先天性白内障术后继发青光眼与中央角膜厚度的研究

目的:探讨儿童先天性白内障手术后无晶状体眼或人工晶状体眼的平均中央角膜厚度(CCT)的改变,并与同年龄组健康人群的中央角膜厚度进行对照研究。方法:该实验包括随机抽样的先天性白内障术后的45个无晶状体眼及人工晶状体眼患者共45眼,同时有46个健康的进行性别和年龄配比的志愿者作为对照研究,对他们进行包括中央角膜厚度及眼压(Goldmann眼压计及Tonopen眼压计)的全面的眼部检查。将测得的眼压与角膜中央厚度结果进行分组比较。结果:研究对象的45眼中包括35只无晶状体眼与10只人工晶状体眼,其角膜厚度中位数为626μm(范围为523~870μm),而正常对照组的中央角膜厚度为556.0μm(范围为490~640μm)其差异有统计学意义(P<0.05);先天性白内障患儿术后无晶状体眼与手术时一期植入人工晶状体的眼之间的中央角膜厚度的差异有统计学意义(P=0.011)。但先天性白内障术后的患儿中二期植入人工晶状体眼与无晶状体眼之间中央角膜厚度的差异则不具备统计学意义(P=0.847)。患者的年龄中位数为36mo(年龄从1wk到10岁不等),且其年龄与CCT之间呈负相关(r=-0.485,P=0.001)。结论:儿童先天性白内障术后无晶状体眼与人工晶状体眼的患者显著比正常对照组的角膜变厚。这种差异对解释术后眼内压升高有重要的作用,同时对儿童先天性白内障无晶状体眼患者术后最常见的继发青光眼的并发症的解释有重要的作用。     

婴儿先天性白内障摘出术后早期中央角膜厚度变化与眼压的相关性研究

目的　测量并观察生后１２个月以内行先天性白内障摘出术患儿术后术眼中央角膜厚度（ｃｅｎｔｒａｌｃｏｒｎｅａｌｔｈｉｃｋｎｅｓｓ,ＣＣＴ）及眼压（ｉｎｔｒａｌｏｃｕｌａｒｐｒｅｓｓｕｒｅ,ＩＯＰ）的变化。方法　选取２６例（４９眼）生后１２个月内行白内障摘出术的先天性白内障患儿为观察组,按行手术时月龄分为三组:１组:月龄≤３个月,２组:３个月＜月龄≤６个月;３组:６个月＜月龄≤１２个月。分别在术前、术后１个月、３个月、６个月时测量术眼ＣＣＴ与ＩＯＰ。另选取与各观察组最后一次随访时的患儿年龄与性别相匹配的相对正常眼婴幼儿作为对照组。结果　观察组术后１个月、３个月、６个月的ＣＣＴ为（５７８．３９±４７．７９）μｍ、（５８１．３４±５１．５４）μｍ、（５８８．２９±４９．９０）μｍ,均显著大于术前（５６３．５６±３７．１４）μｍ及对照组（５３４．９６±４０．３４）μｍ（均为Ｐ＜０．０５）。观察组术前、术后１个月、３个月、６个月ＩＯＰ测量值间差异无统计学意义（Ｐ＞０．０５）,观察组术后６个月ＩＯＰ测量值大于对照组（Ｐ＜０．０５）。观察组术后６个月ＣＣＴ与ＩＯＰ线性相关（ｒ＝０．５３８,Ｐ＝０．００４）。结论　婴儿先天性白内障摘出术后早期的ＣＣＴ显著大于正常同龄婴儿,且与ＩＯＰ线性相关。     

角膜中央厚度对眼内压测量值的影响

原发性青光眼是一种常见的致盲性眼病,其发病率约占全民的１％。多年来,青光眼的一个诊断依据和主要特征是病理性高眼压,因此,眼内压的测量准确与否,对于诊断青光眼无疑是非常关键的。目前,国内外常见的眼压测量仪器有二大类：压陷式和压平式。这是根据眼压计引起眼...     

角膜中央厚度对高眼压症和开角型青光眼眼内压测量值的影响

目的研究角膜中央厚度对高眼压症和原发性开角型青光眼病人的眼内压测量值的影响.方法对44例(88眼)临床诊断为高眼压症的患者,31例(61眼)原发性开角型青光眼患者及52例(104眼)与高眼压症患者屈光状态相近的正常人的角膜中央厚度及眼内压进行检测,用统计学方法比较3组的角膜中央厚度的差异及高眼压症患者的眼内压值与角膜中央厚度的相关关系.结果①高眼压症组的角膜中央厚度的平均值585.6±35.7μm明显高于原发性开角型青光眼(54.1±38.7μm)(P＜0.01)及正常对照组(535.5±29.4μm)(P＜0.01),而原发性开角型青光眼的角膜中央厚度与正常对照组相比无显著性差异(P＜0.05).②将高眼压症患者的角膜中央厚度与眼内压测量值进行简单线性相关分析,可见角膜中央厚度与眼内压测量值呈明显正相关,相关系数为0.636(P＜0.01).角膜中央厚度每增加50μm可使眼内压测量值升高约2mmHg.结论①高眼压症患者的角膜中央厚度明显大于原发性开角型青光眼和正常眼,高眼压症患者的角膜中央厚度与眼内压呈明显的正相关,提示高眼压症患者是由于角膜中央厚度高于正常范围而造成眼内压测量值的升高.②角膜中央厚度值可作为高眼压症及原发性开角型青光眼的诊断与鉴别诊断的重要依据.提示临床工作中,可将角膜中央厚度检测作为排除青光眼的常规检查手段.③当角膜中央厚度在520±50μm的范围内,眼压读数相对准确,如果角膜中央厚度超过570μm,眼压读数相应增高,这可能是高眼压症患者眼压测量值高于正常范围的重要原因之一.     

角膜中央厚度和角膜曲率对青少年眼压的影响

目的 探讨角膜中央厚度和角膜曲率对青少年眼压的影响。方法 观察74例148眼门诊青少年患者的非接触式眼压计(non—contact tonometer，NCT)测量值、角膜中央厚度(central corneal thickness，CCT)和角膜曲率，其中37例74眼为高眼压组，37例74眼为正常眼压组。结果 CCT在高眼压组为(588．63土30．58)μm，对照组为(558．40土27．60)μm，2组均与眼压呈正相关，p＜0．05，差异有显著。CCT在2组间差异不显著(p＞0．05)。角膜曲率与高眼压组和正常对照组NCT测量值之间差异不显著(p＞0．05)。结论 CCT与青少年NCT测量值呈正相关，中央角膜厚度值越大，眼压越偏高。2组间CCT差异不明显，表明CCT并不是影响眼压的唯一因素。     

中央角膜厚度对24h眼压波动的影响

目的:探讨中央角膜厚度(central corneal thickness,CCT)对24h眼压波动的影响。方法:使用Goldmann眼压计测量39例78眼未治疗的青光眼患者和44例88眼年龄匹配的正常对照眼的24h眼压波动(5am,7am,10am,2pm,6pm,10pm),并用超声测厚仪测量CCT。结果:青光眼组和对照组的平均眼压分别为21.33±2.91和16.19±2.33mmHg(t=12.615,P=0.000);峰值分别为24.67±2.72和18.55±2.45mmHg(t=12.613,P=0.000);波动值分别为6.63±3.26和4.72±1.60mmHg(t=4.709,P=0.000);CCT分别为544.44±32.11和537.16±27.66μm(t=1.569,P=0.119)。CCT与青光眼组的眼压波动值无显著相关性(r=0.140,P=0.222);CCT与对照组的眼压波动值亦无显著相关性(r=0.050,P=0.642)。以CCT<545μm为薄角膜组,CCT≥545μm为厚角膜组进行对比分析,青光眼组和对照组的平均眼压、峰值、波动值的差异无显著性(P>0.05)。结论:CCT与24h眼压波动无显著相关性。     

中央角膜厚度对眼压测量值的影响

在青光眼的诊断、治疗与随访过程中，眼压(intmocular preisure，IOP)是一个必不可少的参考因素及重要指标。眼压越高，导致视神经损害的危险性越大。目前临床上常用的Goldmann压平眼压计，不受眼球壁硬度的影响，测量结果较准确，一直被视为眼压测量的“金标准”。然而，其准确性依然受许多因素，如中央角膜厚度(central conleal thickness，CCT)等的影响。     

角膜厚度对眼压测量的影响及其意义

眼压是诊治青光眼的一个重要参数。压平眼压计测量眼压受角膜中央厚度的影响,正常人群中角膜中央厚度个体差异较大,带来眼压测量值也存在差异,这种差异会引起一些临床意义,对高眼压症和正常眼压性青光眼的诊治造成影响。本文就正常人的角膜中央厚度、每日角膜厚度变化曲线、与眼压测量之间的关系以及高眼压和青光眼的角膜厚度方面进行综述。     

先天性白内障术后眼轴角膜曲率及屈光度变化

目的 探讨先天性白内障术后患儿眼轴、角膜曲率及屈光度的变化.方法 对49例（84只眼）先天性白内障行晶状体超声乳化手术联合后囊切除及前部玻璃体切除手术,按年龄分为＜3岁、3～5岁及＞5岁3组.术前及术后1年分别测量眼轴长度、角膜曲率;手术后1周及术后1年验光.结果 3组患儿眼轴长度增长量分别为（1.88±0.93） mm,（1.37±0.78） mm及（0.54±0.82） mm,术后眼轴长度变化量随年龄增长而下降,3组间眼轴增长的长度比较差异有统计学意义.3组角膜曲率变化量分别为（-0.12 ±0.08）D,（＋0.09±0.05）D及（-0.06 ±0.02）D.角膜曲率术前和术后1年变化量3组间比较,差异无统计学意义.术后1周到1年屈光度的变化量分别是-2.06 D,-0.42 D和-0.23 D.3组屈光度数均有向近视方向转移的趋势,但随年龄增大,转移趋势变慢.结论 先天性白内障患儿施行白内障摘出合并前部玻璃体切除Ⅰ期人工晶状体植入术,对患儿眼球的发育无明显影响.儿童植入人工晶状体的屈光度选择应该考虑到儿童的年龄及眼轴的变化的影响.     

Changes of corneal central thickness of aphakia following congenital cataract surgery under the first six months of life

AIM:To observe the central corneal thickness(CCT) changes in infants and young children who had been undergone bilateral congenital cataract surgery,and to compare the changes with normal control group which was selected from healthy population.METHODS:A cross section case-control study contained 28 cases(56 eyes) of bilateral aphakia(aphakic group) due to congenital cataract surgery combining with posterior continuous curvilinear capsulorhexis and with anterior vitrectomy during 2-6 months after birth.Fourteen children(28 eyes) of age-sex matched with the aphalic group were selected as normal control group.CCT and intraocular pressure(IOP) were measured postoperatively and the results were compared between groups.RESULTS:The mean CCT was 653.5±82.4μm in the aphakic group and 579.6±39.2μm in the control group,with a significant difference(P =0.000).The mean value of IOP in aphakic group(22.0±1.6mmHg) was greater than that of control group(16.9±2.1mmHg),P =0.023.There was a negative correlation between age and CCT in normal control group(r =-0.531,P =0.026),and there was no correlation in bilateral aphakia group(r =-0.324,P =0.165).· CONCLUSION:Aphakic children due to congenital cataract surgery have a greater CCT than normal children.It is necessary to consider CCT in evaluating IOP for children after congenital cataract surgery.     

中央角膜厚度对常用眼压计测量值的影响

眼压在青光眼和其他眼科疾病的诊断和疗效评估中起着很重要的作用。已经有不少研究发现,各种眼压计的测量值都受中央角膜厚度的影响。不同的眼压计所受影响不同。本文对中央角膜厚度和不同眼压计测量值的关系进行综述。     

Changes in intraocular pressure and central corneal thickness during pregnancy: a systematic review and Meta-analysis

AIM: To conduct a Meta-analysis for investigating the variations in intraocular pressure (IOP) and central corneal thickness (CCT) during normal pregnancy. METHODS: We searched for clinical trials published up to November 2015 without language or region restrictions in PubMed, EMBASE, Web of Science, the Cochrane Central Register of Controlled Trials, Ovid, EBSCO, Elsevier, the Chinese Biomedicine Database, WanFang, CNKI, CQVIP and Google Scholar. Studies of the ocular changes observed in pregnant women were selected. The main outcomes were assessed by changes in IOP and CCT. RESULTS: Fifteen studies were included. In subgroup analyses, IOP was significantly decreased during the second MD=-1.53, 95%CI (-2.19, -0.87); P<0.00001, and third MD=-2.91, 95%CI (-3.74, -2.08); P<0.00001 trimesters of pregnancy. CCT was increased during the second MD=10.12, 95%CI (2.01, 18.22); P=0.01, trimester of pregnancy; moreover, during the third trimester of pregnancy, the CCT displayed an increasing trend, but the difference was not significant MD=5.98, 95%CI (-1.11, 13.07); P=0.1. CONCLUSION: A decrease in IOP is accompanied by an increase in CCT in the second and third trimesters of a normal pregnancy in women.     

近视眼角膜中央厚度与眼压和屈光度的关系

目的 :探讨近视眼角膜中央厚度 (centralcornealthickness,CCT)与眼压 (IOP)、屈光度之间关系。方法 :10 0例193只眼行角膜中央厚度、眼压、屈光度、眼轴检查 ,并对所得数据行方差分析、直线回归分析。根据角膜中央厚度分四组 :1组 4 4 5 μm 相似文献   

Effects of central corneal thickness,central corneal power,and axial length on intraocular pressure measurement assessed with goldmann applanation tonometry

Purpose  To determine the effects of central corneal thickness (CCT), central corneal power (CCP), and axial length (AL) on the measurement of intraocular pressure (IOP) using Goldmann applanation tonometry, and the effects of CCP and AL on CCT. Methods  Charts of 147 consecutive patients undergoing preoperative examinations for cataract surgery between April 2006 and April 2007 in our clinic were reviewed retrospectively. CCT, CCP, and AL were measured by ultrasonic pachymeter (Micropach Model 200P, Sonomed, Lake Success, N.Y. USA), autorefractokeratometer (KR 8800, Topcon, Tokyo, Japan), and ultrasound biometry (EZ Scan AB 5500+ Sonomed, Lake Success, N.Y. USA). Pearson correlation analysis and multiple linear regression analysis were used as indicated, and only one eye of each subject was included in the statistical analysis. Results  Ninety-eight eyes of 98 patients were included in the study. IOP and CCT were significantly and positively correlated (P < 0.001), and CCT and CCP (P = 0.001) were inversely correlated. Multiple regression analysis showed that the effect of CCT on IOP was statistically significant (P < 0.001), but the effects of CCP and AL on IOP were not significant (P = 0.614, P = 0.831, respectively). IOP increased by 0.29 mmHg for each 10 μm increase in CCT. Conclusions  CCT, but not CCP or AL, significantly affected IOP readings obtained by Goldmann applanation tonometry. The effect of CCP on IOP was weak and not significant despite the significant inverse correlation between CCT and CCP.     

角膜中央厚度与眼压读数

目的　探讨角膜中央厚度与眼压读数的关系。方法　对44例88眼屈光角膜手术前的患者,分别用压平眼压计和超声角膜测厚仪进行角膜中央厚度和眼压的测量,并对二者之间的关系进行统计分析。结果　Ⅰ组角膜中央厚度≥580μm,眼压为21.50～27.00mmHg(23.70mmHg±1.36mmHg)(1kPa=7.5mmHg),屈光度-2.00～-12.00D。Ⅱ组角膜中央厚度＜520μm,眼压为11.00～20.00mmHg(15.66mmHg±1.71mmHg),屈光度-1.25～-11.25D。Ⅰ组眼压高于Ⅱ组（P＜0.001）。结论　角膜厚度与眼压有明显的相关性,即角膜厚度增加眼压相应增高,当眼压读数高于正常时,应考虑到是角膜中央厚度的改变。     

近视眼中央角膜厚度与眼内压的关系探讨

目的探讨近视眼患者中央角膜厚度与眼内压之间关系。方法用超声角膜测厚仪及非接触眼压计对325例（635只眼）近视患者的中央角膜厚度和眼压进行测定,并采用统计学方法处理。结果 325例635只眼的眼压范围为21～30mmHg,平均22.96±3.13mmHg;中央角膜厚度为480～656μm,平均579.35±29.45μm;屈光度为-0.75～-8.50D,平均-5.50±0.58D。近视眼患者角膜厚度不同,其眼压有非常显著性差异（P〈0.01）。近视眼患者的眼压与角膜中央厚度呈正相关（γ=0.538,P〈0.01）。结论近视眼的角膜中央厚度与眼压呈显著正相关。检测中央角膜厚度有助于更正确地估计实际的眼压值。