论著

飞秒激光小切口基质透镜取出术和飞秒制瓣联合准分子激光原位角膜磨镶术术后有效光学区及角膜像差的比较

Comparison of effective optical zone and high order aberrations after small incision lenticule extraction and femtosecond laser-assisted in situ keratomileusis

:36-43
 
目的:比较不同预设光学区组的飞秒激光小切口基质透镜取出术(small incision lenticule extraction,SMILE)和飞秒激光制瓣联合准分子激光原位角膜磨镶术(femtosecond laser-assisted in situ keratomileuses,FS-LASIK)术后有效光学区(effective optical zone,EOZ)大小与角膜高阶像差(high order aberrations,HOAs)变化以及有效光学区大小对角膜高阶像差的影响。方法:收集2019年2月 至2020年5月来佛山市第二人民医院行激光手术的患者80例,均取右眼入组,SMILE组43例,FSLASIK组37例,按预设光学区大小分为6.5 mm和6.0 mm组,分别于术前和术后1个月应用Pentacam三维眼前节分析系统测量有效光学区及总角膜高阶像差、彗差、球差,分析不同预设光学区下SMILE组和FS-LASIK组有效光学大小及与角膜高阶像差的关系。结果:在相同预设光学区下,术后1个月SMILE组的有效光学区均大于FS-LASIK组,差异均有统计学意义(均P<0.05),且SMILE组的角膜总高阶像差、球差、彗差均较FS-LASIK组低,差异均有统计学意义(均P<0.05);对于相同手术方式,预设光学区6.0 mm较6.5 mm组,术后1个月角膜总高阶像差、球差、彗差均升高,差异均有统计学意义(均P<0.05)。结论:SMILE组和FS-LASIK组术后1个月的有效光学区均小于预设光学区,SMILE组大于FS-LASIK组;术后1个月有效光学区越大,角膜高阶像差越小;在相同预设光学区下,SMILE组术后1个月角膜高阶像差小于FS-LASIK组。
Objective: To compare the effective optical zone (EOZ) and the changes in corneal high order aberrations (HOAs) after small incision lenticule extraction (SMILE) with those after femtosecond laser-assisted in situ keratomileuses (FS-LASIK). Methods: This study included 80 subjects who underwent laser refractive surgery at the Second People’s Hospital of Foshan between February 2019 and May 2020. Only data from the right eye of each subject were analyzed. A total of 43 eyes underwent SMILE while 37 eyes received FS-LASIK. The eyes were further stratified into subgroups based on different programmed optical zones: the 6.5 mm group and the 6.0 mm group. EOZ, coma, and spherical aberration were measured with Pentacam 3D anterior segment analysis system preoperatively and one month postoperatively. In addition, the relationship between EOZ and corneal HOAs was analyzed and compared between different optical-zone groups after SMILE and FS-LASIK. Results: For the same programmed optical zone, the SMILE group achieved a significantly greater EOZ than the FS-LASIK group who was measured 1-month postoperatively did (P<0.05). Meanwhile, corneal HOAs, spherical aberration, and coma in the SMILE group are significantly lower than those in the FS-LASIK group (P<0.05). For the same procedure (SMILE or FS-LASIK), the 6.0 mm group demonstrated significantly higher corneal total HOAs, spherical aberration, and coma than the 6.5 mm group did 1-month after the surgery (P<0.05). Conclusion: In both the SMILE and the FS-LASIK groups, 1-month postoperative EOZ was smaller than the programmed optical zone. EOZ in the SMILE group was larger than that in the FS-LASIK group. The larger the 1-month postoperative EOZ was, the lower corneal HOAs were. For the same programmed optical zone, 1-month postoperative corneal HOAs in the SMILE group is lower than that in the FS-LASIK group.
BJO专栏

角膜塑形镜对近视儿童脉络膜厚度和脉络膜轮廓的长期影响

Long-term effect of orthokeratology on choroidal thickness and choroidal contour in myopic children

:63-74
 
目的:调查角膜塑形镜对近视儿童脉络膜厚度和脉络膜轮廓的长期影响。方法:受试者来自一项2年的随机对照试验。研究对象为年龄8~12岁、等效球镜在-1.00~-6.00 D的儿童(n=80),这些研究对象被随机分配到对照组(n=40)和角膜塑形镜组(n=40)。本研究在基线和1、6、12、18、24个月的随访中收集光学相干断层扫描图像(optical coherence tomography,OCT),然后基于OCT图像计算脉络膜厚度和脉络膜轮廓。在这些随访点也同时测量了眼轴长度(axial length,AL)和其他眼生物学参数。结果:在2年内,对照组的脉络膜厚度随时间变薄,脉络膜轮廓变得更加后凸(均P<0.001)。角膜塑形镜可以改善脉络膜厚度(均P<0.001),并在所有随访中维持脉络膜轮廓不后凸(均P<0.05)。在角膜塑形镜组中,脉络膜轮廓在颞侧的变化小于鼻侧(P=0.008),而脉络膜厚度在颞侧以黄斑中心凹为中心、直径3 mm线性扫描区域的增厚更明显(P<0.001)。2年内脉络膜厚度的变化与对照组中2年内AL变化呈负相关(r=-0.52,P<0.001),然而,这一规律被角膜塑形镜打破(r=-0.05 P=0.342)。在多变量回归模型中校正其他变量后,角膜塑形镜对脉络膜厚度的影响是稳定的。结论:角膜塑形镜可以改善脉络膜厚度并维持脉络膜轮廓,但这种效果在长期内趋于减弱。
Objective: To investigate the long-term effect of orthokeratology on the choroidal thickness and choroidal contour in myopic children. Methods:Subjects were from a conducted 2-year Randomized Clinical Trial. Children (n=80) aged 8-12 years with spherical equivalent refraction of -1.00 to -6.00 D were randomly assigned to the control group (n=40) and ortho-k group (n=40). OCT images were collected at the baseline, 1-, 6-, 12-, 18-, and 24-month visits, then the choroidal thickness and choroid contour were calculated. Axial length (AL) and other ocular biometrics were also measured. Results: During two years, in the control group, the choroidal thickness became thinning and the choroidal contour became prolate with time at all visits (all P<0.001). Ortho-k can improve the choroidal thickness (all P<0.001) and maintain the choroidal contour at all visits (all P<0.05). In the ortho-k group, the choroidal contour was less changed in the temporal than nasal (P=0.008), and the choroidal thickness was more thickening in the temporal 3 mm (P<0.001). Two-year change in choroidal thickness was significantly associated with the two-year AL change in the control group (r=-0.52, P<0.001), however, this trend was broken by ortho-k (r=-0.05, P=0.342). After being adjusted by other variables in the multivariable regression model, the effect of ortho-k on choroidal thickness was stable. Conclusions: In a short term, ortho-k can improve the choroidal thickness and maintain the choroidal contour, but this effect diminished in a long term. Further study with larger sample size and longer follow-up is warranted to refine this issue.
论著

双模态全视场光学相干层析技术的角膜缘高分辨率成像

High-resolution imaging of limbus tissue with dual-mode full-field optical coherence tomography

:169-179
 
目的:开发细胞级高分辨率、结构与功能一体化的双模态全视场光学相干层析系统(full-field optical coherence tomography,FFOCT),实现角膜缘组织的双模态FFOCT成像。方法:基于Linnik干涉成像原理,利用高数值孔径显微物镜(NA=0.8)及高速平面互补金属氧化物半导体(complementary metal oxide semiconductor,CMOS)相机,设计搭建高分辨率的组织静态结构和内源动态功能成像一体化双模态FFOCT系统;构建基于四相位调制结构影像提取及时域干涉信号动态频谱分析的功能影像重建算法;对人供体角膜缘组织开展各深度层的双模式FFOCT成像有效性验证。结果:搭建的双模态FFOCT成像系统可实现横向分辨率0.5 μ m,轴向分辨率1.7 μ m,成像视野320 μ m×320 μ m,相机采集速度100 Hz。系统实现角膜缘组织无外源标记情况下的细胞级分辨率三维结构和内源功能成像,FFOCT静态结构影像清晰显示角膜缘上皮、Vogt栅栏、隐窝、基质、血管及淋巴管等结构,FFOCT动态功能影像突出显示了代谢活跃细胞(角膜缘上皮细胞、免疫细胞等)。结论:双模态FFOCT高分辨率成像系统可提供角膜缘微观结构和活细胞无标记内源功能可视化信息,将为角膜缘疾病的研究及临床诊疗提供全新的成像分析技术。
Objective: To develop a cellular-level, high-resolution, integrated dual-modal full-field optical coherence tomography (FFOCT) system capable of simultaneously imaging the structure and function of limbus tissue. Methods: Utilizing the Linnik interference imaging principle, a high-resolution dual-modal FFOCT system was designed and constructed using a high numerical aperture (NA=0.8) microscope objective and a high-speed flat CMOS camera. A functional imaging reconstruction algorithm based on four-phase modulation structure image extraction and dynamic frequency spectrum analysis of temporal interference signals was developed. The effectiveness of dual-mode FFOCT imaging at various depth layers of human corneal limbal tissue was validated. Results: The constructed dual-modal FFOCT imaging system achieved lateral resolution of 0.5 μ m, axial resolution of 1.7 μ m, imaging field of view of 320 μ m × 320 μ m, and camera acquisition speed of 100 Hz. The system enabled cellular-level resolution three-dimensional structural and intrinsic functional imaging of corneal limbal tissue without exogenous labeling. Static structural FFOCT images clearly displayed limbal epithelium, palisades of Vogt, crypts, stroma, blood vessels, and lymphatic vessels, while dynamic functional FFOCT images highlighted metabolically active cells (limbal epithelial cells, immune cells, etc.). Conclusion: The dual-modal FFOCT high-resolution imaging system provides visualization of corneal limbal microstructural and live cell intrinsic functional information without labeling, offering a novel imaging analysis technique for research and clinical diagnosis and treatment of limbal diseases.
论著

角膜 B/F 比值对年龄相关性白内障术后屈光误差的影响

The effect of corneal B/F ratio on postoperative refractive error after age-related cataract surgery

:814-821
 
目的:分析角膜后前表面曲率半径比值(B/F比值)与年龄相关性白内障患者术后屈光误差的关系,探讨B/F比值对人工晶状体(intraocular lens,IOL)度数计算精确性的影响。方法:选取2019年3—11月在天津医科大学眼科医院白内障中心就诊,并拟行单眼白内障手术的年龄相关性白内障患者共197例(197眼),术前应用Pentacam眼前节分析仪测量患者眼前节生物参数,并以B/F比值下限25%、上限25%为界将患者分为下25%组、25%~75%组、上25%组。术后3个月应用全自动电脑验光仪评估患者术后屈光状态,并计算患者术后屈光误差(postoperative refractive error,PE),比较三组平均屈光误差(mean refractive error,ME)、平均绝对误差(mean absolute error,MAE)、中位数绝对误差(median absolute error,MedAE)以及屈光误差在±0.25、±0.50、±0.75、±1.00、>±1.00 D范围内百分比差异。结果:B/F比值与年龄相关性白内障患者术后屈光误差呈中度相关(r=?0.445, P<0.001)。随着B/F比值增大,患者术后屈光状态由远视向近视漂移,术后3个月MAE、MedAE分别为0.55 D、0.46 D。屈光误差在±0.25、±0.50、±0.75、±1.00、>±1.00 D范围的百分比分别为29.4%、52.8%、71.6%、87.6%、12.7%。根据正常年龄相关性白内障人群B/F比值优化得到的矫正角膜折射指数计算角膜曲率后,MAE、MedAE分别为0.51、0.43 D,均低于矫正前(P<0.05)。结论:B/F比值对年龄相关性白内障患者术后屈光状态有影响。随着B/F比值的增加,白内障患者术后屈光状态由远视逐渐向近视漂移,且B/F比值越偏离正常平均值,患者的屈光误差绝对值越大。
Objective: To analyze the relationship between corneal B/F ratio and postoperative refractive error in age-related cataract patients, and to explore the impact of B/F ratio on the accuracy of intraocular lens power calculation. MethodsA total of 197 age-related cataract patients (197 eyes) who were treated in the cataract center of our hospital from March 2019 to November 2019 and were going to undergo monocular cataract surgery were selected. The biological parameters of the anterior segment were measured by Pentacam anterior segment analyzer before surgery, and the patients were divided into three groups (25% below the B/F ratio, 25%~75%, and 25% below the B/F ratio) with the lower limit and the upper limit of 25%. Three months after surgery, the postoperative refractive state of patients was evaluated by automatic computerized refractometer, and the postoperative refractive error (PE) was calculated, and the percentage differences of mean refractive error (ME), mean absolute error (MAE), median absolute error (MedAE) and refractive error in the range of ±0.25, ±0.50, ±0.75, ±1.00 and < ±1.00D were evaluated. Results: The B/F ratio was moderately correlated with postoperative refractive error in age-related cataract patients (r= ?0.445, P < 0.001). With the increase of B/F ratio, the refractive state of patients shifted from hyperopia to myopia after surgery, and the MAE and MedAE were 0.55 D and 0.46 D respectively in 3 months after surgery. The percentages of refractive error in the range of ±0.25, ±0.50, ±0.75, ±1.00 and < ±1.00 D were 29.4%, 52.8%, 71.6%, 87.6% and 12.7%, respectively. After adjusting the corneal curvature according to the B/F ratio of the population based on our previous study, MAE and MedAE were 0.51 D and 0.43 D, respectively, which were lower than those before correction (P< 0.05). Conclusions: There is a correlation between B/F ratio and postoperative refractive error in age-related cataract patients. As the B/F ratio increased, the refractive state of the patient gradually drifted from farsightedness to myopia after cataract surgery, and the more the B/F ratio deviated from the normal average, the greater the absolute value of the patient's refractive error.
论著

角膜横径和晶状体厚度在 Barrett Universal Ⅱ人工晶状体计算公式中的应用价值

Application value of corneal horizontal diameter and lens thickness in Barrett Universal Ⅱ intraocular lens prediction formula

:822-836
 
目的:探讨运用Barrett Universal Ⅱ公式(BUⅡ公式)计算人工晶状体(intraocular lens,IOL)屈光力时,可选参数角膜横径,又称白到白(white-to-white,W T W)与晶状体厚度(lens thickness,LT)的实际应用价值。方法:采用单中心、前瞻性临床研究,连续纳入同一术者顺利进行白内障超声乳化吸除术联合MX60(IOL植入术患眼279眼,术前使用OA-2000非接触式光学生物测量仪测量眼部数据并计算IOL植入度数,代入B UⅡ公式保留或去掉可选参数WTW、LT计算预测结果,进一步根据患者眼轴长度(axial length,AL)分亚组分析。主要结局指标:随访患者至术后1个月以上,比较使用和未使用WTW和LT两个参数、BUⅡ公式预测误差(prediction error,PE)、绝对预测误差(absolute error,AE)、AE小于0.5 D所占比例。结果:总体1上,忽略W T W + LT,PE为-0.05 D(-0.26, 0.18)(P=0.011),其他参数组合的PE与0比较差异无统计学意义(P>0.05)。各参数组合的AE比较差异无统计学意义(0.22~0.23 D,P= 0.404)。同时忽略WTW + LT时AE出现最大值(+1.5 D)。应用WTW + LT、忽略WTW + LT、忽略WTW和忽略LT时纳入患者AE ≤ 0.50 D的比例分别为80.65%、79.57%、80.65%和81.36%。在各眼轴亚组中,忽略LT时,AE ≤ 0.50 D的百分比在短眼轴亚组(80.00% vs.66.67%~73.33%)与长眼轴亚组(77.78% vs. 73.33%~75.56%)中较高。在中等眼轴亚组中,AE ≤ 0.50 D百分比代入全部参数时略高(83.11% vs. 80.82%~82.19%),忽略WTW + LT计算时稍低(80.82%)。结论:使用BU Ⅱ计算IOL屈光力时,可选参数WTW和LT无论是否代入公式中,皆可得到相近的平均预测水平;但是,同时忽略WTW和LT可能出现较大预测误差。对于22 mm ≤ AL<26 mm眼,推荐代入全部参数计算;当AL≤ 22 mm或AL ≥ 26 mm,仅输入WTW的计算方法累积精确度更高,可优先采用。
Objective: To investigate the practical application value of the optional parameters of corneal horizontal diameter or white to white (WTW) and lens thickness (LT) a using Barrett Universal II formula. Methods: Single-center, prospective clinical study. Eligible 279 eyes who underwent uneventful phacoemulsification and enVista MX60 implantation by the same surgeon were consecutively enrolled. OA-2000 (Tomey, Japan) non-contact optical biometry was used to measure the ocular data and calculate the IOL implantation power preoperatively. The BU II network formula was used to retain or remove optional parameters WTW and LT, and the predicted results were calculated. Further subgroup analysis was conducted based on the patient's axial length. Main outcome measures: Follow up patients for more than 1 month after surgery, compare the proportion of using and not using WTW and LT parameters, BU II formula prediction error (PE), absolute prediction error (AE), and AE less than 0.5 D. Results: Overall, ignoring WTW + LT, the median PE was -0.05 D (-0.26, 0.18) (P = 0.011) , and there is no statistically significant difference in PE compared 0 for the other parameter combinations (P > 0.05). There was no significant difference in the median AE of each parameter combination (0.22~0.23 D, P = 0.404). While ignoring both WTW and LT, the maximum AE value (+1.5 D) was found. The proportion of patients with AE ≤ 0.50 D included in the application of WTW+LT, neglect of WTW+LT, neglect of WTW, and neglect of LT were 80.65%, 79.57%, 80.65%, and 81.36%, respectively in each axial subgroup, when LT was ignored, the percentage of AE ≤ 0.50 D was higher in the short axial subgroup (80% vs. 66.67%~73.33%) and the long axial subgroup (77.78% vs. 73.33%~75.56%). In the subgroup of moderate eye axis, the percentage of AE ≤ 0.50 D was slightly higher when all parameters were substituted (83.11% vs. 80.82%~82.19%), and slightly lower when WTW+LT calculation was ignored (80.82%). Conclusions: When applying Barrett Universal II to calculate the refractive power of artificial lenses, the optional parameters WTW and LT can obtain similar average prediction levels regardless of whether they are substituted into the formula; However, ignoring both WTW and LT may result in significant prediction errors. For eyes with a diameter of 22 mm ≤ AL<26 mm, it is recommended to use all parameters for calculation; When AL ≤ 22 mm or AL ≥ 26 mm, the calculation method that only inputs WTW has higher cumulative accuracy, and it is suggested to be prioritized.
论著

折叠顶压球囊治疗裂孔位置距角膜缘后≥15mm的孔源性视网膜脱离初步临床观察

Preliminary clinical observation on the treatment of rhegmatogenous retinal detachment with foldable capsule buckle at a distance of ≥ 15 mm from the edge of the corneal membrane

:551-557
 
目的:初步评价折叠顶压球囊(foldable capsule buckle,FCB)治疗孔源性视网膜脱离(rhegmatogenous retinaldetachment,RRD)的有效性、安全性以及手术可操作性。方法:裂孔位置距角膜缘后≥15 mm的采用前瞻性临床病例研究。选择2020年3月至2021年9月在济南明水眼科医院院行FCB植入术治疗裂孔位置距角膜缘后≥15 mm的10例RRD患者(10眼)。应用眼部B型超声、眼底照相评价手术效果。根据术后有无FCB是否暴露、复视情况、排斥反应、眼球运动障碍等术后并发症的发生情况评价手术的疗效和安全性。结果:随访6个月~2年。10例RRD患者在术后通过眼部B超、眼底照相及光学相干断层扫描(opticalcoherence tomography,OCT)评估视网膜均复位。1例合并黄斑区视网膜脱离的患者视力提高。9例患者术后出现复视,术后1~3个月复视消失,1例在术后4个月仍存在复视,行FCB取出,术后视网膜未出现再脱离,复视症状消失。结论:初步研究可确定折叠顶压球囊植入治疗裂孔位置比较靠后(距角膜缘后≥15 mm)且传统巩膜扣带术操作难度大的孔源性视网膜脱离安全、有效,对眼球损伤小,易于操作。
Objective: To preliminarily evaluate the effectiveness, safety and surgical operability of foldable capsule buckle (FCB) in the treatment of rhegmatogenous retinal detachment (RRD). Methods: It is a prospective clinical case study. Ten patients (10 eyes), with a distance of ≥ 15 mm from the posterior margin of the angular membrane at the location of the fissure, who underwent FCB implantation surgery for RRD at Jinan Mingshui Ophthalmology Hospital from March 2020 to September 2021 were enrolled. The surgical outcome was evaluated by B-ultrasound, fundus photography and optical coherence tomography (OCT). The surgical efficay and safety were evaluated by the postoperative complications, such as FCB exposure, diplopia, rejection, and eye movement limitation. Results: The mean follow-up time was 1 year (6 months to 2 years). Retinal reattachment was evaluated by B-ultrasound, fundus photography and OCT after operation in 10 patients. One patient with macular retinal detachment had improved visual acuity. 9 patients developed diplopia after operation, but diplopia disappears 1-3 months after operation. One patient still had diplopia 4 months after operation, and FCB was removed 4 months after operation. No retinal detachment occurred after operation, and the symptoms of diplopia disappeared.Conclusion: It is confirmed by this preliminary research that the implantation of the foldable capsule buckle is safe and effective to treat rhegmatogenous retinal detachment with a relatively posterior position (≥15 mm from the back of the corneal limbus) with little damage to the ocular and easy to operate, compared with the difficulty and complexity in traditional scleral buckling surgery.
综述

浅谈波士顿I型人工角膜的临床应用和发展

Boston keratoprosthesis type I: application and development

:329-337
 
角膜移植手术是治疗角膜病变重要且有效的手段。但对眼表功能完全失代偿、多次角膜移植排斥等类型的患者,常规同种异体角膜移植手术成功率却非常低。对于这类患者,人工角膜植入术成为复明的新希望。随着人工角膜的设计和植入方式的不断改进,人工角膜的功效及优点已渐渐突显。目前,波士顿I型(领扣型)人工角膜在全球范围内应用最为广泛。现就波士顿I型人工角膜的基本特征、临床应用及未来发展等方面进行阐述。
The corneal transplantation is an effective option for visually impaired patients with keratopathy to restore vision function. However, the success rate of allograft keratoplasty is still very low for those patients with end-stage ocular surface or repeated corneal graft rejection. For those patients, artificial keratoplasty might be a promising alternative option. The efficacy and advantages of artificial keratoplasty have been gradually highlighted, after consistent improvement of the product design and implantation procedure. Nowadays, the Boston type I (collar button) corneal prosthesis is the most widely used product around the world. In this review, the history, indications, postoperative complications and future prospect of Boston type I corneal prosthesis will be summarized.
综述

圆锥角膜铁稳态失衡的研究进展

Recent advances in research on iron homeostasis imbalance in Keratoconus

:145-152
 
铁离子在维持角膜细胞正常代谢、DNA合成和修复等生理活动中发挥关键作用,但过量的铁离子可能引发铁稳态失衡继而导致细胞毒性损伤和死亡。圆锥角膜是最常见的扩张性角膜疾病,其典型的Fleischer环是铁稳态失衡的直接证据。圆锥角膜与铁代谢相关的前期研究显示,铁稳态失衡有可能是诱发圆锥角膜发生和发展的潜在致病机制。文章总结了人体及角膜中正常的铁代谢循环以及圆锥角膜铁稳态失衡的证据,并从维持铁稳态角度出发探索可能的治疗策略,为扩张性眼病治疗提供新的思路。
Iron ions are essential for normal metabolism, DNA synthesis, and cellular repair in corneal cells. Nevertheless, an excess of these ions can disrupt iron homeostasis, leading to cellular toxicity, damage, and death. Keratoconus, the most prevalent ectatic corneal disorder, is often marked by the Fleischer ring, which indicates an imbalance in iron homeostasis. A review of early studies on keratoconus and iron metabolism suggests that this imbalance may be a potential pathogenic mechanism contributing to the onset and progression of the disease. This article aims to provide a comprehensive overview of normal iron metabolism in the human body and cornea, highlighting the evidence of iron homeostasis imbalance in keratoconus. It also explores potential therapeutic strategies focused on maintaining iron homeostasis, thereby offering novel insights into the treatment of ectatic eye diseases. 
论著

白内障人群角膜屈光力的分布及相关因素分析

Distribution and related factors analysis on corneal refractive power in cataract patients

:837-844
 
目的:探讨白内障人群角膜屈光力(corneal refractive power,CRP)的分布特点及与眼生物学参数的相关因素分析。方法:回顾性横断面研究福州眼科医院2019年3月至2022年7月就诊的40岁以上白内障人群共23035眼,使用OA-2000测量其眼轴(axial length,AL)、CRP、前房深度(anterior chamber depth,ACD)、晶状体厚度(lens thickness,LT)、角膜水平直径即白到白(white-to-white,WTW)、中央角膜厚度(central corneal thickness,CCT)。绘制各眼生物学参数及年龄Spearman相关性热力图,绘制CRP与AL、CRP与WTW散点拟合图。将CRP与上述参数及年龄进行Spearman相关性分析,分段数据的线性关系使用Pearson分析及线性回归分析。结果:白内障人群CRP为(44.36±1.52)D,在总体数据中CRP与AL为非线性相关;但在分段数据中存在线性相关:当AL≤25.06 mm,CRP与AL负线性相关(R2 =0.397,P<0.001);当AL>25.06 mm,CRP与AL正线性相关(R2 =0.045,P<0.001);无论AL长短,CRP与WTW、CCT均呈负相关。在总体数据中,CRP与WTW也存在非线性关系;但在分段数据中存在线性相关:当10.52 mm≤WTW≤12.46 mm,CRP与WTW负线性相关(R2 =0.149,P<0.001),并与AL、ACD、CCT呈负相关。结论:CRP与AL、WTW呈非线性相关,使用CRP优化计算人工晶状体(intraocular lens,IOL)屈光力时需适当考虑AL、WTW与CRP的相关性。
Objective: To investigate the distribution characteristics of corneal refractive power (CRP), and analyze the correlation between corneal refractive power and ocular biometric parameters in cataract patients. Methods: A retrospective cross-sectional study was conducted on 2,3035 eyes of cataract patients over 40 years old, who visited Fuzhou Eye Hospital during the period between March 2019 and July 2022. The subjects' examination results of axial length (AL), corneal refractive power (CRP), anterior chamber depth (ACD), lens thickness (LT), horizontal corneal diameter (WTW), central corneal thickness (CCT) were measured by OA-2000. Spearman correlation thermograms of bilological parameters and age for each eyes were worked out. The plot scatter fitting plots of CRP and AL, CRP and WTW were made. Spearman correlation analysis was made among CRP, above-mentioned parameters and age. Linear relationships of the segmented data were analyzed with Pearson and linear regression analysis. Results: In the cataract patients, CRP was (44.36 ± 1.52) D. There was a non-linear correlation between CRP and AL in the total data. However, there was a linear relationship in the segmented data. When AL ≤ 25.06 mm, CRP was negatively linearly correlated with AL (R2 =0.397, P<0.001). When AL>25.06 mm, CRP was weakly positively correlated with AL (R2 =0.045, P<0.001). Regardless of the length of AL, CRP was negatively correlated with WTW and CCT. There was also a nonlinear relationship between CRP and WTW in the total data. But there was a linear correlation in the segmented data.When 10.52 mm ≤ WTW ≤ 12.46 mm, the negative linear correlation was found between CRP and WTW (R2 =0.149, P<0.001), while there was negative correlation among CRP, AL, ACD, and CCT. Conclusion: There is a non-linear correlation among CRP, AL and WTW. To optimize the calculation of intraocular lens (IOL) refractive power with CRP, it is necessary to consider the correlation between AL, WTW, and CRP.
病例报告

准分子激光原位角膜磨镶术后白内障患者术后远视漂移一例

A case of hyperopic drift after cataract surgery in a patient with previous laser in situ keratomileusis

:874-879
 
该文报道了一例40岁女性患者,因“双眼渐进性视物模糊3个月”就诊。患者既往于2005年因高度近视行双眼准分子激光原位角膜磨镶术 (LASIK)。最佳矫正视力OD:0.2 (–11.00 DS/ –1.25 DC×170 °),OS:0.7 (–4.00 DS/ –0.75 DC×25 °)。双眼角膜透明,前房中深,晶状体混浊,豹纹状眼底伴后巩膜葡萄肿。诊断为双眼并发性白内障,并行右眼白内障超声乳化联合人工晶状体 (IOL) 植入术,术中植入+14.0 D IOL一枚,目标屈光度为–0.5 D。术后1周裸眼视力0.3,验光结果示右眼屈光度+2.75 DS,最佳矫正视力0.7。术后2周行右眼IOL置换术,由+14.0 D置换为+17.0 D。右眼术后1周裸眼视力0.8,验光结果示右眼屈光度–0.75 DC×15 °。

It is reported in this article that a 40-year-old female patient presented with "progressive blurred vision of both eyes for 3 months". The patient underwent bilateral laser in situ keratomileusis (LASIK) because of high myopia in 2005. It was recorded that her best corrected visual acuity was 0.2 (–11.00 DS/ –1.25 DC×170 °) in the right eye and 0.7 (–4.00 DS/ –0.75 DC×25 °) in the left, and clear cornea, normal anterior chamber, cloudy lens, tessellated fundus with posterior staphyloma in both eyes. The patient was diagnosed with bilateral complicated cataract. Phacoemulsification combined with intraocular lens (IOL, +14.0 diopter (D)) implantation was performed on the right eye, with the target –0.5D refractive diopter . One week after surgery, it was recorded that the uncorrected visual acuity of the right eye was 0.3, and the best corrected visual acuity was 0.7 (+2.75 DS). IOL replacement of the right eye was performed two weeks after surgery, the +14.0 D IOL was replaced by +17.0 D IOL. One week after surgery, the uncorrected visual acuity of the right eye was 0.8 (–0.75 DC×15 °).
其他期刊
  • 眼科学报

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
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  • Eye Science

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
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