LASIK术后角膜前表面屈光力变化与矫治等效球镜度数的关系

目的:研究LASIK术矫治1.00D的等效球镜度数时角膜前表面屈光力发生的变化。方法:以角膜地形图所测得的角膜前表面屈光力(K值)为标准,角膜前表面屈光力变化量ΔK=K术前-K术后,按矫治等效球镜度数(SE矫治)将患者分成低、中度近视(SE矫治≤-6.00D)及高度近视(SE矫治>-6.00D)两组,计算ΔK/SE矫治,并与由经验公式推导出的0.8进行统计学分析。结果:当矫治1.00D的等效球镜度数时,总体研究对象:低、中度近视组和高度近视组的角膜前表面屈光力分别变化0.89±0.24D,0.94±0.28D和0.83±0.18D;切削的角膜组织分别为11.46±0.76μm,11.87±0.65μm和11.08±0.65μm;角膜的切削量与矫治等效球镜度数呈负相关关系。结论:LASIK术后低、中度近视的角膜前表面屈光力变化大于高度近视。     

高度近视LASIK术后眼压值的变化

目的 探讨LASIK治疗高度近视术后眼压变化与角膜切削量的关系.方法 427例高度近视患者按屈光度分成A组(-6.0D至-10.00D)和B组(-10.0至-21.0D),施行LASIK术前后用非接触眼压计(NCT)测量眼压,并分析其与角膜切削量的关系.结果 两组眼压术后明显下降.A组为12.21±3.22 mmHg;B组为10.48±2.76mmHg(P＜0.001).角膜切削量占术前角膜中央厚度A组为12.4～18.9 %;B组为19.0～34.7 %(P＜0.01).结论 LASIK治疗高度近视术后NCT眼压值下降与角膜中央厚度变薄和抗压强度减弱有关.     

TOSCA与LASIK治疗近视患者术后高阶像差变化对照研究

目的比较角膜地形图引导的个体化切削术(topography supported customized ablation,TOSCA)和LASIK治疗近视患者术后高阶像差的差异,评价TOSCA治疗屈光不正的临床疗效。方法 选取2008年8月至2009年6月在我院接受TOSCA的近视患者45例(87眼)作为治疗组,选取同期接受LASIK的近视患者44例(87眼)作为对照组,分别比较2组患者术后裸眼视力、等效球镜、高阶像差及高阶像差增幅的差异。结果 术后10d、1个月、3个月、6个月,TOSCA组裸眼视力分别为1.00±0.19、1.00±0.21、1.01±0.18、1.01±0.21;LASIK组分别为1.01±0.17、1.00±0.19、1.00±0.20、1.00±0.18,2组比较差异均有统计学意义(均为P>0.05);术后1个月、3个月、6个月,TOSCA组等效球镜度数分别为(-0.31±0.54)D、(-0.33±0.57)D、(-0.34±0.59)D;LASIK组分别为(-0.37±0.48)D、(-0.38±0.46)D、(-0.38±0.43)D,2组比较差异均无统计学意义(均为P>0.05);术后1个月、3个月、6个月,2组各高阶像差值及慧差、垂直慧差的增加百分比之间差异也均无统计学意义(均为P>0.05),而总高阶像差及球差的增加百分比差异均有统计学意义(均为P<0.05)。结论 TOSCA可以降低术后高阶像差的增幅,在一定程度上提高术后视觉质量。     

近视眼和LASIK后眼压与角膜厚度的关系

目的：分析原位角膜磨镶术（laser in situ keratomileusis,ＬＡＳＩＫ）治疗近视眼术 前、术后眼压与角膜中央厚度的关系。方法：２１２只眼采用ＬＡＳＩＫ治疗近视眼。用非接角式眼压计测量术前、术后的眼压以及角膜中央厚度,对眼压与术前、术后角膜中央厚度进行相关分析和回归分析。结果：ＬＡＳＩＫ术前眼压与角膜中央厚度呈正相关,相关系数r＝０．２６８,p＝０．０００。术后眼压的改变与切除的角膜厚度的改这也车正相关,与     

LASIK手术前后眼压变化及其与角膜厚度变化的关系

目的:探讨LASIK术后眼压变化与角膜厚度改变的相关性。方法:选择我院104例201眼行LASIK术的患者,进行手术前后的角膜厚度及眼压的测量,对术后角膜厚度及眼压的变化进行直线相关及一元回归分析,求出回归方程,并行F、t检验,检测回归方程的统计学意义。结果:201眼术后角膜厚度及眼压的变化经行直线相关及一元回归分析,得相关系数R=0.469,R2=0.220,求回归方程为:Y=-3.503+0.043X,经F检验及t检验,得F=8.448,t=2.906,P=0.007。结论:角膜厚度及眼压变化呈直线相关,当角膜厚度改变时,所测的眼压值相应改变。     

激素性高眼压对LASIK术后患者视功能影响的初步研究

目的：探讨激素敏感者LASIK术后早期出现的异常眼压波动对视功能的影响及其潜在机制。

方法：共15例LASIK术后发生激素性高眼压的患者纳入试验组并给予及时有效治疗,另15例未出现高眼压的LASIK术后患者纳入正常对照组。两组患者均嘱定期随访,随访期间所有患者的裸眼视力、对比敏感度、波前像差、角膜地形图等数据被采集用于对比分析。

结果：试验组：患者术后高眼压与术前相比,眼压波动幅度达10.6±4.4mmHg(21.3～32.9mmHg); 患者术后眼压正常时与术后高眼压时相比,裸眼视力、对比敏感度、波前像差、角膜地形图等数据均存在统计学差异。1)裸眼视力：术后眼压正常时优于术后高眼压时的裸眼视力(P<0.001); 2)对比敏感度：术后眼压正常时,患者在3、6、12、18 c/d各频率的对比敏感度均优于高眼压时的对比敏感度(均为P<0.05); 3)波前像差：术后眼压正常时与术后高眼压时相比,患者在总高阶像差、三叶草像差、球差等指标上存在统计学差异(均为P<0.05); 4)角膜地形图：术后眼压正常时与术后高眼压时相比,在Q值、后表面Diff值、角膜中央厚度等指标上存在统计学差异(均为P<0.05)。对照组：随访期内,除角膜中央厚度随时间而增厚外,其它检测指标均无明显变化。

结论：LASIK术后激素易感者发生的短期异常眼压波动可引起显著的视功能改变,而控制眼压波动则可明显改善患者的视觉表现。     

LASIK术后非接触性眼压测定值的改变

目的:研究准分子激光原位角膜磨削术(laser·in situ keratomileusis,LASIK)术后非接触性眼压计(noncontact tonometer,NCT)测量值的准确性。方法:对180例(256只眼)近视患者行IASIK手术,手术前、后采用NCT测量患者的眼压,并测量角膜厚度和角膜曲率,进行统计学分析。结果:LASIK术后NCT测量值明显低于术前,差异有显著性(P<0.001),术后一年眼压下降(6.54±2.1)mmHg(1 mmHg=0.133 kPa)。术后一年眼压下降值与角膜厚度减少及角膜前表面曲率的降低有关(P<0.01),建立二元回归方程如下:Y=0.355+0.0342X1+0.365X2。Y:术前术后眼压差(mmHg),x1:术前术后角膜曲率差(D),x2:角膜切削厚度(μm)结论:LASIK术后NCT眼压测量值明显低于术前,术后所测量眼压与角膜切削厚度、角膜曲率有关。     

动态眼压测量计与压平式眼压计测量LASIK手术前后眼压分析

目的探讨LASIK手术前后眼压的变化规律。方法用三种不同仪器对42人84眼手术后的眼压、角膜厚度进行测量,比较手术前后眼压值及其与中央角膜厚度的关系。结果术后,电子压力感受器测得的眼压呈先升高后下降的趋势,压平式眼压计所测的眼压值较术前接近或下降,且非接触式眼压计组较Goldmann眼压计组下降更明显,中央角膜厚度与电子压力感受器原理的眼压计之间无明显相关,而与两个基于压平原理的眼压计所测值之间有不同程度的关联。结论术后角膜形状的改变对压平式眼压计的结果影响较大,而基于电子压力感受器原理的眼压计基本可以避开上述影响,激素对术后病人眼压影响较普遍,有必要对压平眼压计的结果进行进一步修正,尤其对非接触式眼压计的结果需要加以进一步的考虑。     

LASIK术后眼压测量值的变化分析

目的探讨与准分子激光原位角膜磨镶术(Laser in situ keratomileusis．LASIK)治疗近视眼术后眼压测量值改变有关的各种相关因素。方法54例(103只眼)中高度近视患者按屈光度分成A组(≥-3．0D，＜-6．0D)和B组(≥-6．0D)，施行LASIK术前、术后3月后用非接触式眼压计(non—contact tonometer，NCT)测量眼压，角膜地形图仪测量角膜前表面曲率，超声角膜测厚仪测量中央角膜厚度(central corneal thickness，CCT)。对眼压差与CCT差、角膜曲率差、术前近视度数、术前散光度数、所矫正的等值球镜度数、切削深度、切削直径、年龄、性别、眼别等因素进行相关分析和多元逐步回归分析。结果A、B两组间术前眼压、术前CCT、术后角膜曲率、术后CCT有显著性差异(分别为P=0．011，P=0．031，P＜0．001，P=0．001)，术前曲率及术后眼压无显著性差异(分别为P=0．550，P=0．091)。相关分析显示眼压差与CCT差、角膜曲率差、术前近视度数、所矫正的等值球镜度数、切削深度有显著相关性(分别为P＜0．001．P=0.027，P＜0．001，P＜0．001，P＜0．001)，与年龄、术前散光度数、切削直径无显著相关性(分别为P=0．904，P=0．180，P=0．461)。男、女性之间的眼压差有显著性差异(P＜0．001)，左、右眼之间的眼压差无显著性差异(P=0．363)。经多元逐步回归分析，所得“最优”回归方程为：Y=3．684 0．090Xt-1．251X2 0．827X3，(Y为手术前后眼压差，X1为切削深度，X2为性别，X3为术前近视度数)。结论LASIK术后眼压测量值降低与切削深度、CCT差、术前近视度数、所矫正的等值球镜度数、性别有关。     

降眼压药物治疗LASIK术后屈光回退3例

0引言准分子激光原位角膜磨镶术(Laser in situkeratomileu-sis,LASIK)与准分子激光屈光性角膜切削术(photorefrac-tive keratectomy,PRK)相比较,其术后稳定性大大提高,但是对于高度或超高度近视患者来说,屈光回退的发生率依然相当高[1,2]。一般认为,LASIK术后屈光回退的发病机制可能与组织增生和角膜前膨有关[3],但是到底是以组织增生为主,还是以角膜前膨为主,可能又存在较大的个体差异。对于屈光回退,目前除了在角膜厚度足够、屈光度稳定和排除圆锥角膜的情况下行增强术之外,没有其他治疗手段。我们对3例(6眼)LASIK术后屈光回退患者,运     

甲状腺相关眼病患者眼压与眶压的关系

目的了解甲状腺相关眼病(thyroidassociatedophthalmopathy,TAO)患者眶压与眼压的关系。方法对96例TAOII型患者进行眼球突出度、眶压及眼压测量,将结果及其他相关因素进行分析。结果96例129眼中34眼眼压≥30mmHg(1kPa=7.5mmHg)。高眼压者均有眶压升高。TAO发病早期眶压及眼压升高的发生率较高。结论TAO早期眶压升高可引起眼压升高,并引起视功能损害,眶内静脉系统回流受阻是眼压升高的重要因素,TAO早期眶压升高合并眼压升高时应以药物治疗为主,眼压不能控制时再行眶减压及抗青光眼手术。     

Low intraocular pressure and postural changes in intraocular pressure in patients with Hansen's disease

We found intraocular pressures of less than 7 mm Hg in 11 of 72 patients (15%) with early Hansen's disease. Furthermore, significant postural changes in intraocular pressure (greater than 30%) occurred in 43 of 72 patients (60%). This loss of intraocular pressure homeostasis, which results from reduced aqueous humor production or increased uveoscleral outflow with reduced local adrenergic control in the ciliary body-iris-trabecular meshwork region, suggests that early autonomic neuropathy of the eye may occur in Hansen's disease. The only predictive value for significant postural change in intraocular pressure was the presence of immunologically unstable disease.     

高眼压症患者的随访观察

目的:探讨高眼压症的危险因素、随访指标。方法:对29例高眼压症患者进行3～4(平均3.5)a的随访,随访内容包括眼压、视野、视盘及视神经纤维层等方面的检查。结果:随访过程中25例患者眼压无明显变化,2例眼压呈下降趋势,眼压增高2例。结论:高眼压症与多种致病因素有关,应密切随访观察,出现可疑青光眼改变,积极行抗青光眼的治疗。     

Retcam3系统筛查ROP患儿检出情况及与眼压变化的关系

目的:探讨眼科广域数字成像系统(Retcam3)筛查早产儿视网膜病变(ROP)的能力及与眼压变化的关系。方法:选取2017-08/2019-08我院收治的80例符合筛查标准的早产儿为研究对象,分别采用双目间接检眼镜和Retcam3系统检查,以前者检查结果为金标准,统计Retcam3系统筛查的灵敏度、特异度、阳性和阴性预测值,同时比较筛查前后患儿眼压变化情况。结果:双目间接检眼镜检查ROP患儿37例69眼,Retcam3系统筛查ROP患儿35例65眼,Retcam3检查灵敏度为100%,特异度为95.8%,阳性预测值为94.2%,阴性预测值为100%。Retcam3筛查后左眼和右眼眼压均高于散瞳前(P<0.05)。结论:Retcam3系统能较为准确地筛查ROP患者,但筛查后可引起眼压升高。     

Relationship between intraocular pressure and obesity in children

PURPOSE: To establish the relationship between intraocular pressure (IOP) and obesity in children. METHODS: Seventy-two obese children (body mass index in the 95th percentile or greater) were compared with 72 age-matched and sex-matched controls (body mass index <95th percentile). Both groups underwent Goldmann applanation tonometry (3 times), blood pressure measurement (3 times), and Hertel exophthalmometry. Paired and unpaired t tests and the Cochran-Mantel-Haenzel statistics were used for statistical analysis. RESULTS: The mean IOP between the obese children and controls were significantly different (P<0.0001), even after adjusting for systolic and diastolic blood pressure (P<0.001). Diurnal variation of IOP was higher in obese children (P<0.001). Obese children had higher Hertel values (P<0.001). Sex did not significantly effect IOP in either group (P>0.05). CONCLUSIONS: In addition to its indirect effect on IOP via blood pressure change, obesity is also an independent risk factor for increased IOP.     

Relationship between arterial pulsations and intraocular pressure

A model of the eye is proposed in order to find a relationship between small changes in volume and the intraocular pressure in terms of the physical parameters of the globe. The results show that pulsations in pressure due to small variations in volume are directly proportional to the average intraocular pressure and inversely proportional to the radius of the globe. Comparisons are made between the results of this model and already existing experimental and clinical measurements. Further clinical and experimental studies are suggested to confirm the accuracy of the model. Conclusions are drawn connecting the findings to open angle glaucoma and to the effects of axial myopia and axial hyperopia.     

人眼轴长度与眼内压的相关性研究

观察眼轴长度与非接触眼压测量值之间的关系。 方法:选择在我院眼科门诊就诊的患者及行准分子激光角膜手术术前常规检查的近视患者共508例1010眼,年龄17～53(平均26.65±6.55)岁,分别测量眼轴长度及非接触眼压值,并按眼轴长度分为＜24mm,24～25.99mm,≥26mm三组,应用相关直线回归分析方法分析眼轴长度与眼内压之间的关系,方差分析比较3组眼压的差别。 结果：眼轴长度与眼内压值之间呈正相关性（r=0.138,P＜0.01,Y=7.331+0.296X),≥26mm组的眼内压升高幅度最大。 结论：眼轴长度与眼内压之间存在一定的内在联系,这种联系随着眼轴长度的增加而更为密切,提示临床应重视对高度近视眼的眼内压监测。     

The effect of orbital decompression surgery on refraction and intraocular pressure in patients with thyroid orbitopathy

Purpose

To investigate the effect of orbital decompression surgery in thyroid orbitopathy (TO) on both refractive status and intraocular pressure (IOP).

Patients and methods

A prospective, multicentre, consecutive audit of patients undergoing thyroid decompression surgery. Indications for surgery included cosmetically unacceptable proptosis or corneal exposure. Exclusion criteria included the following: previous orbital surgery, glaucoma, corneal disease, steroid use in the preceding 12 months, or an acute optic neuropathy. Automated refraction, keratometry, pachymetry, Hertel exophthalmometry, and IOP were recorded at 1 month pre- and 3 months postoperatively. IOP using the Tono-Pen (mean of three readings) was measured in the primary, upgaze, and downgaze positions.

Results

Data were collected from 52 orbits of 33 patients (East Grinstead, New York, and Adelaide). There was no significant difference between pre- and postoperative data for sphere, cylinder, or central corneal thickness (CCT). The mean spherical equivalent was −0.43±1.49 D pre-operatively and −0.28±1.52 D postoperatively. The steepest meridian of corneal curvature was 93.1 degrees pre- and 94.2 degrees postoperatively, with no significant difference. Mean IOP significantly decreased when measuring by Goldmann applanation tonometry (GAT) (2.28 mm Hg, ^* P=0.001) and Tono-Pen (3.06 mm Hg, ^* P=<0.0001). IOP measured in upgaze was significantly greater than that in the primary position. Regression analysis between change in IOP and either Hertel exophthalmometry or the number of orbital walls decompressed was non-significant (^*Student''s t-test).

Conclusion

Patients with TO undergoing orbital decompression had, on average, with-the-rule astigmatism not affected by orbital decompression surgery. IOP was significantly reduced by decompression surgery although no relationship between IOP and the degree of decompression was observed.     

Relationship between intraocular pressure and eye growth in chick

In infants, abnormally high intraocular pressure (IOP) results in excessive eye enlargement. In the study reported here, we investigated whether IOP might be a determinant of ocular elongation using the chick as an animal model. Specifically, we examined IOP changes in (I). normally developing eyes, and (II). eyes undergoing altered growth. In the first case (I). developmental changes in IOP, axial length and refractive error were assessed at approximately daily intervals during early development (days 2-11 post-hatch, n = 8), and at weekly intervals from weeks 1 to 6 (n = 8). In the second case (II). opposite ocular growth responses were elicited using -15 D and +15 D defocusing spectacle lenses fitted monocularly to 8-day-old chicks (n = 8 and 7, respectively). Treated eyes were measured 3 and 7 h after lens application (between 9 and 10 am), as well as 1, 2 and 4 days later, around the same time as the initial lens application. In normal development (I). IOP increased over the first post-hatch week, peaking at 18.0 +/- 5.1 mmHg, and declined slowly thereafter to be back to near 'hatching' values at 6 weeks (12.7 +/- 5.3 mmHg at day 2 cf. 13.4 +/- 1.9 mmHg). Eyes elongated at an approximately linear rate over the entire monitoring period. The -15 D and +15 D lenses (II). produced opposing effects on eye growth, as indicated by axial length changes of + 0.67 +/- 0.25 mm cf. -0.33 +/- 0.17 mm over the 4-day treatment period. Both groups showed decreases in IOP over the first 20 h of lens wear. The faster growing eyes of the -15 D group exhibited a later relative increase in IOP. The described changes in IOP are compatible with, but do not prove, a modulatory influence of IOP on early eye growth.     

Corneal biomechanical changes and intraocular pressure in patients with thyroid orbitopathy

AIM: To determine the relevance of the objective parameters addressing the altered biomechanical properties of cornea for glaucoma monitoring in patients with mild or moderate thyroid associated orbitopathy (TAO), and in healthy individuals. METHODS: Twenty-five patients with TAO (group 1) and 25 healthy adults (group 2) were included to the study. Both groups were of a similar age and the ratio women:man. For each patient, the following parameters of both eyes were measured with ocular response analyzer (ORA): corneal hysteresis (CH), corneal resistance factor (CRF), Goldmann correlated intraocular pressure (IOPg) and corneal compensated intraocular pressure (IOPcc). In both groups participating in our study, all measurements were performed within minutes to reduce the diurnal effects. RESULTS: The mean age in group 1 was 56±11y and 76% were women, 24% were men. The mean age in group 2 was 64±11y and 68% were women, 32% were men. CH correlated negatively with IOPg in group 1 (r2=0.10, P<0.05). IOPg strongly correlated with IOPcc in both groups (group 1: r2=0.79, P<0.0001; group 2: r2=0.85, P<0.0001). There was positive correlation between CRF and IOPg in group 1 (r2=0.12, P<0.05) and in group 2 (r2=0.31, P<0.0001). Statistical analysis revealed no significant correlation between CRF and IOPcc in group 1 (r2=0.009, P>0.05) and also no significant correlation in group 2 (r2=0.04, P>0.05). CRF mean value in group 2 (11.51±1.72 mm Hg) was higher than in group 1 (10.85±1.45 mm Hg) (P<0.05). IOPg strongly correlated with IOPcc in both groups (group 1: r2=0.79, P<0.0001; group 2: r2=0.85, P<0.0001). There was also strong correlation between CRF and CH in both populations: group 1: (r2=0.58, P<0.0001), group 2: (r2=0.41, P<0.0001). CONCLUSION: Biomechanical parameters of cornea, as quantified by CH and CRF, and measured together with IOPcc, precisely reveal glaucoma staging in TAO and thus are reliable for diagnosing and follow-up in clinical practice.