高度近视眼白内障手术疗效观察

目的　分析高度近视眼白内障手术效果。方法　高度近视合并白内障病例共１９１ 例（２７９ 只眼）,行白内障术后３ｍｏ以上,随访视力、眼屈光度及并发症,计算测量误差及ＳＲＫ－ＩＩ公式误差。结果　术后矫正视力０ ．５ 者２００ 只眼,占７１．７ ％ ;矫正视力＜ ０．１ 者１３ 只眼,占４ ．７ ％ － 眼轴越长,近视性眼底病变越重。术后发生视网膜脱离２ 只眼（０ ．７％） 。眼轴长度测量误差值平均为０．５３ｍｍ ,ＳＲＫ－ＩＩ公式计算的平均绝对屈光误差值为１．１２Ｄ。结论　高度近视眼白内障手术效果较一般人群差,且眼轴越长效果越差。     

试题与解答

1.以下关于大角膜的描述是正确的是哪一项: A)最常见为常染色体显性遗传;     

蓝光与眼健康

蓝光是波长介于400 ～ 500 nm的短波长光,蓝光对视网膜细胞造成损伤的特性引起了学者广泛的关注.同时,它在调节昼夜节律、产生暗视力以及屈光发育等方面具有重要作用.蓝光是否安全？是否该从日常生活中清除？本文对蓝光的作用及安全性问题作一综述.     

蓝光对豚鼠离焦性近视进展的抑制作用及其视锥细胞密度变化机制

目的观察蓝光干预对光学离焦性近视豚鼠屈光发育的影响及其作用机制。方法选取普通级2周龄三色豚鼠48只, 采用抛硬币法随机分成蓝光组和白光组, 每组各24只。所有豚鼠右眼佩戴-5.00 D镜片建立光学离焦模型, 为实验眼;左眼为自身对照, 不予遮盖。实验前及实验开始后8周, 采用带状光检影镜测量豚鼠屈光度, A型超声测量前房深度、晶状体厚度及眼轴长度, 角膜曲率计测量角膜曲率半径。实验开始后8周, 采用过量麻醉法处死豚鼠, 取右眼眼球并分离视网膜, 采用视网膜铺片免疫荧光染色观察豚鼠视网膜S及M视锥细胞密度;采用高效液相色谱分析法检测视网膜视黄酸表达;采用实时荧光定量PCR检测视网膜视黄酸受体(RAR-β)和巩膜中基质金属蛋白酶2(MMP-2)、组织金属蛋白酶抑制剂2(TIMP-2)及Ⅰ型胶原的表达;采用苏木精-伊红染色观察巩膜厚度变化。结果实验开始后8周, 蓝光组实验眼较白光组实验眼出现(0.63±0.12)D相对远视, 眼轴增长延缓(0.08±0.00)mm;蓝光组对照眼较白光组对照眼出现(0.42±0.09)D相对远视, 眼轴增长延缓(0.08±0.00)mm;蓝光组实验眼较蓝光组对...     

正常角膜及圆锥角膜的生物力学特性比较研究

Objective To compare the corneal hysteresis (CH) and corneal resistance factor (CRF) measured with the Ocular Response Analyzer (ORA) in normal and keratoconic eyes. Methods It was a case-control study. Random selected 96 normal eyes and 46 keratoconic eyes in the same period were included in this study. Normal eyes were divided into 2 groups: high corneal astigmatism (≥3.00 D) and low-to-moderate corneal astigmatism (<3.00 D). Keratoconic eyes were also divided into 3 groups based on Amsler-Krumeich classification: mild (stage Ⅰ), moderate (stage Ⅱ) and severe (stage Ⅲ/Ⅳ). CH and CRF were compared between groups and the areas under ROC curves of the CH and CRF were calculated. Results The mean CH and CRF were (7.1±1.6) mm Hg and (6.3±1.5) mm Hg in keratoconic eyes compared with (10.1±1.3) mm Hg and (10.5±1.6) mm Hg in normal eyes. The difference were statistically significant(t=-11.813, -14.943 ;P<0.001). In normal eyes, there was no difference of CH or CRF between the high corneal astigmatism and low-to- moderate corneal astigmatism (t=0.373,0.095; P>0.05). In keratoconic eyes, there was a significant negative correlation between CH and the keratoconus grade (r=-0.627, P<0.001) and the same relationship was found between CRF and the keratoconus grade (r=-0.587, P<0.001). In multiple linear regression analysis, CH was correlated with central corneal thickness (CCT) and corneal curvature (r=0.320, -0.375;P<0.05) and CRF was correlated with corneal curvature in keratoconic eyes (r=-0.441 ,P<0.01), while they were only correlated with CCT in normal eyes (r=0.367,0.459;P<0.001). The areas under ROC curves of the CH and CRF were 0.9282 and 0.9731 (Z=20.462,38.305 ;P<0.0001), the difference between them was significant (Z =7.134,P=0.008). Conclusions The CH and CRF were significantly lower in keratoconic eyes than in normal eyes, especially on CRF. The long-term follow-up of CH and CRF may provide information for evaluation of progression of keratoconus. They may be included as indicators for detecting keratoconus.     

准分子激光原位角膜磨镶术与角膜上皮下磨镶术对中高度近视高阶像差影响的对比研究

目的 比较准分子激光原位角膜磨镶术（LASIK）和准分子激光上皮下磨镶术（LASEK）对中高度近视眼高阶像差的影响。方法 选择中高度近视行准分子激光屈光手术的连续病例27例（41眼）,其中LASIK14例（23眼）、LASEK13例（18眼）。使用Zeiss-WASCA客观像差仪在术前和术后6月测量患眼暗室自然瞳孔下的波前像差。结果 术后6月两组总高阶像差均方根（RMSh）以及3～5阶高阶像差均方根（RMS3～5）均明显高于术前,以RMS4最明显。LASIK组术后RMSh的增幅高于LASEIK组（P=0.042）。LASIK组术后Y轴彗差（Z8）与球差（Z12）明显增高（均P〈0.01）。LASEK组术后Z12明显增高（P〈0.01）。LASIK组术后Z8大于LASEK组（P=0.021）。结论 对于中高度近视矫正,LASEK对高阶像差的影响比LASIK小。     

正常角膜及圆锥角膜的生物力学特性比较研究

Objective To compare the corneal hysteresis (CH) and corneal resistance factor (CRF) measured with the Ocular Response Analyzer (ORA) in normal and keratoconic eyes. Methods It was a case-control study. Random selected 96 normal eyes and 46 keratoconic eyes in the same period were included in this study. Normal eyes were divided into 2 groups: high corneal astigmatism (≥3.00 D) and low-to-moderate corneal astigmatism (<3.00 D). Keratoconic eyes were also divided into 3 groups based on Amsler-Krumeich classification: mild (stage Ⅰ), moderate (stage Ⅱ) and severe (stage Ⅲ/Ⅳ). CH and CRF were compared between groups and the areas under ROC curves of the CH and CRF were calculated. Results The mean CH and CRF were (7.1±1.6) mm Hg and (6.3±1.5) mm Hg in keratoconic eyes compared with (10.1±1.3) mm Hg and (10.5±1.6) mm Hg in normal eyes. The difference were statistically significant(t=-11.813, -14.943 ;P<0.001). In normal eyes, there was no difference of CH or CRF between the high corneal astigmatism and low-to- moderate corneal astigmatism (t=0.373,0.095; P>0.05). In keratoconic eyes, there was a significant negative correlation between CH and the keratoconus grade (r=-0.627, P<0.001) and the same relationship was found between CRF and the keratoconus grade (r=-0.587, P<0.001). In multiple linear regression analysis, CH was correlated with central corneal thickness (CCT) and corneal curvature (r=0.320, -0.375;P<0.05) and CRF was correlated with corneal curvature in keratoconic eyes (r=-0.441 ,P<0.01), while they were only correlated with CCT in normal eyes (r=0.367,0.459;P<0.001). The areas under ROC curves of the CH and CRF were 0.9282 and 0.9731 (Z=20.462,38.305 ;P<0.0001), the difference between them was significant (Z =7.134,P=0.008). Conclusions The CH and CRF were significantly lower in keratoconic eyes than in normal eyes, especially on CRF. The long-term follow-up of CH and CRF may provide information for evaluation of progression of keratoconus. They may be included as indicators for detecting keratoconus.     

玩游戏、看电视、宅孩子 小心暑期近视高发

在城市中,近视率居高不下,还在持续增长。是孩子的课业负担重、用眼习惯差？还是电子类产品与孩子“亲密过度”？暑期里,如何保护孩子的“心灵之窗”,不让“近视”找上门？     

体内实验观察bFGF对视网膜色素上皮细胞再生的促进作用

目的：观察重组人碱性成纤维细胞生长因子（basic fibroblast growth factor,bFGF)在体内对兔视网膜色素上皮（retinal pigment epithelium RPE) 细胞再生的作用。方法：应用氩绿激光照射，造成兔RPE损伤模型，照射后应用bFGF3000U/50uL玻璃体腔内注射，眼底荧光素血管造影检查，测定照射后1－4d透见荧光面积和荧光素渗漏面积，并与对照眼进行比较。结果：照射后第1天和第2天，2组眼的透见荧光面积和荧光素渗漏面积无显著差异（P＝0．534，0．283），第3天和第4天，2组眼的透见荧光面积和荧光素渗漏面积有显著差异（P＝0．0180，0．0007）。结论：体内外源性bFGF能促进RPE的再生和修复，bFGF不具有种属特异性。