飞秒激光LASIK术后角膜生物力学的改变

目的：探讨飞秒激光LASIK术后角膜生物力学指标的改变,为飞秒激光LASIK术的安全性研究提供理论依据。

方法：选取2014-06/2016-06于我院行手术治疗的85例170眼近视患者,所有患者均采用飞秒激光LASIK术治疗,对符合纳入标准的病历资料进行回顾性分析。术前和术后3、6mo采用眼反应分析仪测量角膜补偿眼压(corneal compensated intraocular pressure,IOPcc)、角膜阻力因子(corneal resistance factor,CRF)、角膜滞后量(corneal hysteresis,CH)以及模拟Goldmann眼压(Goldmann correlated IOP value,IOPg),采用A型超声测量仪测量中央角膜厚度。

结果：术后3、6mo中央角膜厚度显著低于术前,差异有统计学意义(P<0.05); 术后3、6mo时IOPcc、CRF、CH、IOPg等角膜生物力学指标均显著低于术前,差异有统计学意义(P<0.05); 术后3、6mo各指标比较,差异无统计学意义(P>0.05); 角膜切削厚度为98.67±7.56μm,CH和CRF变化量分别为3.40±0.34mmHg、3.55±0.43mmHg,角膜切削厚度与CH、CRF变化量呈明显正相关(r=0.232、0.254,P<0.001)。

结论：飞秒激光LASIK术后角膜厚度显著降低,术后各项角膜生物力学指标均显著下降,且3mo后基本趋于稳定。     

SMILE与FS-LASIK术后眼压和角膜生物力学指标的变化比较

目的：比较飞秒激光小切口角膜基质透镜取出术(small incision lenticule extraction,SMILE)、飞秒辅助LASIK术(FS-LASIK)两种手术方式术后眼压和角膜生物力学指标的变化。

方法：选取我院自愿接受SMILE手术101例202眼和FS-LASIK手术101例202眼近视患者,分别于术前、术后1mo应用眼反应分析仪(ocular response analyzer,ORA)检测角膜补偿眼压(corneal compensated intraocular pressure,IOPcc)、模拟Goldmann眼压(Goldmann correlated IOP value,IOPg)、角膜阻力因子(corneal resistance factor,CRF)、角膜滞后量(corneal hysteresis,CH)。比较术后1mo与术前测量值的差异,两组CRF、CH降低值的差异。

结果：术后1mo SMILE组IOPcc、IOPg分别为13.84±2.22、10.81±2.52mmHg,较术前16.15±2.90、15.95±3.08mmHg显著降低(t=-13.58、-32.91,均P<0.01)。CRF、CH术后测量值7.52±1.41、8.66±1.19mmHg较术前10.72±1.61、10.60±1.43mmHg显著降低(t=-41.21、-24.03,均P<0.01)。CRF、CH分别较术前降低3.19±1.10、1.93±1.14mmHg。FS-LASIK组术后1mo IOPcc、IOPg分别为13.99±2.33、10.10±2.55mmHg,较术前15.88±3.29、14.86±3.34mmHg显著降低(t=-10.09、-23.00,均P<0.01)。CRF、CH术后测量值6.68±1.14、7.90±1.27mmHg较术前9.93±1.85、9.98±1.60mmHg显著降低(t=-24.84、-18.90,均P<0.01)。CRF、CH分别较术前降低3.25±1.86、2.08±1.57mmHg。CRF、CH术后降低值SMILE 组显著小于FS-LASIK组(t=-0.351、-1.081,均P<0.01)。

结论：两种手术方式术后角膜生物力学和眼压测量值均较术前显著降低。CRF、CH术后降低值,SMILE 组显著低于FS-LASIK组。     

白内障超声乳化术中不同位置透明角膜切口对术后手术源性角膜高阶像差的影响

目的：比较白内障超声乳化术中不同位置2.8mm透明角膜切口术后手术源性角膜高阶像差的改变情况。

方法：回顾性分析2015-03/2016-04于我院行白内障超声乳化手术治疗并采用2.8mm透明角膜切口的100例100眼白内障患者的临床资料，按切口位置分为A组(颞侧透明角膜切口， 55眼)、B组(上方透明角膜切口，45眼)，比较两组患者术前和术后1d，1wk，1、3mo最佳矫正视力(best corrected visual acuity，BCVA)、手术源性散光(surgically induced astigmatism，SIA)和角膜地形图的变化，并采用波前像差分析仪测定角膜波前像差，记录角膜6mm范围内高阶像差的变化。

结果：术后1d，1wk，1、3mo，两组患者BCVA(LogMAR值)均降低，与术前比较差异有统计学意义(P<0.05)，A组患者术后1d、1wk、1mo时BCVA(LogMAR值)均低于B组(P<0.05)； 术后1wk，1、3mo两组患者SIA均降低(P<0.05)，A组术后不同时间点SIA均低于B组，差异有统计学意义(P<0.05)； 术后1d两组患者表面非对称性指数(surface asymmetry index，SAI)、表面规则指数(surface regularity index，SRI)均上升，术后1wk，1、3mo逐渐降低，A组术后1d、1wk时SRI、SAI均低于B组(P<0.05)； 术后3mo，A组角膜表面总高阶像差(total higher-order aberrations，tHOAs)、四阶球差(spherical aberration，SA)与B组比较，差异有统计学意义(P<0.05)。

结论：白内障超声乳化手术采用2.8mm颞侧透明角膜切口可促进患者术后视力恢复，减轻手术对角膜形态的影响，降低角膜高阶像差。     

角膜地形图引导下不同手术切口对超声乳化术后角膜表面形态和泪膜的影响

目的：分析在角膜地形图引导下不同角膜切口对白内障超声乳化术后角膜表面形态和泪膜的影响。

方法：回顾性研究。选取2019-06/2020-12在我院行白内障超声乳化术患者56例60眼为研究对象,分为透明角膜切口组和角巩膜缘切口组,对存在角膜散光的患者,做与散光同轴向切口。比较术前及术后1wk,1、3mo最佳矫正视力(BCVA)、OSDI问卷、泪膜破裂时间(TBUT)、角膜表面规则指数(SRI)、角膜表面非对称指数(SAI)和角膜表面散光值(CYL)。

结果：两组术后BCVA较术前均提高(P<0.01); 术后1wk,3mo两组患者OSDI评分较术前有差异(P<0.01); 术后1mo两组TBUT较术前均有不同程度缩短(P<0.05); 两组术后SAI和SRI均呈现不同程度上升,术后1wk,1mo角巩膜缘切口组SAI值明显低于透明角膜切口组(P<0.05); 术后1wk两组CYL增长较术前均显著(P<0.05),随着时间的推移逐渐下降,术后3mo时透明角膜切口组较术前仍有所增高。

结论：角巩膜缘切口对术后角膜表面形态及泪膜的影响更小,能有效降低患者术后眼部不适症状。     

飞秒激光与角膜板层刀辅助LASIK术后早期角膜生物力学变化的比较

目的：基于角膜基质床厚度/术前角膜厚度(residual corneal stroma thickness /corneal thickness,RCST/CT)的不同,比较飞秒激光辅助LASIK和角膜板层刀辅助LASIK术后早期角膜生物力学的变化。

方法：选取190例379眼,其中飞秒激光辅助LASIK组94例187眼,角膜板层刀辅助LASIK组96例192眼。根据术后剩余RCST/CT的不同,将飞秒激光辅助LASIK组(FS-IK组)和角膜板层刀辅助LASIK组(M-IK组)各分为三组,IK-Ⅰ组(RCST/CT<55%)、IK-Ⅱ组(55%≤RCST/CT<60%)和IK-Ⅲ组(RCST/CT≥60%)。分别于术前、术后1mo和3mo应用眼反应分析仪(reichert ocular response analyzer,ORA)检测角膜滞后量(corneal hysteresis,CH)和角膜阻力因子(corneal resistance factor,CRF)。

结果：不同手术方式(FS-IK与M-IK)比较,CH和CRF均无统计学差异(F=0.44,F=2.56,P=0.51,P=0.11)。不同的RCST/CT比较,CH和CRF均有统计学差异(F=103.03,128.48,P均<0.05)。Ⅰ组CH和CRF较Ⅱ组明显减小(P<0.05),Ⅱ组CH和CRF较Ⅲ组明显减小(P<0.05),Ⅰ组CH和CRF较Ⅲ组明显减小(P<0.05)。术前及术后不同时间比较,CH和CRF均有统计学差异(F=576.99, 1162.06,P均<0.05)。术后1mo和3mo,CH和CRF均较术前明显减小(P<0.05),术后1mo和术后3mo比较,CH和CRF差异无统计学意义(P>0.05)。

结论：无论是飞秒激光辅助LASIK还是角膜板层刀辅助LASIK在术后早期角膜生物力学参数均下降,但两种手术方式对角膜生物力学的影响无差异。LASIK术后保留角膜基质床比例越小对角膜生物力学的影响越大。     

飞秒激光和角膜板层刀制瓣LASIK术后泪膜的变化

目的：观察飞秒激光和角膜板层刀制瓣LASIK术后泪膜的变化。

方法：回顾性分析150例300眼近视患者,根据制作角膜瓣方法不同分为两组,组1为飞秒激光(Intralase FS60KHz)制作角膜瓣,95例190眼; 组2为Moria M₂ 90号板层刀制瓣,55例110眼。观察两组术前、术后1wk; 1,3,6mo患者的干眼症状评分、泪膜破裂时间(tear break-up time,BUT)、泪液分泌试验(Schirmer I test,S I t)、角膜荧光素染色(corneal fluorescence staining,FL)评分的变化。

结果：干眼症状评分：两组术后1wk; 1,3mo差异有统计学意义(P<0.05),术后6mo差异无统计学意义(P>0.05)。BUT：两组术后1wk; 1,3mo差异有统计学意义(P<0.05),术后6mo差异无统计学意义(P>0.05)。SchirmerⅠ试验：两组术后1wk; 1,3mo差异有统计学意义(P<0.05),术后6mo差异无统计学意义(P>0.05)。荧光素染色评分：两组术后1wk; 1,3mo差异有统计学意义(P<0.05),术后6mo差异无统计学意义(P>0.05)。

结论：飞秒激光和角膜板层刀制瓣LASIK术后早期泪膜功能减退,但飞秒激光制瓣术后泪膜功能恢复更快。     

高龄硬核白内障小切口非超声乳化与超声乳化术后角膜内皮细胞观察

目的：对比观察高龄硬核白内障小切口非超声乳化与超声乳化术后角膜内皮细胞的变化。

方法：回顾性分析行小切口非超声乳化的白内障囊外摘除联合人工晶状体植入术者为A组36例40眼,超声乳化术联合人工晶状体植入术者为B组38例46眼,比较两组手术时间,术前,术后1、6mo裸眼视力、角膜内皮的变化。

结果：两组的手术时间比较无差异; 术后1mo UCVA≥0.5的术眼,两组间比较差异有统计学意义(χ²=5.174,P=0.023); 术后1、6mo两组间角膜内皮细胞计数比较,差异有统计学意义(t=2.565,P=0.038; t=2.774,P=0.041),角膜内皮细胞丢失率比较,差异均有统计学意义(P<0.05)。术后1、6mo两组间细胞平均面积(AVC)比较,差异有统计学意义(t=2.225,P=0.045; t=2.153,P=0.039); 两组术后1、6mo两组间变异系数(CV)比较,差异均有统计学意义(P<0.05)。

结论：小切口非超声乳化是治疗高龄硬核白内障患者更安全、有效的手术方法。     

丝裂霉素C辅助PRK的临床观察及并发症分析

目的： 观察丝裂霉素C(mitomycin C, MMC)辅助准分子激光角膜切削术(PRK)的疗效及并发症分析。

方法：回顾性临床病例研究。随机选择2009年40例80眼实施PRK治疗近视的患者作为常规组,2010年PRK术中应用0.2g/L MMC 20s的40例80眼作为MMC组。术后7d; 1,3,6,12mo观察裸眼视力、屈光状态以及角膜上皮愈合、发生糜烂、角膜干燥和haze情况,两组数据进行对比分析。

结果：术后12mo随访期间,两组裸眼视力、术后等效球镜、角膜上皮愈合及干眼情况差异无统计学意义。常规组有2眼,MMC组有9眼发生角膜糜烂伴丝状角膜炎,两组差异有统计学意义(Pearson χ²=4.783,P<0.05)。全部病例均治愈,没有复发病例。常规组、MMC组术后1,3,6,12mo haze的发生率分别为26%,6%,2%,0和44%,25%,10%,2%,术后1mo(Pearson χ²=5.385,P<0.05)、3mo(Pearson χ²=10.667,P=0.001)差异有统计学意义。

结论：PRK术中使用0.2g/L MMC可以减少术后haze的发生。MMC对PRK术中保留的角膜上皮的影响可能是术后角膜糜烂发生的原因之一,术中要避免接触到治疗区外保留的正常角膜上皮。     

翼状胬肉切除联合Ologen胶原基质植入与自体结膜瓣移植术的疗效及安全性

目的：分析翼状胬肉切除联合Ologen胶原基质植入与翼状胬肉切除联合自体结膜瓣移植术后的疗效及安全性。

方法：选取我院2017-01/2020-01收治的翼状胬肉患者80例87眼,随机分为观察组(40例44眼,接受翼状胬肉切除联合Ologen胶原基质植入术)与对照组(40例43眼,接受翼状胬肉切除联合自体结膜瓣移植术)。随访至术后12mo,比较两组患者最佳矫正视力、角膜散光度、表面不对称指数(SAI)、表面规则指数(SRI)、角膜上皮愈合、翼状胬肉复发及并发症发生情况。

结果：两组术后6、12mo时视力变化情况均无差异(P>0.05); 两组术后1、3mo时角膜散光度、SAI、SRI较术前均显著下降,观察组术后3mo时角膜散光度及术后1、3mo时SAI、SRI显著低于对照组(均P<0.05); 观察组术后1wk时角膜上皮愈合率显著高于对照组(73% vs 46%,P<0.05),至术后2wk两组角膜上皮均愈合; 两组术后12mo内未见翼状胬肉复发,术后6、12mo时翼状胬肉复发情况均无差异(P>0.05); 两组术后并发症发生率无差异(7% vs 14%,P>0.05)。

结论：翼状胬肉切除联合Ologen胶原基质植入与翼状胬肉切除联合自体结膜瓣移植术治疗翼状胬肉均可获得可靠的疗效,且安全性相当,但前者在改善角膜散光度、角膜创面规则形态上优势更显著,更利于角膜创面恢复规则形态。     

Pentacam与AS-OCT测量眼前节生物参数的比较

目的：在两组人群中比较Pentacam眼前节分析仪与眼前节光相干断层扫描(AS-OCT)测量的角膜曲率及角膜散光、中央角膜厚度和前房深度的差异性、相关性及一致性,为临床使用提供参考。

方法：前瞻性临床研究。纳入青年近视术前检查者64例124眼、年龄相关性白内障患者61例85眼,先后使用Pentacam和AS-OCT进行测量,获得眼前节生物参数。在两组人群中采用配对样本t检验分别对两种仪器测量结果的差异性进行比较,所得数据的相关性采用 Pearson相关性分析,测量结果的一致性采用 Bland-Altman 分析。

结果：近视组两种仪器测得的陡峭角膜曲率(Ks)、平坦角膜曲率(Kf)、平均角膜曲率(Km)有显著差异(P<0.001),而白内障组测得的Ks、Kf、Km无差异(P>0.05),两组人群两种仪器测量的J₀(散光参数)、平均角膜厚度(CCT)、前房深度(ACD)均有差异(P<0.05),测得J₄₅(散光参数)无差异(P>0.05)。两组人群中两种仪器测量的Ks、Kf、Km、J₀、J₄₅、CCT及ACD均具有线性相关(P<0.001)。近视组测量的Ks、Kf、Km的一致性良好,而白内障组测量的Ks、Kf、Km的一致性较差。

结论：Pentacam和AS-OCT测量散光参数、CCT及ACD时具有较好一致性,可互换使用,而测量Ks、Kf、Km时的一致性受年龄相关因素影响,优先考虑选择Pentacam。     

近视人群中角膜生物力学特性的分布

目的：分析伊朗近视眼及散光人群中角膜生物力学参数的分布特征。

方法：对接受激光矫正手术的近视眼及散光患者180眼进行前后节、显然验光等效球镜度、Orbscan II和Zywave全面的术前检查。用眼反应分析仪测量角膜滞后量,角膜阻力因子,模拟Goldmann眼压值及角膜补偿后眼压值。分析所有角膜生物力学的分布特性及其与显然验光等效球镜度、性别和年龄的相关性。数据采用SPSS 17软件进行统计学分析,以P<0.05为有显著性差异。

结果：平均年龄为28.20±6.78岁。平均显然验光等效球镜为-4.21±1.19D。平均角膜滞后量,角膜阻力因子,模拟Goldmann眼压值和角膜补偿后眼压值分别为10.00±1.28mmHg,10.17±1.45mmHg,15.71±2.67mmHg和 16.68±2.41mmHg。近视人群中,28.4%角膜滞后量约为10mmHg,71%从9mmHg增长到11mmHg。25.9%的近视人群的角膜阻力因子为10mmHg,48.7%为9mmHg增长到11mmHg。显然验光等效球镜与角膜滞后量(Rs=0.001,P=0.71)和显然验光等效球镜与角膜阻力因子(Rs=0.01,P=0.18)之间正相关性不明显。

结论：研究显示了伊朗近视眼人群中角膜生物力学的分布特征(角膜滞后量,角膜阻力因子,模拟Goldmann眼压值及角膜补偿后眼压值),并证实了角膜生物力学特性参数和显然验光等效球镜,年龄及性别之间没有统计学相关性。     

Corneal Biomechanical Characteristics in Patıents with Behçet Disease

Aim: To examine corneal biomechanical properties, intraocular pressure, and central corneal thickness in uveitic eyes with Behçet disease (BD) and to compare them with healthy controls. Methods: This study included 40 eyes of 34 patients with ocular BD and 20 eyes of 20 healthy controls. Eyes with ocular BD were subdivided into active and inactive groups. Ocular response analyzer (ORA) measurements were performed on the 20 eyes of 16 patients with active BD (group 1), 20 eyes of 18 patients with inactive BD (group 2), and 20 eyes of 20 healthy volunteers who served as the control group (group 3). Corneal hysteresis (CH), corneal resistance factor (CRF), intraocular pressure (Goldmann correlated [IOPg], and corneal compensated [IOPcc]) and central corneal thickness (CCT) values were recorded. Results: Mean age of patients in groups 1, 2, and 3 was 33.81?±?9.36, 32.38?±?9.08, and 31.05?±?5.85 years, respectively (p?=?0.76). Mean CH, CRF, IOPg, IOPcc, and CCT values in groups 1, 2, and 3 were [8.51?±?1.88, 9.72?±?2.11, 19.87?±?2.92, 16.13?±?3.29, and 592.50?±?39.95], [8.46?±?1.82, 8.45?±?1.98, 15.89?±?2.68, 15.35?±?2.91, and 528.35?±?19.18], and [8.47?±?1.48, 8.43?±?1.58, 15.59?±?2.74, 15.42?±?3.19, and 526.30?±?18.21], respectively [(p₁?=?0.040, 0.904, <0.001, 0.495 and <0.001 for CRF, CH, IOPg, IOPcc and CCT in group 1, respectively), (p₂?=?0.989, 0.904, 0.659, 0.989, and 0.989 for CRF, CH, IOPg, IOPcc and CCT in group 2, respectively), (p₃?=?0.989, 0.904, 0.660, 0.989, and 0.989 for CRF, CH, IOPg, IOPcc and CCT in group 3, respectively)]. Conclusion: CRF, IOPg, and CCT values altered in active BD group when compared with inactive BD and control group (p?相似文献   

LASIK术后角膜生物力学变化与眼压测量值的相关性

目的 观察LASIK术后角膜生物力学参数和眼压测量值的变化及角膜生物力学变化与眼压的相关性。设计 前瞻性病例系列。研究对象 哈尔滨医科大学附属第一医院2014年1-12月LASIK手术患者81例（162眼）。方法 应用非接触眼压计（non-contact tonometer,NCT）分别在术前及术后3个月测量眼压。同时应用眼反应分析仪（ocular response analyzer,ORA）测量角膜滞后量（corneal hysteresis,CH）、角膜阻力因子（corneal resistance factor, CRF）、模拟Goldmann 眼压（Goldmann intraocular pressure,IOPg）和角膜补偿眼压（corneal-compensated intraocular pressure,IOPcc）。比较手术前后各参数的变化并分析术后角膜生物力学参数变化与眼压测量值的相关性。 主要指标 手术前后NCT、IOPcc、IOPg、CH、CRF。 结果 LASIK术后3个月CH、CRF、IOPcc、IOPg、NCT测量值与术前比较均显著降低,术后IOPcc与IOPg和NCT之间比较差异均有统计学意义（P<0.05）;△CH、△CRF与△IOPcc、△IOPcc- IOPg和△IOPcc-△NCT均成负相关,△CH、△CRF与△IOPg和△NCT均成正相关（P<0.05）;CH和CRF的减少量与眼压测量值下降具有相关性（P<0.05）。结论 LASIK术后角膜生物力学参数和眼压测量值均较术前显著降低,眼压测量值下降与CH和CRF的减少量具有相关性,说明眼压下降的程度可能受角膜生物力学特性的影响。     

Are There Any Changes in Corneal Biomechanics and Central Corneal Thickness in Fuchs’ Uveitis?

Purpose: To compare corneal biomechanics, intraocular pressure (IOP) and central corneal thickness (CCT) of 38 patients with unilateral Fuchs’ uveitis (FU) with 42 healthy controls.

Methods: Corneal hysteresis (CH), corneal resistance factor (CRF), Goldmann-correlated and corneal-compensated IOP (IOPg and IOPcc, respectively) and CCT were measured.

Results: The mean CH, CRF, and IOPg of the involved FU eyes were significantly lower (9.5?±?1.6, 9.0?±?1.9 and 13.1?±?4.3?mmHg) than contralateral eyes (10.1?±?1.7, 9.9?±?1.7 and 14.6?±?3.4?mmHg), and controls (10.5?±?1.5, 10.3?±?1.5 and 14.8?±?2.5?mmHg), respectively. There was no significant difference for mean IOPcc between involved FU or contralateral eyes and controls (14.8?±?4.1, 15.5?±?3.4 and 15.0?±?2.7?mmHg). The CCT values correlated with CH and CRF in the involved and contralateral eyes.

Conclusions: Involved FU eyes had lower CH, CRF, and IOPg than contralateral eyes and controls, with no difference regarding IOPcc.     

FS-LASIK与FS-LASIK联合快速角膜胶原交联术矫正高度近视术后早期屈光度及角膜高阶像差比较

目的：比较飞秒激光辅助的准分子激光原位角膜磨镶术(FS-LASIK)与FS-LASIK联合快速角膜胶原交联术(FS-LASIK Xtra)矫正高度近视术后早期屈光度及角膜高阶像差变化特点,评估两种术式矫正高度近视的早期效果。

方法：回顾性病例对照研究。纳入2019-04/2020-04在我院进行FS-LASIK Xtra及FS-LASIK的高度近视患者42例84眼,每组各21例42眼,术后随访3mo,比较两组患者术后裸眼视力(UCVA)、等效球镜(SE)、散光度及角膜高阶像差。

结果：FS-LASIK Xtra组患者术后1d UCVA(LogMAR)低于FS-LASIK组(P<0.01),其余时间点两组间比较均无差异(P>0.05)。两组患者术后SE均较术前明显降低,术后3mo,FS-LASIK Xtra组有38眼(90%)、FS-LASIK组有41眼(98%)术眼SE在±1.00D以内。两组患者术后均有35眼(83%)的术眼残余散光在0.50D以内。两组术后3mo角膜总高阶像差、球差、彗差及三叶草差均较术前增大,FS-LASIK Xtra组总高阶像差及三叶草差大于FS-LASIK组(均P<0.05)。

结论：FS-LASIK与FS-LASIK Xtra矫正高度近视在术后早期均具有较好的有效性和可预测性,术后早期角膜总高阶像差均增加,且行FS-LASIK Xtra增加更显著。     

Corneal biomechanical properties changes after coaxial 2.2-mm microincision and standard 3.0-mm phacoemulsification

AIM: To compare the changes in corneal biomechanics measured by ocular response analyzer (ORA) after 2.2-mm microincision cataract surgery and 3.0-mm standard coaxial phacoemulsification. METHODS: The prospective nonrandomized study comprised eyes with cataract that had 2.2-mm coaxial microincision or 3.0-mm standard incision phacoemulsification. The corneal hysteresis (CH), corneal resistance factor (CRF), corneal-compensated intraocular pressure (IOPcc) and Goldmann-correlated intraocular pressure (IOPg) were measured by ORA preoperatively and at 1d, 1-, 2-, 3- and 4-week postoperatively. Results were analyzed and compared between groups. RESULTS: In both groups, CH decreased in the immediate postoperative period (P<0.05), returned to the preoperative level at one week (P=0.249) in the 2.2-mm group, and at two weeks in the 3.0-mm group (P=0.264); there was no significant change in CRF values. In 2.2-mm group, mean IOPcc and IOPg increased at 1d postoperatively (both P<0.05), and returned to preoperative level at one week (P=0.491 and P=0.923, respectively). In 3.0-mm group, mean IOPcc and IOPg increased at 1d and 1wk postoperatively (P=0.005 and P=0.029, respectively), and returned to preoperative level at 2wk (P=0.347 and P=0.887, respectively). CONCLUSION: Significant differences between preoperative and postoperative corneal biomechanical values were found for CH, IOPcc and IOPg. But the recovery time courses were different between the two groups. The 2.2-mm coaxial microincision cataract surgery group seemed recovery faster compared to the 3.0-mm standard coaxial phacoemulsification group.     

Evaluation of corneal biomechanical properties following penetrating keratoplasty using ocular response analyzer

Purpose:

To evaluate corneal biomechanical properties in eyes that has undergone penetrating keratoplasty (PK).

Materials and Methods:

Retrospective observational study in a tertiary care centre. Data recorded included ocular response analyzer (ORA) values of normal and post-keratoplasty eyes [corneal hysteresis (CH), corneal resistance factor (CRF), Goldmann-correlated intraocular pressure (IOPg), and cornea-compensated intraocular pressure (IOPcc)], corneal topography, and central corneal thickness (CCT). Wilcoxon signed rank test was used to analyze the difference in ORA parameter between post-PK eyes and normal eyes. Correlation between parameters was evaluated with Spearman''s rho correlation.

Results:

The ORA study of 100 eyes of 50 normal subjects and 54 post-keratoplasty eyes of 51 patients showed CH of 8.340 ± 1.85 and 9.923 ± 1.558, CRF of 8.846 ± 2.39 and 9.577 ± 1.631 in post-PK eyes and normal eyes, respectively. CH and CRF did not correlate with post-keratoplasty astigmatism (P =0.311 and 0.276, respectively) while a significant correlation was observed with IOPg (P =0.004) and IOPcc (P < 0.001).

Conclusion:

Biomechanical profiles were significantly decreased in post-keratoplasty eyes with significant correlation with higher IOP as compared with that in normal eyes.     

全飞秒激光小切口角膜基质透镜取出术对角膜表面规则指数的影响

目的:分析全飞秒激光小切口角膜基质透镜取出术(SMILE)对角膜表面规则指数(SRI)的影响。方法:回顾性病例研究。选取2017-01/2019-12秦皇岛视光眼科医院210例401眼近视患者为研究对象,依据采取的矫正手术将其分为观察组110例205眼行SMILE,对照组100例196眼行飞秒激光辅助的准分子激光原位角膜磨镶术(FS-LASIK)。比较两组患者手术前后裸眼视力(UCVA)、最佳矫正视力(BCVA)、角膜前表面6mm范围的非球面参数Q值和SRI。结果:术后3、6mo两组患者UCVA、BCVA均较术前改善(P<0.05),但组间比较无差异(P>0.05);观察组术后3、6mo、1a SRI高于对照组(P<0.05);术后两组患者各时点非球面参数Q值均高于术前,且观察组术后6mo,1a非球面参数Q值低于对照组(P<0.05)。结论:与FS-LASIK相比,SMILE术后有相似的视力恢复效果,但SMILE术后SRI大、对非球面参数Q值影响小。     

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.