IOL-Master 对高度近视眼人工晶状体度数测量的临床研究

目的 通过比较非接触式光学相干生物测量仪(intraocular len-master,IOL-Master)与传统超声生物测量法联合角膜曲率计测量法对高度近视眼人工晶状体度数测量的准确性及特点,评价IOL-Master的临床应用价值.方法 高度近视且患有老年性白内障的患者19例30 眼,术前分别用IOL-Master、超声波生物测量仪联合角膜曲率计测量眼轴长度和角膜曲率,使用SRK/T公式计算人工晶状体度数.对患者施行白内障超声乳化摘出术,按照超声波检查法得出的人工晶状体度数植入可折叠人工晶状体.术后1个月随诊检查视力及眼屈光度.结果 超声波检查法和IOL-Master检查得出的眼轴分别是(28.789±1.853)mm和(29.057±1.828)mm,2者相比差异有统计学意义(P=0.001＜0.05);角膜曲率计和IOL-Master测量角膜曲率分别为43.336±1.439和43.548±1.445,2者相比差异有统计学意义(P=0.02＜0.05).术后1个月患者平均绝对屈光误差值(mean absolute refractive error,MAFE):IOL-Master为0～1.25 D,平均(0.517±0.273)D,A超联合角膜曲率计为0～1.75 D,平均(0.792±0.386)D,2者相比差异有统计学意义(P=0.001＜0.05).IOL-Master和A超联合角膜曲率计的MAFE为0～0.50 D者分别占70.0%和43.3%,χ2检验差异有统计学意义(χ2=4.019,P＜0.05).IOL-Master和A超联合角膜曲率计的MAFE为0～1.00 D者分别占86.7%和73.3%,χ2检验差异无统计学意义(χ2=1.531,P＞0.05).结论 IOL-Master是一种高精确性、非接触性、操作简单、安全可靠的人工晶状体度数测量工具.与A超相比,IOL-Master对眼轴长度测量精确性较高,尤其是对高度近视眼患者.     

前房型人工晶状体植入治疗高度近视的有效性及安全性评估

目的　探讨有晶状体眼前房型人工晶状体植入术矫正高度近视的有效性和安全性。方法　对 5 1例 92眼高度近视患者行巩膜隧道切口有晶状体眼前房型人工晶状体植入术。平均年龄2 8 14岁 ,术前矫正视力 0 15～ 1 0 ,平均近视度数 (-14 90± 1 1)D ,平均散光度数 (-1 3 8±0 3 )D ,平均植入人工晶状体屈光度数 (-14 82± 1 3 3 )D。结果　术后所有患者裸眼视力提高 ;79眼 (85 87% )裸眼视力≥ 0 5 ;63眼 (68 48% )术后裸眼视力较术前最佳矫正视力提高。术后平均近视度数 (-0 5 4± 0 3 7)D ,平均散光度数 (-0 67± 0 14 )D。术后平均角膜内皮细胞数目为(2 90 5± 2 69)个 /mm2 ,较术前减少了 7 0 2 %。术后平均随访时间 18个月。无严重并发症发生。结论　有晶状体眼前房型人工晶状体植入术是矫治高度近视安全、有效的方法 ,具有术后视力好、并发症少、预测屈光状态准确性及稳定性好等优点     

IOLMaster与四种人工晶状体屈光度计算公式的准确性研究

目的 评价IOLMaster与四种人工晶状体屈光度计算公式(SRKⅡ、SRK/T、Holladay l、Haigis)的准确性,为其临床应用提供依据.方法 选取顺利施行白内障超声乳化摘出联合后房型人工晶状体植入手术的患者100例(100眼)(AL≥22.0 mm),应用IOL-Master测量眼前节相关参数(B组),同时应用接触式A型超声、电脑验光仪测量作为对照(A组).术后2周测量实际屈光度.根据植入的人工晶状体度数分别应用机器自带的四种人工晶状体屈光度计算公式计算术眼的平均绝对屈光误差(mean absoluate error,MAE).结果 B组测量的眼轴长度(axial length,AL)、前房深度值分别为(24.17±1.73) mm、(2.94±0.49) mm,高于A组(23.61±1.83)mm、(2.69±0.51)mm(均为P＜0.05),而角膜曲率测量差异无统计学意义(P＞0.05).不同AL下,两组通过四个人工晶状体屈光度计算公式所得的MAE差异均无统计学意义(均为P＞0.05).22.0≤AL＜ 26.0 mm患眼中四种计算公式所得MAE差异无统计学意义(均为P＞0.05),而AL≥26 mm患眼中应用Haigis人工晶状体屈光度计算公式所得MAE:A组为(0.80±0.50)D,B组为(0.71±0.65)D,小于SRKⅡ公式计算所得MAE:A组为(1.29±0.89)D,B组为(1.28±0.92)D(P＜0.05).结论 IOLMaster前节生物测量与传统接触式A型超声、电脑验光仪测量通过四种计算公式预测人工晶状体度数具有相同的准确性;22.0≤AL＜ 26.0 mm患者SRKⅡ、SRK/T、Holladay 1、Haigis公式具有相同的准确性;AL≥26.0 mm患者Haigis公式准确性优于SRKⅡ公式.     

负度数人工晶状体植入术治疗白内障合并超高度近视眼

目的 观察白内障超声乳化联合负度数Sensar AR40e折叠式人工晶状体植入治疗超高度近视合并白内障的临床疗效.方法 对超高度近视合并白内障行超声乳化白内障吸除联合负度数Sensar AR40e人工晶状体植入术的35例(59只眼)患者进行回顾性研究,记录术前眼轴长度,观察手术并发症和术后视力、屈光度数及其与预期屈光度数的偏差值(屈光度数偏差值).术后随访时间为3～12个月.结果 术前平均眼轴长度为31.34mm.术后最佳矫正视力≥0.2共49只眼(83.05%),≥0.5者共26只眼(44.07%).术后屈光度数偏差值＜±1.00 D共31只眼(52.54%),<±2.00 D共52只眼(88.14%).术中仅1只眼晶状体后囊膜破裂;术后6只眼晶状体后囊轻度混浊,随访期间无视网膜和脉络膜脱离.结论 白内障超声乳化联合负度数人工晶状体植入术治疗白内障合并超高度近视眼安全、有效.植入负度数后房型人工晶状体既可以维持眼内组织的稳定性,又可同时进行屈光矫正.     

IOL-MASTER测量人工晶体屈光度的精确性研究

目的比较IOL-Master与传统方法测量人工晶体度数的准确性,以了解其特点及应用价值。方法分析2005年1月～6月间于我院行白内障超声乳化摘除及人工晶状体植入术的年龄相关性白内障167人213眼,术前分别用IOL-Master、传统的超声生物测量仪和角膜曲率计测量眼轴长度和角膜曲率,使用SRK-II或SRK/T公式计算植入人工晶体的度数。术后3m检查患者屈光状态。结果用IOL-Master和超声生物测量仪检测眼轴长度:L>26mm组分别为21.47±0.58mm和21.60±0.64mm,两者对比有显著性差异(P<0.05),L≤26mm各组,两者对比无显著性差异(P>0.05);IOL-Master和角膜曲率计检测量角膜曲率分别为44.27±1.72D和43.92±1.53D,两者对比无显著性差异(P>0.05);术后3m,两种方法的绝对屈光误差比较:L>26mm组分别为0.885±0.683D和1.459±0.724D,两者对比有显著性差异(P<0.05),L≤26mm各组,两者对比无显著性差异(P>0.05)。结论应用IOL-Master测量人工晶状体度数,具有准确性、非接触性、操作简便、安全而且病人易于接受的特点,但也有一定局限性,不能完全替代A超。     

屈光性晶状体置换术矫治中老年高度近视临床观察

目的 评价屈光性晶状体置换术在矫治中老年患者高度近视的疗效,为临床此项手术的开展提供依据.方法 高度近视患者47例(80只眼),年龄为43～71岁,平均(53.71±7.26)岁,等效球镜度数(SE)-10.75～-33.00D,平均(-20.78±5.18)D,术前最佳矫正视力(BCVA)0.05～0.9,植入单片式球面人工晶状体(IOL),角膜散光≥-1.5D者联合散光性角膜切开术(AK).随访1年,观察手术前后的视力、屈光状态、角膜内皮细胞数量、眼压、前房、IOL位置和眼底情况,并进行比较.结果 术后1年时,65%(52只眼)BCVA≥0.5;所有眼SE显著改善.非联合AK组(53只眼)预测误差范围为-2.25～+2.54D,平均(-0.23±1.03)D,其绝对误差范围在±0.5D内者18只眼(33.96%),±0.5～±1.0D者16只眼(30.19%),±1.0～±1.5D者12只眼(22.64%),大于±1.5D者7只眼(13.21%);眼轴长度、植入IOL度数分别与预测性误差具有直线相关性,但相关系数较小(r=0.329,0.388).矢量分析提示,联合AK组(27只眼),实际AK矫止效应(1.72±0.93)D,手术效应轴与术前散光轴的夹角为(5.1±3.1)度:术中发生后囊膜破裂、术后后囊膜混浊及眼底山血各1只眼,未见其他并发症.结论 屈光性晶状体置换术矫治中老年高度近视眼安全、有效,屈光状态稳定,可显著提高患者生活质量.     

透明晶状体屈光手术的疗效观察

目的 :评价透明晶状体屈光手术的有效性、预测性和安全性。方法 :对屈光不正患者 5 8例 87眼行透明晶状体超声乳化摘除联合折叠式人工晶状体植入。患者年龄 2 5～ 73岁 ,平均 5 4 .32岁。将病例分为 3组 ,A组为高度近视共 6 1眼 ,眼轴长度 (2 9.5 7± 2 .10 )mm ,等效球镜度数 (- 11.93± 4 .6 4 )D ,植入人工晶状体屈光度 ( 9.0± 3.82 )D ;B组为远视共 17眼 ,眼轴长度 (2 2 .39± 0 .96 )mm ,等效球镜度数 ( 2 .2 9± 1.0 5 )D ,植入人工晶状体屈光度 ( 2 2 .70± 2 .0 8)D ;C组为屈光参差共 9眼 ,眼轴长度 (2 8.4 8± 1.77)mm ,屈光参差度数 (- 11.2 5± 5 .38)D ,植入人工晶状体屈光度 ( 10 .6 2±3.6 2 )D。随访 3～ 36个月。结果 :术后最佳矫正视力 87眼均达到或超过术前最佳矫正视力 ;术后裸眼视力达到或超过术前最佳矫正视力者在A、B、C组分别占 86 .89%、94 .12 %和88.89% ;术后裸眼视力 0 .5以上者分别为 5 4 .10 %、4 1.18%和 5 5 .5 6 % ;术中未发生后囊破裂。随访中 12眼发生后囊混浊 ,未发现视网膜脱离、黄斑囊样水肿等并发症。结论 :透明晶状体屈光手术与目前的角膜屈光手术相比 ,可能更适宜于中年以上不愿戴镜和戴镜不能矫治的屈光不正患者 ,但其远期疗效尚需长期随访     

晶状体眼前房型人工晶状体植入术矫正高度近视后放大率与视力的关系

目的 探讨有晶状体眼前房型人工晶状体植入术后高度近视患者视网膜成像放大率的变化规律,了解视网膜放大率变化与视力提高量之间的关系。方法 对近视屈光度为-15．13D～29．00D的23例患者（30只眼）行有晶状体眼前房型人工晶状体植人术,手术前后检查最佳矫正视力、屈光度、眼屈光参数（角膜曲率、前房深度、眼轴长度、人工晶状体位置）。根据模型眼理论,应用ZEMAX光学设计软件计算手术前后视网膜成像放大率的变化,分析放大率变化与屈光度、最佳矫正视力（BCVA）、视力提高量之间的关系。结果 术后3个月,28只眼（93％）术后BCVA超过术前,2只眼（7％）术后BCVA等于术前。屈光度与放大率变化成正相关,近视越深放大率变化越大（r=0．996,P〈0．01）;屈光度与手术前后最佳矫正视力均为负相关（r=-0．62,-0．57;P〈0．01）;近视越深,最佳矫正视力越差;放大率变化与视力提高量成正相关（r=0．42,P=0．02）;放大率变化较大,术后视力提高量较多。结论 有晶状体眼前房型人工晶状体植入术后视网膜成像放大率变大是影响术后最佳矫正视力提高的因素之一,视力提高量与放大率变化量有一定的相关性。     

IOL-Master测量硅油填充眼眼轴长度的临床评价

目的 探讨IOL-Master测量硅油填充眼眼轴长度可行性以及其计算晶状体度数的精确性.方法 选择2007年6月至2008年12月间在本院行玻璃体切割联合眼内硅油填充术3～6个月后,行白内障摘除人工晶状体植入联合硅油取出术的患者,共78例,83只眼.术前行IOL-Master测量眼轴长度,并将测量值用SRK/Ⅱ公式计算出人工晶状体度数.术后1周行接触式A超,术后3个月行IOL-Master复测眼轴长度.术后3月综合验光仪行主觉验光.结果 眼轴长度测量结果术前IOL-Master与术后A超及IOL-Master分别比较,差异无统计学意义(P=0.505,0.065),但是术后A超与IOL-Master测量结果差异有统计学意义(P=0.012).术后3个月绝对屈光误差≤0.5D共73只眼,占88.0%;>0.5D共10只眼,占12.0%.结论 IOL-Master对于硅油填充眼的眼轴长度测量具有较好可信性,其计算人工晶状体度数预测性高.     

有晶状体眼前房型人工晶状体植入术前后眼轴和前房测量的可靠性

目的评价IOL-Master测量有晶状体眼前房型人工晶状体植入术后的眼轴以及前房深度的可靠性,为即将面临的晶状体眼前房型人工晶状体植入术后发生的白内障的人工晶状体测算提供临床指导。方法对近视屈光度为-9.75~-21.625 D的17例患者32眼行有晶状体眼前房型人工晶状体植入术,手术前及术后第1个月用IOL-Master测量术眼的前房深度和眼轴长度,分析手术前后术眼的眼轴和前房深度测量值的一致性。结果有晶状体眼前房人工晶状体植入术前的平均眼轴长度为(29.83±1.76)mm,术后平均眼轴长度为(29.85±1.76)mm,手术前后眼轴长度的差异无显著性(P=0.180)。而人工晶状体植入术前的平均前房深度为(3.66±0.19)mm,术后平均前房深度为(3.59±0.23)mm,二者的测量结果差异具有显著性(P=0.003)。结论IOL-Master可以用来测量有晶状体眼前房型人工晶状体眼植入术后的眼轴长度,但不是测量术后前房深度的有效方法。     

Secondary Artisan-Verysise aphakic lens implantation

PURPOSE: To evaluate efficacy, predictability and safety of Artisan-Verysise intraocular lens (IOL) secondary implantation for aphakia correction. SETTING: Instituto de Microcirugía Ocular, and Autonoma University of Barcelona, Barcelona, Spain. METHODS: Uncorrected visual acuity, best spectacle-corrected visual acuity (BSCVA), manifest refraction, endothelial cell count, and clinical complications were evaluated. Sixteen consecutive eyes of 14 patients with aphakia were submitted to surgery. Postoperative examinations were done at 6 weeks, 6 months, 1 year, and every year for at least 3 years. An iris-supported Artisan-Verysise IOL was implanted for aphakia correction. RESULTS: Thirty-six months after Artisan-Verysise lens implantation, BSCVA was 20/40 or better in 6 eyes (37.5%). Preoperatively, 5 eyes had the same BSCVA (31.25%). Mean postoperative spherical equivalent (SE) was 0.46 diopter (D). Mean endothelial cell loss was 10.9% 36 months postoperatively. The cell loss occurred predominantly during the first year (7.78%). Cystoid macular edema was observed in 2 cases, 1 of them associated with chronic unresponsive low intraocular pressure. No other serious complications were observed. CONCLUSION: Artisan-Verysise IOL implantation seems a safe, predictable, and effective option for aphakic eyes without capsule support.     

婴幼儿人工晶状体植入术后屈光状态变化的长期观察

目的　研究婴幼儿人工晶状体（intraocular lens,IOL）植入术后的屈光状态的变化,为婴幼儿白内障患者植入IOL的屈光度及预留远视屈光度的临床应用提供依据。方法　回顾性分析中国医科大学附属盛京医院2006年5月至2017年5月手术治疗的婴幼儿白内障患儿38例（65眼）,随访时间（3.55±2.46）a;按植入IOL时的月龄和植入IOL时的眼轴长度分别分组。通过组间比较、回归分析眼轴长度、植入IOL时年龄、植入IOL度数、预留屈光度、术后屈光状态等的关系。结果　年龄≤24个月组及＞24个月组两组间植入IOL度数、预留屈光度、末次随访时年龄差异均有统计学意义（均为P＜0.05）,IOL植入时眼轴长度、随访时间、末次随访时眼轴长度、末次随访时屈光状态差异均无统计学意义（均为P>0.05）;两组间末次随访时屈光状态达到理想屈光度±1.00 D内的百分比相比差异无统计学意义（P>0.05）,达到±2.00 D内及±3.00 D内的百分比相比差异均有统计学意义（均为P<0.05）。植入IOL时眼轴长度＜21 mm、21~<22 mm、≥22 mm 3组间IOL植入时眼轴长度、植入IOL度数、预留屈光度、随访时间、末次随访时眼轴长度差异均有统计学意义（均为P＜0.05）;3组间末次随访时屈光状态差异无统计学意义（P>0.05）;3组间末次随访时屈光状态达到理想屈光度±1.00 D内、±2.00 D内及±3.00 D内的百分比相比差异均无统计学意义（均为P>0.05）。65眼中28眼（43.1%）末次随访时屈光状态可达到理想屈光度±1.00 D内,44眼（67.7%）末次随访时屈光状态在预期屈光度±2.00 D内,52眼（80.0%）末次随访时屈光状态在预期屈光度±3.00 D内。术后近视漂移度数与手术时月龄相关,末次随访时屈光状态与末次随访时眼轴长度、IOL植入手术时月龄、末次随访时年龄相关。预留屈光度（Y）与IOL植入时月龄（X₁）及IOL植入时眼轴长度（X₂）相关,Y=13.599-0.043X₁-0.427X₂ （R²=0.674,F=64.225,P＜0.001）。结论　根据婴幼儿白内障患者个体化眼轴发育的不同,参照婴幼儿IOL植入时屈光度预留方案来确定预植入的IOL度数,在患儿发育到学龄期时,患眼可以达到或接近正常儿童屈光状态。     

Analysis of intraocular lens power calculation for eyes with previous myopic LASIK

PURPOSE: To evaluate the effectiveness of a manual keratometry (K) adjusted value for intraocular lens (IOL) power calculation in patients who underwent cataract surgery following previous myopic LASIK. METHODS: Sixteen eyes of 14 consecutive patients who underwent cataract surgery after previous LASIK were evaluated retrospectively. All IOL powers were calculated using an adjusted K value (K minus 1.0 diopter [D]) with the Binkhorst II formula aiming for -0.75 to -1.00 D final refraction. Additionally, the IOL power for each eye was retrospectively calculated using K, refractive-derived K, and adjusted K with the Binkhorst II, Holladay I, and SRK/T formulas. The final refraction was used as a criterion of accuracy of each approach. RESULTS: Uncorrected visual acuity > or = 20/40 was achieved in 14 (87.5%) of 16 eyes. The mean postoperative spherical equivalent refraction was -0.41 +/- 0.57 D (range: +0.50 to -2.00 D). Twelve (75%) of 16 eyes were within +/- 0.50 D of emmetropia and 15 (94%) of 16 eyes were within +/- 1.00 D. No eye was > +1.00 D. CONCLUSIONS: Using an adjusted K with the Binkhorst II formula, aiming for -0.75 to -1.00 D, and with the Holladay I formula, aiming for -0.50 to -1.00 D, measuring K with a regular manual keratometer permits determination of an IOL power after myopic LASIK without the need of preoperative LASIK refractive data.     

Refractive lens exchange versus iris-claw Artisan phakic intraocular lens for hyperopia

PURPOSE: To study a paired-match comparison between refractive lens exchange with pseudophakic IOL implant (RLE) and Artisan phakic IOL for high hyperopia. METHODS: Nineteen eyes (12 patients, 20 to 41 years old) with an Artisan phakic IOL (Model 203: 1.00-D increment) for hyperopia from +2.75 to +9.25 D were matched to 19 eyes (15 patients, 26 to 46 yr) with hyperopia from +2.75 to +7.50 D, who had refractive lens exchange (pseudophakic IOL implantation; lenses: 0.50-D increment). Average paired-match difference was 1.13 D and 7.7 years of age. RESULTS: At 1 month after surgery, 84% of refractive lens exchange/pseudophakic IOL eyes and 94% of Artisan phakic IOL eyes had a spherical equivalent refraction within +/- 1.00 D of emmetropia; 58% and 68% of eyes, respectively, were within +/- 0.50 D (P = .97). No eye lost lines of best spectacle-corrected visual acuity (BSCVA) and no significant changes in BSCVA were found in any eye at 1 month after surgery (P = .17). The percentage of eyes with uncorrected visual acuity (UCVA) of 20/40 or better improved from 79% to 89% of eyes at 1 to 2 months after phakic IOL; it remained at 89% to 82% of eyes from 1 to 2 months after refractive lens exchange/ pseudophakic IOL. The coefficient of correlation showed statistically better accuracy (intended vs. achieved refraction; P = .035) for the Artisan phakic IOL (R = 0.83) than for refractive lens exchange/ pseudophakic IOL (R = 0.50). CONCLUSIONS: Spherical equivalent refraction outcome and BSCVA after surgery were similar for both procedures. The Artisan phakic IOL in carefully selected patients provided a better overall outcome for young patients with high hyperopia whose accommodation was preserved, as compared to refractive lens exchange.     

IOL-Master测量硅油填充眼屈光结果分析

目的评价IOL—Master测量硅油填充眼屈光度数的准确性并分析不同因素与术后屈光误差的关系。方法29例（29眼）硅油填充眼行硅油取出联合人工晶状体（IOL）植入术,术前用IOL—Master进行IOL测量。根据不同病因、硅油放置时间、眼轴、术后并发症等因素进行分类,研究术后视力恢复情况及测量误差产生的原因。结果术后视力较术前均有不同程度的提高,屈光度数的平均预测误差为0．329±0．846（-1．5～-2．0D）,眼轴长度（P〉0．05）、病因[裂孔源性（t=0．478,P=0．637）、黄斑裂孔（t=0．135,P=0．895）]、是否近视（t=0．435,P=0．667）与术后产生的屈光误差均无相关性,硅油存留时间〈1年者术后矫正视力恢复好。结论硅油填充眼患者采用硅油取出联合IOL植入术对视力有一定提高,IOL—Master测量硅油填充眼IOL度数是相对准确、安全、方便的方式。     

光学相干生物测量仪测量人工晶体度数的初步研究

目的:通过比较光学相干生物测量仪（IOL Master）与传统人工晶体测量法对人工晶体度数测量的特点及准确性,评价新型光学相干生物测量仪的临床应用价值。方法:50例50只眼老年性白内障患者,术前分别应用IOL Master、超声波生物测量仪及角膜曲率计测量眼轴长度和角膜曲率。使用SRK-Ⅱ公式计算人工晶体度数。对患者施行超声乳化白内障摘除术后,按照超声波检查法得出的人工晶度数植入可折叠人工晶体。术后三个月随诊检查视力及眼屈光度。结果:超声波检查法和IOL　Master检查得出的眼轴分别为23.59±0.89和23.64±0.80,两者对比差异无显著性（P=0.13）;角膜曲率计和IOL Master测量角膜曲率分别为44.05±2.05和43.99±2.16,两者对比差异无显著性（P=0.30）。术后3个月病人平均绝对屈光误差≤±0.5D和≤±1D各占94％和100％。结论:应用新型光学相干生物测量仪进行人工晶体度数测量,具有非接触性、高准确性、安全而病人易于接受的特点。     

Acrysof IQ Restor多焦点Toric人工晶状体植入术后临床效果观察

目的：评价白内障患者超声乳化术中植入Acrysof IQ Restor多焦点Toric人工晶体矫正术前规则角膜散光的早期临床效果、安全性,以及术后人工晶状体眼的视功能状态。方法：搜集自2013年至今在我院行白内障超声乳化术并植入Acrysof IQ Restor多焦点Toric人工晶状体的白内障患者18例(23眼)进行分析,术前患者散光均大于1.0 D。术后随访3个月,分别观察术后1周、1个月以及3个月的裸眼远视力,最佳矫正远视力以及裸眼近视力,术前散光以及术后3个月时残余散光、等效球镜度数和人工晶状体的旋转度。结果：术后3个月患者裸眼远视力0.89±0.21,最佳矫正远视力0.95±0.38,等效球镜为?0.5~+0.25D,裸眼近视力为0.82±0.19。术后3个月验光全眼散光为(0.38±0.15) D,较术前散光(1.79±0.43) D有明显降低(P<0.05)。术后3个月人工晶状体的轴位平均偏离(3.48±1.21)°。结论：Acrysof IQ Restor多焦点Toric人工晶状体为白内障患者提供了良好的术后全程视力和视觉质量,并校正了术前角膜散光,实现了患者高度满意率和脱镜率,可预测性好,并有良好的旋转稳定性。     

One-year results of PRK in low and moderate myopia: fewer than 0.5% of eyes lose two or more lines of vision

PURPOSE: To retrospectively evaluate the results of myopic photorefractive keratectomy (PRK) for different levels of intended correction, including analysis of loss of best spectacle-corrected visual acuity. METHODS: Four hundred seventy-five consecutive eyes with 1 year of follow-up that had PRK for the correction of 1-7 diopters (D) of myopia by using the Summit SVS Apex excimer laser. Three hundred forty-eight eyes were examined at 1 year. This study was confined to the 236 eyes with 1 year of follow-up that had PRK without astigmatic keratotomy. Eyes also were analyzed according to the range of attempted correction (0-3 D, low; 3.1-6D, moderate; and > or =6.1 D, high moderate). Manifest refraction, uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), surface regularity index (SRI), and surface asymmetry index (SAI) were evaluated for each group. RESULTS: One year after PRK, 91% of all eyes were within 1 diopter and 73% of eyes were within 0.5 diopter of emmetropia. Uncorrected visual acuity was 20/25 or better in 79% and 20/40 or better in 96% of eyes. Two lines of BSCVA were lost in only 0.4% of eyes (one of 236). No eye lost >2 lines of BSCVA, and 30% gained one line. Mean SRI and SAI were increased as compared with preoperative values, but were within the normal range for our patient population (ranges, 0.2-1.0 and 0.1-0.7, respectively). UCVA, BSCVA, and predictability decreased, whereas SAI and SRI increased, with increasing attempted correction. CONCLUSION: PRK effectively reduced myopia in all eyes with 12 months' follow-up. Predictability tended to decrease with increasing attempted correction, even for low to moderate myopia. PRK may induce mild surface asymmetry and irregularity, and these alterations tend to increase with higher attempted correction. Fewer than 0.5% of eyes lost > or =2 lines of best-corrected visual acuity.     

IOL-Master在高度近视白内障人工晶状体度数测量中的应用

目的 比较IOL-Master和A型超声测量高度轴性近视白内障患者眼轴的准确性. 方法分析2008年9月至2009年9月行白内障超声乳化摘除及人工晶状体植入术的高度轴性近视白内障患者18例(28只眼),分别用接触式A超、IOL-Master两种方法测量眼轴长度,IOL-Master测量角膜曲率,SRK/T公式计算人工晶体度数,术后3个月随诊检查视力和屈光度. 结果接触式A超测量的眼轴均值为(28.71±1.14)mm,IOL-Master为(29.31±1.27)mm;接触式A超和IOL-Master间差异有统计学意义(P ＜0.05).结论 IOL-Master测量眼轴准确性较高;而A超方法测量变异度较大;IOL-Master准确性、非接触性对高度轴性近视白内障手术人工晶状体度数的选择有重要意义.