超声乳化白内障摘除术的角膜内皮细胞观察

用角膜内皮细胞分析仪对５８例（６９眼）超声乳化白内障摘除术行内皮细胞观察。手术前和术后３－６月的内皮细胞密度分别为２５８１．９±３４３．２个／ｍｍ２和２２７４．６±４０６．７个／ｍｍ２，细胞丧失率为１１．９％。平均细胞面积分别为３４２．１８±１３９．２１μｍ２和３９３．０３±２０３．４５μｍ２，变异系数分别为４０．６８％和５１．７％，六角形细胞比率分别为５５．３±１３．６％和４６．４±１７．１％，均有显著性差异。角膜厚度分别为５６１．８±３６．７μｍ和５７０．１±３４．４μｍ，无显著性差异。术后矫正视力０．５以上者占８９．７％，１．０以上者占６１．８％。     

深低温长期保存角膜穿透性角膜移植术临床报告

目的　评价深低温长期保存角膜在穿透性角膜移植术中的应有价值。方法　应用深低温长期保存２１ ～１ ２３０ｄ 的供眼角膜行穿透性角膜移植术３４ 例（３５ 眼） 。结果　术后随访２ ～３０（ 平均７３ ±４０） ｍｏ ,角膜植片透明率达８２９ ％ ,部分患者视力改善,角膜植片内皮细胞密度达９０３ ～３ ０８３７ 个·ｍ ｍ －２（ 平均１ ６４１８ ±５９９３ 个·ｍ ｍ － ２） 。结论　深低温长期保存角膜具有较好的临床应用价值     

恶性高血压性视网膜病变的光学相干断层扫描观察

目的　评价使用光学相干断层扫描（ｏｐｔｉｃａｌｃｏｈｅｒｅｎｃｅｔｏｍｏｇｒａｐｈｙ,ＯＣＴ）对恶性高血压性视网膜病变疗效观察的有效性。方法　对２６例（３１眼）恶性高血压性视网膜病变患者的资料进行回顾性分析,对比分析治疗前及治疗后１５ｄ、１个月、３个月时的视力、视盘周围视网膜神经纤维层厚度、黄斑区视网膜神经上皮层厚度和黄斑区６ｍｍ直径神经上皮总体容积的变化。结果　与治疗前相比,治疗后１５ｄ视力提高者２２眼,治疗后１个月为２６眼,治疗后３个月为２９眼。患者视盘周围视网膜神经纤维层厚度及黄斑区视网膜神经上皮层厚度治疗前为（３９３．２０±１８．０５）μｍ和（４８６．５８±６９．００）μｍ,治疗后１５ｄ、１个月、３个月分别为（３６３．２０±２６．８０）μｍ和（３９２．１３±３０．６５）μｍ、（３４２．７５±２５．８２）μｍ和（３１５．０３±２２．３３）μｍ、（３０５．６４±２３．３８）μｍ和（２１３．８７±２５．６８）μｍ;黄斑区６ｍｍ直径神经上皮总体容积治疗前为（１７．０４±３．３１）ｍｍ３,治疗后１５ｄ、１个月、３个月分别为（１１．０７±２．０２）ｍｍ３、（９．３６±０．９３）ｍｍ３、（８．４２±０．７５）ｍｍ３;各指标与治疗前比较差异均具有统计学意义（均为Ｐ＜０．０５）,治疗后各时间点间两两比较差异亦均有统计学意义（均为Ｐ＜０．０５）。结论　恶性高血压性视网膜病变的视盘周围视网膜神经纤维层厚度、黄斑区视网膜神经上皮层厚度和黄斑区６ｍｍ直径神经上皮总体容积变化与其病变程度相关,ＯＣＴ对恶性高血压性视网膜病变疗效评价具有重要意义,能够为病情的追踪和指导用药提供客观依据。     

飞秒激光辅助超声乳化白内障吸出术临床观察

目的　评价飞秒激光辅助的超声乳化白内障吸出术临床效果及安全性。方法　２４例（３６眼）白内障患者采用飞秒激光辅助进行超声乳化白内障吸出术。术前裸眼视力为眼前数指～０．５,采用ＬｅｎＳＸ飞秒激光系统进行前囊膜切开、碎核、透明角膜切口。观察术后患者视力、角膜内皮细胞计数、并发症等情况。结果　所有患者手术顺利,术中无并发症发生。术后１ｄ,裸眼视力从术前眼前数指～０．５提高到０．１～１．２。术前内皮细胞计数平均为２７３３ｍｍ－２,随访至术后１个月时,内皮细胞计数平均为２５２９ｍｍ－２,术后内皮细胞丢失率为７％。结论　飞秒激光辅助的超声乳化白内障吸出术治疗白内障具有良好的临床效果及安全性。     

同轴微小切口超声乳化吸出术在闭角型青光眼滤过术后白内障中的应用

目的　比较同轴微小切口与标准切口超声乳化吸出术在原发性闭角型青光眼（ｐｒｉｍａｒｙａｎｇｌｅｃｌｏｓｕｒｅｇｌａｕｃｏｍａ,ＰＡＣＧ）滤过术后白内障摘出术中的安全性与有效性。方法　连续收集抗ＰＡＣＧ滤过术后白内障患者７２例（９０眼）,随机分为两组:试验组３７例（４９眼）行２．０ｍｍ同轴微小切口超声乳化术,对照组３５例（４１眼）行３．０ｍｍ标准透明角膜切口超声乳化术,观察两组术中有效超声乳化时间、超声能量及术中前房稳定性,于术后１ｄ、７ｄ观察角膜水肿、视力情况,同时于术前、术后７ｄ观察两组患者角膜内皮细胞计数、角膜散光。结果　试验组和对照组患者术中超声乳化时间分别为（６．４３±１．０３）ｓ、（６．５４±１．２５）ｓ,超声能量分别为（１６．５２±２．３５）％、（１５．９４±３．５３）％,两组间超声乳化时间和超声能量比较,差异均无统计学意义（均为Ｐ＞００５）。两组术后角膜水肿均以１级为主,术后１ｄ、７ｄ两组角膜水肿程度比较,差异均有统计学意义（均为Ｐ＜０．０５）。术后１ｄ、７ｄ试验组最佳矫正视力均好于对照组,差异均有统计学意义（均为Ｐ＜０．０５）。试验组术前角膜散光为（０．５２±０．２８）Ｄ,术后７ｄ为（０．５６±０．３２）Ｄ,差异无统计学意义（Ｐ＞０．０５）;对照组术前角膜散光为（０．４９±０．３１）Ｄ,术后７ｄ为（０．７２±０．４３）Ｄ,差异有统计学意义（Ｐ＜０．０５）;两组术后７ｄ角膜散光比较,差异有统计学意义（Ｐ＜０．０５）。两组术后７ｄ角膜内皮细胞计数均低于术前（均为Ｐ＜０．０１）;术后７ｄ试验组角膜内皮细胞计数高于对照组,差异有显著统计学意义（Ｐ＜０．０１）。结论　同轴微小切口超声乳化术具有术中前房稳定性好,术后角膜内皮细胞丢失率低,促进视力迅速恢复,安全可靠等优点。     

抽空房水C3F8充填前房全眼球保存角膜在穿透角膜移植中的应用

为验证抽空房水前房内注入Ｃ３Ｆ８全眼球湿房保存角膜延长角膜内皮细胞的存活时间。取人尸体眼球３０只，保存平均４．３天，行同种异体部分穿透角膜移植术，术后随访平均８．８个月。通过角膜透明度，角膜厚度，角膜内皮细胞的活体观察等证明内皮细胞的存活情况及功能。结果术后观察期间内角膜植片均透明，角膜厚度术后１个月恢复正常，内皮细胞密度在１５００～５３００个／ｍｍ２，术后有３例发生排斥反应，及时治疗得到控制。结论：抽空房水前房内注入Ｃ３Ｆ８全眼球湿房保存角膜７天内内皮细胞活性良好，并可应用于临床。     

飞秒激光深基质切削供体角膜基质面的规则性评估

目的:观察飞秒激光深基质切削角膜供体的精准性及基质面光滑程度.方法:FS200型飞秒激光对眼库中期保存的供体角膜5只做深基质切削,将同一供体角膜分割为板层植片和内皮植片,预留后板层厚度大于150μm.激光频率200kHz,激光能量基质切削选择1.2μ.J,边切能量1.2μJ.观察指标:角膜内皮瓣厚度、切割后的角膜组织学变化(HE染色)、电镜下角膜基质面规则程度评级.结果:供体角膜平均厚度为534±24μm.预设角膜后板层厚度为199±7μm,获得后板层厚度在196±40μm(Z=-0.13,P=0.89).角膜组织HE染色显示切削面略有不光滑.扫描电镜下,前板层基质面规则程度评分1.2±0.4分,角膜后板层基质规则程度评分为2.4±0.5分,差异有统计学意义(Z=-2.12,P=0.03).结论:FS200飞秒激光深基质切削精准性良好.FS200飞秒激光制备供体角膜的前板层较后板层基质面光滑.     

糖尿病视网膜病变患者白内障超声乳化术后黄斑水肿的分析

目的　观察糖尿病视网膜病变患者白内障超声乳化术后黄斑水肿情况并分析其部分原因。方法　本研究为前瞻性研究,对在北京大学第三医院眼科中心行常规白内障超声乳化的糖尿病患者分别在术前及术后１个月、３个月时行相关检查并对结果进行统计学分析。结果　共６５例９６眼纳入数据分析。术后１个月、３个月视力分别为（０．０８±０．１３）ＬｏｇＭＡＲ和（０．０７±０．１１）ＬｏｇＭＡＲ,均较术前的（０．５９±０．１８）ＬｏｇＭＡＲ明显升高（均为Ｐ＜０．００１）。黄斑中心厚度术前为（２５３．６±２９．２）μｍ,术后１个月时增加至（２７７．１±１００．２）μｍ（Ｐ＝０．００８）,术后３个月时增加至（２７５．０±９４．１）μｍ（Ｐ＝０．０１０）,而黄斑内环区视网膜厚度则从术前的（３２１．３±２５．０）μｍ分别增加至术后１个月的（３４２．１±６５．６）μｍ（Ｐ＜０．００１）和术后３个月的（３４７．７±８０．０）μｍ（Ｐ＜０．００１）,黄斑外环区视网膜厚度则从术前的（２７８．８±１９．９）μｍ增加至术后１个月的（２８８．６±５０．１）μｍ（Ｐ＝０．０２５）和术后３个月的（２８９．６±５４．１）μｍ（均为Ｐ＝０．０２５）。黄斑容积从术前的（１０．１１±０．７３）ｍｍ３增加至术后１个月的（１０．６５±２．３１）ｍｍ３（Ｐ＝０．００６）和术后３个月的（１０．７３±２．４４）ｍｍ３（Ｐ＝０．００３）。术前共２２眼存在糖尿病性黄斑水肿（ｄｉａ-ｂｅｔｉｃｍａｃｕｌａｒｅｄｅｍａ,ＤＭＥ）,其中中心型ＤＭＥ２眼,非中心型ＤＭＥ１４眼,弥漫型ＤＭＥ６眼。不同ＤＭＥ分组术后１个月及３个月的黄斑中心厚度均值及改变量存在显著差异（均为Ｐ＜０．０５）。患眼术后的黄斑中心厚度与术前糖尿病视网膜病变的严重程度相关（１个月时ｒ＝０．３３１,Ｐ＝０．００１;３个月时ｒ＝０．３１８,Ｐ＝０．００２）。但糖尿病病程长短及术前是否行激光治疗与术后黄斑中心厚度无明显相关性。结论　糖尿病患者行常规白内障超声乳化术后有出现黄斑水肿的可能性,患者术后的黄斑水肿程度与术前黄斑水肿的类型以及术前糖尿病视网膜病变严重程度均相关。     

眼前节OCT对角膜穿通伤术后角膜伤口对合及愈合情况的观察

目的　应用眼前节光学相干断层扫描（ａｎｔｅｒｉｏｒｓｅｇｍｅｎｔｏｐｔｉｃａｌｃｏｈｅｒｅｎｃｅｔｏｍｏｇｒａｐｈｙ,ＡＳ-ＯＣＴ）对角膜穿通伤缝合术后的角膜伤口对合及愈合情况进行观察,探讨ＡＳ-ＯＣＴ在角膜伤口愈合过程中的评价作用。方法　回顾性分析２０１２年２月至２０１４年８月在我眼科中心因角膜穿通伤行角膜裂伤缝合术的４６例（４６眼）患者临床资料,术后１ｄ、１周、１个月、３个月、６个月分别行裂隙灯显微镜和ＡＳ-ＯＣＴ检查,对比观察角膜穿通伤缝合术后角膜伤口的最大厚度、角膜水肿的变化、角膜伤口内口的对合及愈合情况。结果　术后１ｄＡＳ-ＯＣＴ显示角膜伤口内口裂开１５例（３２．６％）,角膜伤口内口出现高低错位１７例（３６．９％）,角膜伤口对合良好１１例（２３．９％）,伤口内口有眼内容物附着３例（６．５％）。所有患者术后１ｄＡＳ-ＯＣＴ显示角膜伤口不同程度水肿,角膜伤口内口裂开、内口高低错位、对合良好这三种伤口形态伤口处最大角膜厚度分别为（１２２４．１±１９３．５）μｍ、（１２６７．１±１８４．３）μｍ、（１０８６．３±１１７．１）μｍ,内口错位患者角膜伤口厚度最大,内口对合良好患者角膜伤口厚度最小,术后１ｄ、１周、３个月两者之间差异均有统计学意义（均为Ｐ＜０．０５）。术后１ｄ、１周、１个月检查时,角膜伤口内口裂开、高低错位、对合良好患者角膜伤口处厚度与对侧眼对称部位角膜厚度相比差异均有统计学意义（均为Ｐ＜０．０５）。对合良好患者术后３个月时角膜伤口处厚度与对侧眼对称部位角膜厚度比较差异无统计学意义（Ｐ＞０．０５）,角膜内口裂开患者术后６个月时角膜伤口处厚度与对侧眼对称部位角膜厚度比较差异无统计学意义（Ｐ＞０．０５）,内口高低错位患者术后６个月时角膜伤口处厚度与对侧眼对称部位角膜厚度比较差异仍有统计学意义（Ｐ＜０．０５）。结论　ＡＳ-ＯＣＴ能清晰地观察角膜伤口的对合及愈合过程,是评价角膜裂伤缝合术后角膜伤口愈合情况的有效工具。     

正常人眼的角膜厚度

用ＮＩＤＥＫ超声角膜测厚仪对９７人（１９０只眼）正常角膜行中央、旁中央和周边部共９个点测量。结果表明此３部分的平均厚度分别为５４８．２±４０．１μｍ、５８５．３±３７．７μｍ和６９３．６±３７．９μｍ。在各部分中以上方为最厚，颞侧最薄。另外不同性别和眼别的角膜厚度均无显著性差别，儿童的角膜较成人的厚。     

Improvement of human corneal endothelium in culture after prolonged hypothermic storage

PURPOSE: To evaluate whether the organ culture method for human cornea preservation may be applied to corneas stored for several days at 4 degrees C. METHODS: The cell density, viability, and morphology of corneal endothelium were examined in 140 human corneas stored at 4 degrees C for the minimal time required for transport to the bank and for the preliminary controls of cornea status (1.6 +/- 1.1 days) and in 46 corneas preserved at 4 degrees C for 6.1 +/- 1.9 days in Optisol-GS. The evaluation was repeated after 19.7 +/- 9.1 days of incubation at 31 degrees C in a culture medium containing 2% newborn calf serum. RESULTS: After the hypothermic storage the corneal endothelium had a mean density of 2475 +/- 159 cells/mm2 without significant difference between the short and the long-term incubation. Several corneas of the two groups showed signs of endothelium degeneration and were positive to trypan blue test. After the incubation at 31 degrees C, the corneas with endothelial degeneration decreased by 52.2% and those positive to trypan blue decreased by 21.7%. Polymorphism (enlarged endothelial cells) increased from 9.6% to 14.5% of the corneas. The remodeling of the endothelium led to a 6.7% decrease in cell density. These results were similar after short-term and long-term storage at 4 degrees C. CONCLUSIONS: Organ culture was effective in improving corneal endothelium when the hypothermic storage was prolonged to the upper temporal limit for this procedure (7-10 days). These results may encourage the possibility of an eye bank to allocate the available cornea pool, thus decreasing the risk of discarding precious material.     

应用干燥保存猴角膜对猴眼部分穿透角膜移植实验研究

用干燥保存10～57d 猴角膜,对10只猴(10眼)进行同种异体部分穿透角膜移植。共观察了9眼,最短者1个月,最长11个月以上。结果透明愈合者3眼,半透明2眼。对维持透明8个月的植片,行茜素红和台盼兰联合染色,内皮细胞层呈正常形态。提示:干燥保存角膜内皮细胞,可能并非死细胞。在活体房水培育和再水合作用下,经过一段复苏过程,可以恢复其正常形态和功能。     

飞秒激光在猪眼角膜板层切削中的实验研究

目的:探讨飞秒激光在离体猪眼角膜行板层切削的切削深度、平滑度及可行性。方法:新鲜离体猪眼及甘油保存复水猪眼各10只,利用飞秒激光进行板层切削。激光切削前后对角膜进行测厚,计算角膜瓣厚度。同时选择徒手制作同样直径角膜瓣,扫描电镜观察两种方法制瓣的角膜基质面的形态区别。结果:新鲜离体猪眼角膜瓣厚度为394.10±12.04μm,甘油保存复水后猪眼角膜瓣厚度为366.30±15.28μm。飞秒激光切削的角膜表面较徒手剥离的角膜表面光滑。结论:飞秒激光在离体猪眼表面切削深度与设定切削深度存在差异,其切削表面光滑,在角膜移植中具有广泛应用前景。     

Properties of Corneas Reconstructed with Cultured Human Corneal Endothelial Cells and Human Corneal Stroma

Purpose

To examine the properties of corneas tissue-engineered with cultured human corneal endothelial cells (HCEC) and human corneal stroma.

Methods

Primary HCEC cultures were established from endothelial cell layer explants and propagated on culture dishes coated with bovine corneal endothelial extracellular matrix. A cell suspension of HCEC at the fifth passage was transferred onto human corneal stroma deprived of endothelial cells, and the corneas were gently centrifuged to enhance cell attachment. The cell density of the tissue-engineered corneas was examined after staining with alizarin red and trypan blue. The tissue-engineered corneas were histologically examined by light and electron microscopy. The pump function of the tissue-engineered corneas was measured using an Ussing chamber.

Results

The mean endothelial cell density of four tissue-engineered corneas was 2380 ± 264 cells/mm² (mean ± SD). HCEC on the tissue-engineered corneas had a morphology similar to HCEC in vivo. The pump function parameters of the tissue-engineered corneas were 55%–75% of those of normal corneas.

Conclusions

HCEC on the tissue-engineered corneas have morphology and cellular density similar to HCEC in vivo, whereas the pump function of the tissue-engineered corneas was lower than in normal corneas. Jpn J Ophthalmol 2005;49:448–452 © Japanese Ophthalmological Society 2005     

Corneal function after storage in dexsol or optisol.

Rabbit corneas were stored in Dexsol or Optisol (Chiron, Irvine, CA) for up to 2 wk at 4 degrees C. The thickness of corneas placed in Dexsol decreased 10 microns after they were placed initially in Dexsol, then increased approximately 8 microns/d for 7 d and 3 microns/d thereafter. Corneas placed in Optisol decreased 35 microns in thickness initially, then increased 2 microns/d thereafter. Human corneas showed similar thickness changes to those of the rabbit when stored in these media. After 5.5, 10, and 14 d in storage, rabbit corneas from each medium were cultured to assess their net deturgescence ability. Identical groups were cultured in media containing 20 microM ouabain to monitor the corneas' passive swelling characteristics. Corneas stored in either medium showed similar net deturgescence and passive swelling patterns after each storage period. Deturgescence rates decreased with increasing storage time, primarily because the rates of passive corneal swelling increased with storage time. Knowledge of the net deturgescence and passive swelling rates allowed an estimation of the total deturgescence activity of corneas after removal from Dexsol or Optisol. The total deturgescence activity of corneas stored in Dexsol for 5.5, 10, and 14 d was 85%, 68%, and 63% of control corneas, which were processed identically but not stored before culture. Corneas stored in Optisol exhibited 87%, 71%, and 69% of control deturgescence activity, respectively. These experiments show that Optisol was not significantly better than Dexsol in retaining poststorage corneal deturgescence activity but was superior to Dexsol in preventing corneal swelling during storage.     

Effects of intraocular irrigants on the preserved human corneal endothelium

Either a simple balanced salt solution (BSS) or a bicarbonate-buffered, glutathione-containing commercial irrigant (BSS Plus, Alcon Laboratories, Fort Worth, Texas, U.S.A.) may be used during the vitrectomy portion of a corneal transplant procedure. To simulate the conditions present in the anterior chamber during the first few hours after vitrectomy and grafting, we performed in vitro perfusions of stored human corneas using each irrigant and measured corneal thickness over a 3-hour period. Irrespective of the preservation medium used (McCarey Kaufman, Chondroin Sulfate or Dexsol, all from Chiron Ophthalmics, Irvine, California) or duration of storage (2 or 4 days), corneas irrigated with BSS Plus exhibited significantly (p less than .05) decreased thickness compared with their paired mates irrigated with BSS. In ultrastructural studies performed on postperfusion corneas, there was a tendency toward improved surface morphology in the in vitro BSS Plus-perfused tissue. This study shows that in vitro corneal thickness after preservation is significantly irrigant dependent, with BSS Plus providing the essential ingredients to promote the corneal endothelial pump function.     

LASIK术中用飞秒激光制瓣的临床观察

目的 观察LASIK术中使用飞秒激光制作角膜瓣的临床效果及分析飞秒激光仪制作不理想瓣的处理方法.方法 将2402例(4697眼)应用飞秒激光制作角膜瓣后行LASIK的近视患者.根据术前设计角膜瓣厚度分成90 μm的255例(479只眼),110 μm 2091例(4138只眼),140 μm 56例(80只眼),术后1周使用傅立叶光学相干断层扫描测量角膜瓣的实际厚度进行分析.结果 术后1周实际角膜瓣厚度:90 μm角膜瓣平均厚度[90.54±6.06(82～ 101 )]μm,110 μm角膜瓣平均厚度[109.79±7.62(103～116)]μm,140μm角膜瓣平均厚度[138.85±5.68(129～147)]μm,术后实际角膜瓣厚度与术前预先设计角膜瓣厚度差异无统计学意义(P＞0.01).在制瓣过程中,出现5种不理想的角膜瓣问题:角膜切削基质面中心颗粒大、角膜切削面基质面有条纹、角膜切削基质面条形粘连、角膜切削基质面中心粘连、飞秒激光切削角膜后角结膜结合处出现气泡,并总结其处理方法.结论 飞秒激光制作角膜瓣行LASIK,切削精确、安全性高,在一定程度上可抑制手术造成的像差、提高对比敏感度.     

Endothelial cell survival on transplanted human corneas preserved by organ culture with 1.35% chondroitin sulfate

We transplanted 30 donor corneas preserved at 34 C for 15 to 33 days in culture medium containing 1.35% chondroitin sulfate and compared them with 30 corneas transplanted during the same period, but preserved only in McCarey-Kaufman medium at 4 C for one to 81 hours. Two months after keratoplasty there was no statistically significant difference in central endothelial cell loss between the organ-cultured grafts and those preserved in McCarey-Kaufman medium (9% vs 7% cell loss, respectively). The study detected with 90% power a difference in cell loss of approximately 10% or more. On the first postoperative day, the organ-cultured grafts were thicker than those grafts preserved in McCarey-Kaufman medium, and the thickest corneas were those cultured for the longest times. The corneal thickness was similar in the two groups after three weeks. These results demonstrated that donor corneal endothelial cells preserved for up to one month at 34 C in 1.35% chondroitin sulfate appear to survive and function after keratoplasty as well as those preserved at 4 C for one to three days in McCarey-Kaufman medium.     

Corneal function after storage in commercial eye bank media

Rabbit corneas were stored in commercially prepared media (K-Sol, M-K, CSM, or Dexsol) for 3, 6, 9, or 12 days. Corneas stored in each medium showed decreased post-storage deturgescence with increased storage time. This effect was most pronounced in corneas stored in K-Sol, followed by those in M-K, CSM, and Dexsol. Corneas stored in K-Sol also exhibited the fastest swelling rate when cultured in the presence of 20 microM ouabain, followed by those in M-K, Dexsol, and CSM. An estimate of the active ion transport capacity of each experimental group was made by determining the area between each group's corneal thickness profiles in the presence and absence of ouabain. Corneas stored in M-K, K-Sol, or CSM retained approximately 70% of control activity after 3 days storage and 65% after 6 days storage. Corneas stored in Dexsol had 92% of control activity after 3 days of storage, 78% after 6 days, and 44% after 12 days.     

高度近视VisuMax飞秒激光制作超薄角膜瓣预测性研究

目的探讨VisuMax飞秒激光制作超薄角膜瓣应用于高度近视的可预测性及其影响因素。方法前瞻性临床研究。连续选取11例（21眼）欲行飞秒激光原位角膜磨镶术高度近视患者．使用VisuMax飞秒激光制作预计瓣厚度为85μm的超薄角膜瓣,制瓣前、后分别使用A型超声测厚仪测量术眼中央角膜厚度和中央基质床厚度,相减得出实际瓣厚度,采用Pearson相关分析实际角膜瓣厚度与术前眼压、等效球镜度、角膜曲率、水平角膜直径和角膜厚度的相关性。结果平均术中角膜瓣厚度为（96．0±10．5）μm,角膜瓣厚度与术前眼压、等效球镜度、角膜曲率及水平角膜直径的相关性无统计学意义,与术前中央角膜厚度呈正相关（r=0．512,P=0．018）。结论VisuMax飞秒激光制作超薄角膜瓣应用于高度近视的预测性良好,制作85μm瓣的实际瓣厚度与术前中央角膜厚度相关。