近视眼角膜中央厚度与眼压测量值的关系研究

目的:探讨近视眼角膜中央厚度(CCT)与眼压测量值的关系。方法:对359例701眼不同屈光度近视眼用Keeler Pulsair3000非接触眼压计(NCT)测量眼压(IOP),同时测量CCT和平均中央角膜曲率(K)。结果:CCT与眼压值的直线回归方程为:IOP(mmHg)=6.20+0.02CCT(μm)(F=55.153,p=0.0001),低、中、高、超高度近视眼的眼压值或CCT均无显著差异;K值与眼压值无直线相关关系(r=-0.0520,p=0.2410)。结论:近视眼的CCT越厚,眼压值越高,CCT每增加10μm,眼压值增加0.2mmHg。     

RBT与修氏眼压计测量特殊患者眼压的一致性评价

目的探讨回弹式眼压计(rebound tonometer,RBT)测量角膜病变、固视能力差等特殊患者眼压的临床应用价值。方法对同一群特殊患者31例35只眼先后采用RBT和修氏眼压计进行测量,应用配对t检验、相关分析和Bland-Altman分析评价两种测量方法所获结果的一致性。结果 RBT和修氏眼压计测得的眼压分别为(27.4±5.5)mmHg和(29.4±5.8)mmHg(1 mmHg=0.133 kPa),两者呈正相关关系(r=0.952,P=0.000),RBT的测量值略低于修氏眼压计,差异有统计学意义(t=-6.53,P=0.000),一致性欠佳。结论 RBT和修氏眼压计均可应用于其他眼压计测量困难的病例,尽管结果不一定准确,但仍可为临床提供参考。RBT为方便定量测量这些特殊患者的眼压提供了新的途径。     

原发性急性闭角型青光眼高眼压持续状态下的手术治疗

目的：探讨闭角型青光眼高眼压持续状态下手术的特点及临床疗效。方法：对52例54只眼,使用局部和全身药物治疗,眼压不能良好控制的原发性闭角型青光眼进行改良小梁切除术治疗。结果：54只眼顺利完成手术,术后其中2眼出现前房出血,2眼出现脉络膜脱离,6眼出现浅前房经过相应的处理后稳定。术后1个月随访时,视力提高或保持不变的有47只眼占87%,眼压≤21mmHg者44只眼占81.5%。结论：原发性急性闭角型青光眼高眼压持续状态下施行改良小梁切除术是可行、安全有效的。     

Predictability and limitations of non-invasive murine tonometry: comparison of two devices

Our purpose was to evaluate the accuracy, reproducibility and predictive ability of two non-invasive tonometers developed for intraocular pressure (IOP) measurements in the mouse. The prototype impact-rebound tonometer (I-R) and a prototype optical interferometry tonometer (OIT) utilizing a fiberoptic pressure sensor, were compared. Enucleated eyes from C57/BL6 mice were used for the calibration. The anterior chamber was cannulated and the IOP was adjusted in increments of 5 cm of H2O (open stopcock method). A calibration curve was generated for each individual eye along with a master calibration curve for all eyes. Two operators measured the IOP. The instruments were then used in alternating order to measure the IOP in C57/BL6 and in DBA2/J animals. The same eyes were subsequently cannulated and the error of the non-invasive tonometers was determined. Both tonometers yielded almost equivalent ex vivo calibration curves with individual R2 of 0.9878 and 0.9902 respectively. Both instruments were highly reproducible. In vivo the I-R tonometer underestimated while the OIT overestimated the IOP. This error was systematic and therefore predictable. The confidence intervals of this error were determined by comparing the IOP estimates provided by each tonometer with the measurements obtained invasively by cannulation in vivo. The 95% CI of the error were 2.36 mmHg for the I-R and 2.62 mmHg for the OIT respectively. Non-invasive tonometry in the mouse is feasible. Both non-invasive instruments provide accurate and reproducible measurements with the OIT requiring calibration curves for each individual investigator.     

超声乳化白内障手术对剥脱综合征性青光眼的降眼压作用

目的 观察和分析剥脱综合征性青光眼患者行超声乳化白内障摘除人工晶体植入术后的眼压变化。方法 对7例伴有高眼压、明显影响视力的白内障但尚无严重的视神经、视野损害的剥脱综合征患者施行超声乳化白内障摘除人工晶体植入术，比较手术前后的眼压变化。结果 术前平均眼压31．57mmHg，术后1周时平均眼压18．19mmHg，降幅为13．38mmHg，术前术后眼压差异极显著。结论 伴有明显影响视力白内障的剥脱综合征性青光眼病人在行超声乳化白内障摘除人工晶体植入术后眼压会显著下降，对那些尚未发生明显视神经视野损害的剥脱综合征性青光眼患者，行超声乳化白内障摘除人工晶体植入术可有效降低眼压。     

儿童阅读强度与眼内压的关系

目的探讨阅读强度与眼压的关系及其可能的原因。方法以班为单位,随机抽取锦州地区重点、普通及农村小学各一所的五年级任意一班的全体学生进行群体采样,在志愿的原则下,对每班中一直在所属学校学习的11岁同学进行验光、眼压及眼球生物学参数等的测量。所得全部数据经计算机SPSS11.5软件采用方差分析和卡方检验进行统计学处理分析。探讨阅读强度与眼压的关系。结果各学校学生眼压的平均值分别为:重点小学(22.08±3.47)mmHg、普通小学(20.40±2.47)mmHg、农村小学(19.48±2.7)mmHg;方差分析P<0.05,差异具有统计学意义。不同学校高眼压发生率分别为重点小学56%、普通小学30%、农村小学19.48%;卡方检验意义显著,P<0.05。其他参数的组间差异的方差分析无统计学意义。结论结果表明随着阅读强度的加大、眼压水平及高眼压发生率也呈增高趋势,提示阅读强度与眼压之间存在一定的关系,即随着人类的进化而不断增大的阅读强度和压力可导致青光眼发病率的升高。     

眼外伤玻璃体视网膜晶状体联合手术疗效分析

目的评价眼外伤玻璃体及视网膜的病变合并晶状体浑浊采用视网膜手术、玻璃体切除联合晶状体手术,Ⅰ期或Ⅱ期人工晶状体植入的效果及可行性。方法采用晶状体囊外摘出、晶状体超声粉碎或晶状体切除联合玻璃体视网膜复位手术。分3组:Ⅰ期人工晶状体植入组、Ⅱ期人工晶状体植入组及未植入人工晶状体组。结果54例(54眼)仅2眼视力不变,其余均在术前视力的基础上有所提高。其中37眼Ⅰ期或Ⅱ期植入人工晶状体组,最佳矫正视力均在0.05以上,人工晶状体均顺利植入。结论眼外伤玻璃体视网膜晶状体联合手术,条件允许时Ⅰ期植入人工晶状体是一种比较理想的治疗方法。而Ⅱ期植入仍不失为良好的后续治疗。     

原发性急性闭角型青光眼高眼压持续状态下的手术治疗

目的探讨闭角型青光眼高眼压持续状态下手术的特点，并评价其临床疗效。方法对52例54只眼，使用局部和全身药物治疗，眼压不能良好控制的原发性闭角型青光眼进行改良小梁切除术治疗。结果54只眼顺利完成手术，术后其中2眼出现前房出血，2眼出现脉络膜脱离，6眼出现浅前房经过相应的处理后稳定。术后1月随访时，视力提高或保持不变的有47只眼占87％，眼压≤21mmHg者有44只眼占81．5％。结论原发性急性闭角型青光眼高眼压持续状态下施行改良小梁切除术是必要、可行，安全有效的。     

闭合性眼挫伤致迅即光感消失原因分析

目的 探讨闭合性眼挫伤后迅即光感消失的原因及其临床判断方法。方法 回顾分析１５例临床资料。结果 ⑴１０例屈光间质清楚者６例为视神经挫伤,４例为视神经撕脱;视神经撕脱者伤眼眼压显著低于对侧。⑵５例屈光间质不清者,１例为视神经撕脱,２例为隐匿性示破裂,１例疑为球壁破裂,１例疑为致密性玻璃体积血,除视神经撕掊的１例外,均无眼压下降。结论 观察眼压是区别视神经挫伤或撕脱的有效手段,但伴有严重眼内出血时,眼     

Significance of non-intraocular pressure (IOP)-related factors particularly in normal tension glaucoma: Looking beyond IOP

Purpose:To study the relationship between intraocular pressure (IOP) and mean ocular perfusion pressure (MOPP) in patients with POAG and NTG. The secondary objective was to identify other contributory ischemic factors.Methods:This was an observational cross-sectional study from a tertiary eye hospital in patients who underwent full-day diurnal variation of tension (DVT). Blood pressure (BP) and IOP measurements were done every 3 h over 24 h. Mean arterial pressure (MAP) and MOPP were calculated. The nocturnal dip in BP was assessed; patients were classified as non-dippers, dippers, and over-dippers. The circadian MOPP fluctuation (CMF) was calculated using the Kruskal–Wallis test, and its relationship with type and severity of visual field was assessed.Results:In total, 149 patients were evaluated; 109 were classified as NTG, and 40 were classified as POAG. A nocturnal dip in BP was noted in 20% of NTG and 17.5% of POAG. The MAP was found to be lower in patients with NTG than POAG. In the NTG subgroup, we found that 20% of patients were over-dippers, 32% were dippers, and 48% were non-dippers. The CMF showed a greater fluctuation for over-dippers (P = 0.004 for the RE and 0.003 for the LE) than dippers and non-dippers. A weak positive correlation of CMF with the severity of fields was found.Conclusion:A 24-h monitoring of IOP, BP, MOPP, and assessment of systemic risk factors for primary glaucoma acts as an invaluable tool for the comprehensive management of NTG despite the limitations posed by DVT and BP recording.