced perfusion failure in the conjunctiva. In such cases, APS should be considered and anticoagulation therapy associated with steroid therapy should be initiated. In systemic lupus erythematosus (SLE), chemosis, severe hepatitis, and hemophagocytic syndrome (HPS) are rare complications. It is well known that many cases of SLE are complicated with antiphospholipid syndrome (APS), which causes arteriovenous thrombosis. We report a case of SLE with transient myopia and severe chemosis complicated with severe hepatitis and HPS. As this patient had antiphospholipid antibodies, these ocular complications were considered to be related to APS. Received: August 23, 2000 / Accepted: November 24, 2000     

N-乙酰半胱氨酸治疗老年吸入性肺炎的疗效观察

目的 观察N-乙酰半胱氨酸治疗老年吸入性肺炎疗效和安全性.方法 将68例老年吸入性肺炎的患者随机分为治疗组和对照组,两组均给予常规治疗,治疗组加用N-乙酰半胱氨酸,然后比较两组血氧饱和度恢复时间、呼吸困难改善时间、吸痰次数、病灶吸收显效时间及平均住院天数等方面的差异.结果 治疗结束时,两组血氧饱和度恢复时间、呼吸困难改善时间、吸痰次数、病灶吸收显效时间及平均住院天数等方面差异有显著性(P＜0.01),且安全性较高.结论 应用N-乙酰半胱氨酸治疗老年吸入性肺炎能明显改善患者的临床症状,缩短疗程,改善预后,无明显副反应.