眼压计的临床应用

眼压是诊断青光眼和观察疗效的重要依据 ,因而眼压测量是眼科基础及临床工作中最重要的基本检查之一。临床上眼压的测量是以使眼的角膜产生某一程度的压平或压陷所需的力量作为根据的 ,测量眼压的方法有压陷法及压平法两种。传统的Schiotz(修氏 )眼压计 90多年来一直被沿用于眼科 ,经过长期的研究及实践应用 ,眼压测量仪器的设计获得了不断的改进 ,测量精度也持续得以提高 ,Goldmann压平式眼压计、非接触性眼压计 ( NCT)等多种眼压计被广泛应用于临床。现就临床上常用的三种眼压计的特性作一文献综述。1　眼压计的测量原理　　修氏眼压计…     

非接触眼压计及Schiotz眼压计对近视眼眼压的对比研究

对７５例１５０眼中高度近视进行非接触眼压计及Ｓｃｈｉｏｔｚ眼压计对比研究结果发现，两者在近视眼中有着相当的一致性，差异无显著性。眼内压随近视增加而增加，但差异无显著性，另外，近视眼Ｅ值较正常眼显著小，且随近视增加而减少，对以上结果及原因作了探讨。     

兔眼中央角膜厚度与Perkins压平眼压关系的研究

目的探讨中央角膜厚度(CCT)与Perkins压平眼压的关系,建立CCT、真实眼压与Perkins压平眼压三者关系的数学模型和CCT对Perkins压平眼压的校正公式。方法健康新西兰大耳白兔32只,双眼中1只眼行准分子激光屈光性角膜切削术(PRK),另1只眼测得的数据对行PRK眼得出的数据进行验证。采用随机数字表法随机取1只眼,采用PRK,人为改变兔眼的CCT,建立不同CCT的活体眼模型,分别采用Perkins压平眼压计、A型超声角膜测厚仪、角膜曲率计测量术前、术后Perkins压平眼压、CCT、角膜曲率以及应用电子直接眼压计测量真实眼压,分别对术前和术后测量值做相关分析和多元线性回归分析,并对另1组未行PRK眼测得的真实眼压、Perkins压平眼压、CCT对实验组得出的公式进行验证。结果兔眼双眼Perkins压平眼压、CCT、角膜曲率无统计学差别,无论是术前还是术后Perkins压平眼压与CCT均显著相关(r=0.761P<0.01;r=0.829,P<0.01),与角膜曲率无关(r=0.098,P>0.05;r=0.260P>0.05)。对术前、术后Perkins压平眼压与CCT建立回归公式,曲线的斜率分别为0.066、0.053,Perkins压平眼压的改变与CCT的改变有关。对真实眼压Y与Perkins压平眼压、CCT三者的关系建立回归公式为Y=12.107+1.254X1-0.033X2(X1=Perkins压平眼压,X2=CCT)。结论CCT的改变影响Perkins压平眼压的测量值,临床上应根据CCT来校正Perkins压平眼压的测量值。     

常用几种眼压计在临床应用中的特点

<正>眼压测量是眼科临床工作中常规检查。眼压测量值对眼科疾病的诊治、病情观察、疗效观察、用药情况观察及对青光眼的诊断及治疗随访有着重要意义。     

Long-term intraocular pressure fluctuation of primary angle closure disease following laser peripheral iridotomy/iridoplasty

Background  Many studies indicated that short-term and long-term intraocular pressure (IOP) fluctuations in primary open angle glaucoma patients might lead to glaucomatous progression. However, seldom study has evaluated the long-term fluctuation of IOP in primary chronic angle closure diseases. The objective of this study was to investigate the long-term IOP fluctuation of primary angle closure diseases and its associations following laser peripheral iridotomy (LPI) with or without laser peripheral iridoplasty.

Methods  A total of 158 patients with primary angle closure suspect (PACS, n=21), primary angle closure (PAC, n=81) and primary angle closure glaucoma (PACG, n=55) had been treated by LPI with or without laser peripheral iridoplasty and followed up for more than 12 months. IOP was measured with Goldman applanation tonometer. Multivariate linear regression with generalized estimating equation (GEE) regression models was used to evaluate the association of long-term IOP fluctuation (maximum IOP minus minimum IOP) with gender, age, baseline IOP, baseline peripheral anterior synechia (PAS), baseline vertical cup/disc ratio (VCDR), baseline mean deviation (MD), need for IOP-lowering medications.

Results  IOP fluctuation during follow-up in PACS, PAC and PACG groups were (4.83±2.90), (5.67±3.35), and (9.40±7.14) mmHg, respectively. IOP fluctuation was strongly correlated with baseline IOP (r=0.356, P <0.001), PAS (r=0.374, P <0.001). IOP fluctuation was higher in patients with higher baseline IOP (0.18 mmHg per unit increase, 95% CI: 0.05–0.31 mmHg).

Conclusions  Long-term IOP fluctuation in PACG group was larger than that in PACS or PAC group. Eyes with higher baseline IOP were observed to have larger long-term IOP fluctuation.

     

飞秒LASIK手术后角膜生物力学变化观察

目的对比飞秒激光制瓣的准分子激光原位角膜磨镶术(FS-LASIK)手术前后应用眼反应分析仪(Ocular Response Analyzer,ORA)及非接触眼压计(non-contact tonometer,NCT)测量眼压结果的不同。方法随机选取接受FS-LASIK手术的近视眼患者100例(200眼),分别于术前及术后3个月应用ORA检测角膜补偿眼压(corneal compensated intraocular pressure,IOPcc)、模拟Goldmann眼压((Goldmann correlated IOP value,IOPg),再应用NCT测量眼压。分析比较术前、术后眼压测量结果的差异。应用A型超声测量角膜厚度,应用地形图仪测量角膜屈光度。结果术前及术后3个月角膜平均厚度分别为(541.18±32.80,454.64±37.10)μm,差异有统计学意义(t=55.120,P=0.000);术前及术后3个月角膜屈光度分别为(43.88±1.43,38.87±2.27)D,差异有统计学意义(t=42.301,P=0.000)。结论 FS-LASIK手术不仅改变了角膜的厚度及硬度,也改变了角膜的曲率,IOPcc由于矫正了厚度及硬度的影响,所以术后比NCT更接近真实眼压值,但都比术前低。     

准分子激光屈光性角膜手术对眼压测量的影响

目的 研究准分子激光屈光性角膜手术对眼压测量的影响。方法 ４１例（８０眼）手术前后和Ｓｃｈｉｏｔｚ眼压计及非接触式眼压计）ＮＣＴ）分别测量眼压,并进行统计学分析。结果 （１）Ｓｃｈｉｏｔｚ眼压计所测眼压手术前后无显著差异,ＮＣＴ则有显著性差异;手术前后ＮＣＴ所测眼压值均显著低于Ｓｃｈｉｏｔｚ眼压计。（２）手术前后忾测眼压差值显著大于Ｓｃｈｉｏｔｚ则有所测得者;近视度与Ｓｃｈｉｏｔｚ眼压所测眼压差值     

LASIK对非接触型眼压计测量眼压的影响

目的：分析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的影响因素。方法：采用ＬＡＳＩＫ治疗２１４只近视眼。用非接触式眼压计测量术前、术后的眼压。对眼压与术前、术后各因素进行相关分析和多元逐步回归分析。结果：ＬＡＳＩＫ术后１月的眼压明显低于术前,差异具有显著性意义（ｓｔｕｄｅｎｔ ｔ检验,Ｐ〈０．０００１）。ＬＳＡＩＫ术后眼压的降