硅油填充眼的超声检查

目的 观察硅油填充眼超声检查的声像特征及影响因素。 方法 对47例47只硅油填充眼硅油取出手术前后分别进行A型（测定眼轴长度）和B型超声检查。 按超声仪默认参数测定硅油取出手术前后眼轴长度及玻璃体腔容积并观察其声像图特征。 结果 A型超声检查，无晶状体眼硅油取出手术前眼轴长度是手术后的1.465倍，有晶状体眼硅油取出手术前眼轴长度是手术后的1.284倍。按硅油在超声波中的传输速度修改参数后，无晶状体眼硅油取出手术前眼轴长度比手术后长(0.78±0.34) mm，有晶状体眼硅油取出手术前眼轴长度比手术后长(0.56±0.32) mm。B型超声检查，硅油填充眼玻璃体腔容积明显扩大，根据硅油填充量的多少，可分为充满型和部分充满型硅油填充声像；合并视网膜脱离的硅油填充眼可见眼后节多个弧形回声带。 结论 硅油填充眼的眼轴增长，其B型超声影像特征主要受超声波在硅油中的传输速度、硅油填充量、硅油乳化等因素的影响。 （中华眼底病杂志，2004，20：349-351）     

硅油填充眼超声生物测量法的临床观察

目的 探讨硅油填充眼超声生物测量法的临床效果.方法 系列病例研究.根据超声测距原理,对相同高度的平衡盐溶液和硅油进行对比研究,计算出其间的测距比例常数(0.674),从而建立硅油填充眼矫正眼轴的测算公式,即公式=ab+0.674×bc(a、b、c分别为角膜顶点、晶状体后极或囊膜中央点、黄斑表面).然后,采用Vivid 7型超声诊断仪对150例(150只眼)硅油填充眼取出硅油前后的眼轴和玻璃体腔前后径进行测量,根据眼轴的长度分为两组,即第1组患者的眼轴长度<25 mm,第2组患者的眼轴长度≥25 mm.其中76只眼在硅油取出联合人工晶状体(IOL)植入术前,按Sanders retzlaff kvaff T公式计算出IOL度数,将术后实际屈光状态与术前预见屈光状态进行比较.两组患者术前后眼轴长度、玻璃体腔前后径、屈光状态进行比较,采用配对t检验.结果 150例(150只眼)硅油填充眼患者术后随访3个月,视网膜病变稳定.生物测量结果:第1组111只眼,硅油取出术前矫正眼轴长度为21.10～24.90 mm,平均(22.77±1.00)mm;硅油取出术后眼轴长度21.00-24.70 mm,平均(22.76±0.99)mm;两者之间的差异无统计学意义(t=0.518,P>0.05);111只眼取出硅油前与后玻璃体腔前后径的超声测量值分别为(26.57±2.14)mm和(17.90±1.38)mm,后者与前者的比值为0.673 78.第2组39只眼,硅油取出术前矫正眼轴长度为25.00～30.58 mm,平均(26.52±1.31)mm;硅油取出术后眼轴长度为25.00～30.59mm,平均(26.53±1.29)mm;两者之间的差异也无统计学意义(t=0.109,P>0.05);39只眼硅油取出前与后玻璃体腔前后径的超声测量值分别为(32.01±2.90)mm和(21.57±2.04)mm,后者与前者的比值为0.673 95.两组76例(76只眼)IOL植入术后患者随访3个月以上,其术后实际屈光状态与术前预见屈光状态分别进行比较,差异均无统计学意义(t_1=0.253,P_1>0.05;t_2=0.209,P_2>0.05).结论 硅油填充眼的超声生物测量法准确、简便,临床应用效果好.     

声速调整法在硅油填充眼眼轴测量中的应用

目的通过调整超声波在硅油中的传导速度，用A型超声测量硅油填充眼眼轴，并验证这一方法的可靠性。方法选取38例硅油填充眼，测出所用型号硅油中超声波的传导速度，以该超声波速度测量硅油填充眼眼轴，与取硅油后3个月再次测量的眼轴长度对比。结果取油前平均眼轴长度为（23．51±0．78）mm，取油后平均眼轴长度为（23.49±0．88）mm，取油前后眼轴长度均值差异无统计学意义（P〉0．05）。结论通过调整超声波在硅油中的传导速度，可准确测量硅油填充眼眼轴。     

A超分段测量法在硅油填充眼生物测量中的应用

目的 评价应用A超分段测量法对硅油填充眼进行生物测量的准确性.方法 前瞻性选取2008年1月至12月间在我院行硅油取出术的硅油填充眼患者29例(29眼),在术前、术后3个月均用眼科A超测量眼轴长度并进行比较;其中硅油填充眼的A超分段测量法采用仰卧位接触法测量,硅油泡长度采用1 532 m·s-1的声速值测得表观长度后乘以0.644,得到硅油泡的实际长度,并考虑到硅油泡下水层的厚度,即计算公式为:硅油填充眼的眼轴长度=前房深度+晶状体厚度+0.644×硅油泡的表观长度+硅油泡下水层的厚度.结果 用眼科A超分段测量法测得术前、术后的眼轴长度平均为(26.11±2.85)mm、(26.06±2.80)mm;同一患眼术前、术后眼轴长度的差值平均为(0.06±0.27)mm,术前、术后测得结果高度相关,相关系数为0.995,差异无统计学意义(P=0.283＞0.05);患眼术后与对侧眼眼轴长度的差值水平为(1.69±2.28)mm,双眼眼轴长度相关性差,相关系数为0.549,差异无统计学意义(P=0.816＞0.05).结论 A超分段测量法可对硅油填充眼进行准确可靠的生物测量.     

A超分段测量法及IOL Master在硅油填充眼生物测量中的应用

目的 评价应用A超分段测量法及光学相干生物测量仪(IOLMaster)对硅油填充眼进行生物测量的准确性.方法 前瞻性选取2008年1月至12月拟行硅油取出术的患者总共29例29眼,手术前、后使用眼科A/B超及IOL Master两种方式测量眼轴,并分别进行比较;A超分段测量法计算公式为:硅油填充眼的眼轴长度=前房深度+晶状体厚度+0.644×硅油泡的表观长度(声速值1532m/s)+硅油泡下水层的厚度.结果 用眼科A超分段测量法测得手术前、后的眼轴长为(26.11±2.85)mm、(26.06±2.80)mm,其差值为(0.06±0.27)mm(P =0.226);IOLMater测得手术前、后的眼轴长为(26.37±2.80)mm、(26.29±2.77)mm,其差值为(-0.04±0.15)mm(P=0.315);IOLMaster测得的术前和术后眼轴长与术后A超眼轴长差值分别为(0.18±0.17)mm(P ＜0.01)、-0.23±0.13 mm(P＜0.01).两种方法在术前术后测得的眼轴长度结果均显示高度相关(相关系数＞0.99).结论 A超分段测量法及IOL Master均可对硅油填充眼进行准确可靠的眼轴测量.     

IOL-Master测量硅油眼轴长精确性的研究

目的:比较IOL-Master与A超测量硅油填充眼轴长的准确性,探讨两种临床应用特点。方法:分析14例玻璃切割术后硅油填充眼分别采取A超和IOL-Master测量眼轴长度。结果:A超测得硅油眼轴长分别为仰卧位22.48±5.19mm,坐位25.10±4.19mm;IOL-Master测得硅油眼轴长为26.32±4.16mm。不同体位A超测量硅油眼轴长度有显著差异(t=-6.27,P<0.01),用IOL-Master和A超两种方法测量硅油眼眼轴长度有显著统计学差异(t=-6.08,P<0.01)。结论:A超和IOL-Master用于正常眼轴长的测量都具有精确性高的特点,IOL-Master采用非接触方法更为简便;对硅油填充眼测量时A超受体位及屈光介质声学性质影响而差异显著,而IOL-Master可克服声学测量缺陷,对于硅油填充眼轴长测量更为准确。因此临床上应根据个体情况选择不同的测量方法以准确测量眼轴长度。     

硅油填充眼A超眼轴测算及人工晶状体度数计算

目的:评价声速调整法测量硅油眼眼轴、测算人工晶状体度数的准确性。方法:对2003/2008年于我院治疗的24例硅油填充术后并发性白内障患者,采取坐位眼轴测量并改变硅油眼中超声波的传播速度来修正眼轴长度,再将计算所得眼轴长度代入SRKII公式计算拟植入的人工晶状体度数。行硅油取出术联合白内障摘除+人工晶状体植入术。术后3mo测量眼轴及屈光状态。对手术前后眼轴长度进行对比,将术后屈光状态与术前预期值比较。结果:硅油取出术前平均眼轴长度为25.25±0.65mm,术后平均眼轴长度为24.80±0.67mm,取油前后眼轴长度均值差异无统计学意义。手术后屈光度与术前预期值差值平均为1.50±0.40D,差异无统计学意义。结论:通过坐位测量并调整超声波在硅油中的传导速度,可准确测量硅油填充眼眼轴,较传统方法测算人工晶状体度数准确率更高。     

硅油填充眼眼轴的A型超声测量

目的 评价修改相应参数后A型超声直接测量硅油填充眼眼轴长度的临床应用效果。方法 将超声波在玻璃体中的传播速度1532m／s改设为在硅油中的传播速度987m／s后，对11例有晶状体硅油填充眼，按A型超声其他默认参数，在“Phakic、Auto＋Save”模式下自动测得眼轴长；13例无晶状体硅油填充眼，在“Aphakic、Manual”模式下，手动测得眼轴长。取平均值，用SRK-T公式计算出IOL度数。硅油取出联合IOL植入术后3个月，在“Acrylic、Auto＋Save”模式下，按A型超声其他默认参数，自动测量眼轴；并测定术后屈光度。结果11例有晶状体硅油填充眼术前眼轴测量值23．94～28．68（平均25．74±1．65）mm；实际眼轴值23．60～28．94（平均25．68±1．73）mm。实际眼轴与术前测量值的差值为-0．51～0．36（平均-0．06±0．30）mm，二者间差异，无统计学意义。13例无晶状体硅油填充眼术前眼轴测量值23．86～28．70（平均25．89±1．50）mm；实际眼轴值23．92～28．52（平均25．82±1．38）mm。实际眼轴与术前测量值的差值为-0．45～0．54（平均-0．07±0．29）mm，二者间差异，无统计学意义。硅油取出联合IOL植入术后，两组屈光度分别为-1．25～1．75（平均-0．07±1．09）D、-2．00～2．25（平均0．31±1．35）D；二者间差异，无统计学意义。结论将超声波在玻璃体中的传播速度改设为在硅油中的传播速度后，再按A型超声其他默认参数，有晶状体眼在。Phakic、Auto＋Save”模式下自动测量、无晶状体眼在“Aphakic、Manual”模式下手动测量，是获得硅油填充眼眼轴值较为准确、快速、实用、价廉的方法，值得推广应用。     

A超测量硅油填充眼眼轴准确性研究

目的:探讨A超在硅油填充眼眼轴测量中的准确性。方法:由于硅油与玻璃体的屈光指数不同,超声波在硅油中的传播速度发生变化,从而可导致眼轴的测量值出现偏差,采用实验的方法对超声波在硅油中的传播速度进行测量,进而对眼轴值进行修正。选取24例行玻璃体切割伴硅油填充术的患者,应用A超分别对患眼、健眼进行眼轴测量,并对所测得患眼眼轴值进行修正,应用IOL-Master对患眼眼轴进行测量,对各眼轴长度进行比较。结果:A超测得患眼眼轴为31.97±6.07mm,修正后患眼眼轴为23.94±4.17mm,健眼眼轴为23.74±1.40mm,IOL-Master测量的眼轴长度为24.77±0.82mm。结论:A超经修正后可准确测量硅油眼的眼轴长度,可以应用于IOL-Master不能测量的病例。     

幼儿人工晶体眼视觉发育探讨及人工晶体度数的选择

目的探讨幼儿植入人工晶体后视觉发育的特点以及选择合理的人工晶体度数的依据.方法随访在1993～1996年于我院施行白内障人工晶体手术的儿童患者68例89眼,手术时年龄分为两组A组2～5岁35例51眼,B组6～14岁33例38眼,观察随访期3～6年患者的眼轴长度和验光屈光度变化.结果A组平均眼轴长度变化为3.09±1.91mm,平均屈光度变化为4.13±2.91D.B组眼轴长度平均变化为0.83±0.77mm,平均屈光度变化为2.08±1.37D.结论儿童人工晶体眼仍存在视觉发育的近视化趋向,故较小年龄患儿人工晶体度数应以低度欠矫为原则.     

Prevalence of dry eye in Japanese eye centers

Background: The purpose of the investigation was to ascertain the prevalence of dry eye in new outpatients. Methods: A total of 2127 consecutive new outpatients seen in eight Japanese centers from April 1992 to January 1993 underwent comprehensive examinations, including double vital staining and measurement of tear film break-up time, basal tear secretion, and tear clearance. Dry eye was diagnosed if patients had abnormalities of both the tear film and the ocular surface. Results: Three hundred fifty-nine patients (17%) had dry eye. There was no seasonal pattern for dry eye. The condition was significantly more common in Tokyo than in suburban areas (P < 0.01). The prevalence of dry eye in visual display terminal (VDT) users and contact lens (CL) wearers was significantly higher than in non-VDT users and non-CL wearers (P < 0.05 and P < 0.02, respectively). Conclusion: Our findings suggest that dry eye is one of the most common ocular disorders encountered by physicians. Furthermore, if patients use VDTs or wear CLs, the likelihood of dry eye occurring is higher.     

A test eye for wavefront eye refractors

PURPOSE: A multi-site study was conducted to test feasibility of a modified automatic refractor style test eye as a test device for wavefront refractors of various types and to determine whether a) they could be measured and b) when measurements could be made, to see if they were similar. This study did not attempt to assess which instrument most accurately measures the aberrations of the test eye or human eye. METHODS: Three automatic refractor style test eyes were modified for use as test devices for wavefront refractors. One had a simple spherical front surface, and two had additional aberrations added. The test eyes and holder were circulated to 11 test sites where attempts were made to measure them with eight different wave-front refractor systems. RESULTS: Eight (100%) of the eight wavefront refractor systems tested successfully measured the test eyes. The systems did not give similar results for the same test eye. In some cases, coma was reported where none was present. Differences in reported defocus values reflect different approaches for compensating for the dispersion of the eye. A corneal topography system could measure and recognize the aberrations of the test eyes as well as the wavefront refractor systems tested. Interferometry, on the other hand, did not prove to be a successful method to assess the surface of the test eyes. CONCLUSIONS: The test eye design may be used as a test device for wavefront refractor systems. This type of test eye can detect systematic differences between various wavefront refractors and can serve as a useful calibration and comparison tool.     

卡波姆眼用凝胶联合聚乙二醇滴眼液治疗干眼症的疗效

目的:探讨卡波姆眼用凝胶联合聚乙二醇滴眼液治疗干眼症的临床疗效.方法:干眼症患者120例240眼随机分为观察组(60例120眼)和对照组(60例120眼),两组患者均给予聚乙二醇滴眼液,观察组在此基础上使用卡波姆眼用凝胶,疗程为1mo.对两组患者白细胞介素-1β(interleukin-1β,IL-1β)水平和肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)水平、眼部症状评分[眼表疾病指数(ocular surface disease index,OSDI)、泪膜破裂时间(break-up time,BUT)、基础泪液分泌试验Ⅰ(SchirmerⅠtest,SⅠt)、角膜荧光素染色(corneal fluorescein staining,FL)]、疗效和不良反应进行比较.结果:治疗后两组患者泪液中IL-1β 和TNF-α 水平、OSDI和FL较治疗前均明显降低,BUT和SⅠt较治疗前均明显升高,差异均具有统计学意义(P<0.05),且观察组泪液中IL-1β水平、TNF-α 水平、OSDI、BUT、SⅠt、FL改善程度均优于对照组(P<0.05).对照组总有效率明显低于观察组,差异具有统计学意义(x2=5.065,P=0.024).两组患者中无1例出现眼部不适症状和药物不耐受.结论:卡波姆眼用凝胶联合聚乙二醇滴眼液治疗干眼症疗效明显,优于单用聚乙二醇滴眼液,且不增加患者的不良反应.     

The role of eye protection in work-related eye injuries

Purpose/Background: A recent survey of general hospitals by the Victorian Injury Surveillance System found that ocular trauma represented 15% of work-related injuries. As circumstances surrounding occupational eye injuries have been poorly documented previously, their associations to occupation, industry and work-safety practices, including safety eyewear use, need to be identified to develop appropriate preventive strategies for high-risk groups.
Design and Setting: From a prospective cross-sectional survey of all eye injuries treated at the Royal Victorian Eye and Ear Hospital, work-related cases were analysed for demographic, occupational and safety eye-wear information. Hospital-based data were supplemented by information from Workcover Authorities and Labour Force statistics to derive incidence and cost estimates.
Results: There were 9390 eye injuries during the 18-month survey period: 42% ( n = 3923) of total and 29% ( n =52) of penetrating ocular injuries occurred at work. The most frequently injured were metal, automotive and building trades workers grinding and drilling (41% of outpatients) and hammering (53% of penetrating eye injuries). Automotive workers had the highest frequency for penetrating injuries, and most were exposed to hammering and were also the least likely to wear safety eye-wear.
Conclusion: Eye injuries are frequent (10% of work-related injuries) and highly preventable by the correct use of safety eye-wear, a cost-effective intervention that may result in cost savings of £59 million for work-type activities in the occupational and domestic settings in Australia each year.     

玻璃酸钠滴眼液联合鱼腥草滴眼液治疗干眼症的疗效观察

目的:研究单纯玻璃酸钠滴眼液,及其联合鱼腥草滴眼液治疗干眼症的临床疗效。方法:选取确诊的干眼症患者125例198眼,随机分为单纯玻璃酸钠滴眼液组(A组)63例100眼和玻璃酸钠滴眼液联合鱼腥草滴眼液组(B组)62例98眼。A组用1g/L玻璃酸钠滴眼液治疗;B组交替给予1g/L玻璃酸钠滴眼液和鱼腥草滴眼液治疗。连续治疗2mo后,比较两组治疗前后的临床症状、泪液基础分泌试验(SⅠt)、泪膜破裂时间(BUT)及角膜荧光素染色(FL)程度。结果:两种治疗方法均可明显改善干眼症患者的临床症状、SⅠt,BUT和FL程度;但B组的主观症状、SⅠt,BUT和FL的改善程度明显优于A组。结论:玻璃酸钠滴眼液联合鱼腥草滴眼液可明显改善干眼症患者的临床症状,提高疗效。     

Dynamic eye plant models and the control of eye movements

Models of the oculomotor plant (globe, muscles, pulleys, and orbital tissues) fall into three categories: 1) one-dimensional dynamic with lumped plant elements, 2) three-dimensional dynamic with lumped plant elements, or 3) three-dimensional static with distinct plant elements. The second class of models is most often used when studying the neural control of 3-D eye movement, because they best represent the plant dynamics. However, they are often faulted because they make two unrealistic assumptions: 1) muscle pairs act along the three orthogonal axes ( symmetry assumption ); and 2) the force generated by the muscles depends only on their innervation ( force assumption ). It turns out that the symmetry assumption is quite benign, because in a realistic model of the plant the deviations from orthogonal axes can be easily accounted for by simple adjustments to the innervation. In contrast, the force assumption introduces some serious problems. In the present paper, the authors show that a realistic, dynamic model of the geometry of the orbit, with independent muscles, makes different predictions than a similar model with lumped muscles. This difference arises because muscle force is a function of both innervation and muscle length.