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 °).
病例报告

角膜偏心切削 LASIK 术后白内障一例

Cataract after LASIK with eccentriccorneal ablation: a case report

:880-886
 
准分子激光原位角膜磨镶术(laser-assisted in situ keratomileusis,LASIK)是矫正屈光不正的重要角膜屈光手术方式之一。经过准分子激光切削的角膜,生物测量数据发生改变。对于此类患者,通过常规测量获得的参数数据以及使用常规计算公式确定的IOL屈光度将变得不再准确,由此将会导致术后较大的屈光误差,进而影响患者的视觉质量。本文报道一例46岁的男性白内障患者。该患者既往双眼屈光不正,曾接受过LASIK手术治疗。白内障术前角膜地形图检查发现该患者双眼存在角膜偏心切削,这为IOL屈光度的确定带来困难。手术医生通过角膜地形图判断角膜切削的居中性,在特定区域内选择角膜曲率K值,并采用Barrett True K公式计算出IOL屈光度。白内障术后患眼屈光误差相对较小,视力提高,视觉质量改善。
Laser-assisted in situ keratomileusis (LASIK) is a crucial corneal refractive surgery for correcting refractive errors. The cornea, after undergoing excimer laser ablation, undergoes changes in biometric measurements. For such patients, conventional measurements and IOL power calculations based on standard formulas may no longer be accurate, leading  to significant postoperative refractive errors and subsequently impacting the patient's visual quality. This article presents a case of a 46-year-old male cataract patient who had a history of refractive errors in both eyes and had previously undergone LASIK surgery. Preoperative corneal topography revealed corneal eccentric ablation in both eyes, posing challenges in determining IOL power. The surgeon assessed the centration of corneal ablation using corneal topography, selected the keratometry value (K value) within specific corneal regions, and calculated the IOL power using the Barrett True K formula. Postoperatively, the cataract patient experienced relatively minor refractive errors, leading to improved vision and enhanced visual quality.
综述

经角膜电刺激在视网膜疾病治疗中的研究进展

Research progress of transcorneal electrical stimulation in the treatment of retinal diseases

:708-714
 
近年来,眼部电流刺激(electrical stimulation,ES)在不同方向的研究中逐渐揭示了其在多种视网膜疾病中的潜在治疗价值。其中,经角膜电刺激(transcorneal electrical stimulation,TES)作为一种非侵入性的治疗方法,能对视网膜、视神经、眼底血管及其相关结构产生积极的影响。TES能够改善视力,在保护感光细胞和减缓疾病进展方面显示出积极效果,提高患者的生存质量,还能够在不损伤眼球的情况下调节大脑中的神经元活动,为视网膜疾病的治疗提供一种新的选择。该文对近年来TES在视网膜色素变性(retinitis pigmentosa,RP)、年龄相关性黄斑变性(age-related macular degeneration,AMD)、视网膜血管病、青光眼以及视神经病变等疾病中的应用研究进行了综述。研究发现,TES治疗是一种安全且无需手术的辅助治疗工具,具有广泛的应用前景。该文旨在为临床医师提供一个全面的TES研究概述,并深入探讨其在眼科学领域的潜在应用价值。然而,TES治疗的具体机制仍需进一步探讨,以便更好地应用于临床实践。同时,未来研究还应关注TES与其他治疗方法相结合的效果,以期为患者提供更多有效的治疗选择。
In recent years, electrical stimulation of the eye (ES) has gradually revealed its potential therapeutic value in a variety of retinal diseasesin different directions. Among them, transcorneal electrical stimulation (TES), as a non-invasive treatment, can have a positive effect on the retina, optic nerve, fundus vessels and related structures. TES can improve vision, show positive effects in protecting photoreceptor cells and slowing disease progression, improve the quality of life of patients, and can regulate neuronal activity in the brain without damaging the eyeball, providing a new option for the treatment of retinal diseases. The research on the application on TES on retinitis pigementosa (RP), age-related macular degeneration (AMD), retinal angiopathy, glaucoma and optic neuropathy are reviewed in this article. It is found in the study that TES therapy is a safe and surgery-free adjuvant therapy tool, and has a wide application prospect. The purpose of this article is to provide clinicians with a comprehensive overview of TES research,and to explore its potential application value in the field of ophthalmology. However, the specific mechanism of TES therapy still needs to be further explored in order to better apply in clinical practice. At the same time, future studies should also focus on the effect of combining TES with other treatment methods, in order to provide more effective treatment options for patients.
封面简介

角膜神经移植术治疗神经营养性角膜病变的研究进展

Research progress in the treatment of neurotrophic keratopathy with corneal neurotization

:-
 
神经营养性角膜病变是一种与角膜神经退行性改变有关的疾病,角膜神经的知觉和营养功能受损,导致角膜上皮缺损、角膜溃疡甚至角膜穿孔。目前人工泪液、治疗性角膜绷带镜、泪点栓塞、羊膜移植,睑缘缝合等治疗措施仍是治疗神经营养性角膜病变的主要治疗方式,对于轻中度病变患者,具有较好的治疗效果,而对于重度病变患者,药物治疗及简单的手术干预治疗效果不佳,病情反复发作。由于重度神经营养性角膜病变患者的角膜神经完全消失,丧失角膜感觉,对未恢复角膜神经营养功能的角膜白斑或溃疡患者行角膜移植术,可能导致角膜移植术后上皮持续不愈合,因此恢复角膜神经营养功能是复明的重要保障手段。角膜神经移植术是重度神经营养性角膜病变患者恢复角膜神经营养功能,提高角膜知觉,改善角膜透明度的重要和有效的治疗方法。角膜神经移植术通过将具有正常功能的供体神经移植到麻痹眼角膜缘周围,使神经末梢重新长入角膜基质,恢复角膜知觉功能。随着角膜神经移植术的术式的不断改进,其良好的术后效果和优点已经渐渐突显。角膜神经移植术包括直接角膜神经移植和间接角膜神经移植,促使角膜神经重新生长,重建角膜神经的营养和知觉功能。角膜神经移植手术已有40年历史,1981年Samii等首次报告了角膜神经移植术,2009年Terzis等成功地实施了第1例直接角膜神经移植术,2014年Elbaz等进行了第1例以腓肠神经作为间置移植物的间接角膜神经移植。封面展示了神经营养性角膜病变患者未接受治疗前的和接受角膜神经移植术后的眼表角膜图像。由于角膜神经退行性改变,角膜失去神经支配,继而出现角膜上皮缺损,角膜缘新生血管形成,经角膜神经移植后,角膜上皮愈合,角膜透明度改善,同时角膜缘新生血管消退。
神经营养性角膜病变是一种与角膜神经退行性改变有关的疾病,角膜神经的知觉和营养功能受损,导致角膜上皮缺损、角膜溃疡甚至角膜穿孔。目前人工泪液、治疗性角膜绷带镜、泪点栓塞、羊膜移植,睑缘缝合等治疗措施仍是治疗神经营养性角膜病变的主要治疗方式,对于轻中度病变患者,具有较好的治疗效果,而对于重度病变患者,药物治疗及简单的手术干预治疗效果不佳,病情反复发作。由于重度神经营养性角膜病变患者的角膜神经完全消失,丧失角膜感觉,对未恢复角膜神经营养功能的角膜白斑或溃疡患者行角膜移植术,可能导致角膜移植术后上皮持续不愈合,因此恢复角膜神经营养功能是复明的重要保障手段。角膜神经移植术是重度神经营养性角膜病变患者恢复角膜神经营养功能,提高角膜知觉,改善角膜透明度的重要和有效的治疗方法。角膜神经移植术通过将具有正常功能的供体神经移植到麻痹眼角膜缘周围,使神经末梢重新长入角膜基质,恢复角膜知觉功能。随着角膜神经移植术的术式的不断改进,其良好的术后效果和优点已经渐渐突显。角膜神经移植术包括直接角膜神经移植和间接角膜神经移植,促使角膜神经重新生长,重建角膜神经的营养和知觉功能。角膜神经移植手术已有40年历史,1981年Samii等首次报告了角膜神经移植术,2009年Terzis等成功地实施了第1例直接角膜神经移植术,2014年Elbaz等进行了第1例以腓肠神经作为间置移植物的间接角膜神经移植。封面展示了神经营养性角膜病变患者未接受治疗前的和接受角膜神经移植术后的眼表角膜图像。由于角膜神经退行性改变,角膜失去神经支配,继而出现角膜上皮缺损,角膜缘新生血管形成,经角膜神经移植后,角膜上皮愈合,角膜透明度改善,同时角膜缘新生血管消退。

TGF-β1 短期眼部应用对兔眼角膜碱烧伤后整合素 β1 表达的作用

Effect of TGF-β1 on Expr ession of Integrin β1 Following Corneal Alkali Burns in Rabbits

:13-17
 
目的: 研究 TGF-β1 短期眼部应用对兔角膜碱烧伤后整合素 β1 表达和角膜上皮愈合的影响,探求其对角膜碱烧伤的治疗作用。
方法: 制备大耳白家兔角膜碱烧伤模型, 一组给予 TGF-β1 (浓度为 200 ng /ml) 局部滴眼, 每日 3 次, 连续 7 日; 另一组给予 PBS 溶液代替, 处理相同。于角膜碱烧伤后每日观察角膜上皮愈合面积, 并于烧伤后 6 h、1 d、3 d、7 d 和 14 d 5 个时间点应用免疫组化方法检测 TGF-β1 实验组与 PBS 组角膜整合素 β1 表达情况。
结果: 烧伤后 4 d、10 d、11 d、12 d 和 14 d 实验组和对照组上皮愈合率比较, 差异有统计学意义(P < 0.05) , 两组随着上皮修复过程的进行, 整合素 β1 的表达均逐渐增加, 烧伤后 7 d、14 d两个时间点实验组和对照组整合素 β1 平均灰度值比较, 差异有显著性(P < 0.05) 。
结论: TGF-β1 在活体实验中能促进整合素 β1 的表达, 而后者的增加可以促进角膜上皮细胞向损伤区域的移行和粘附, 从而减少碱烧伤愈合过程中上皮再次脱落现象, 有利于创伤愈合。
Purpose: To observe the effect of TGF-β1 applied topically to the alkali-injured rabbit eye on corneal epithelial wound healing and expression of integrin β1 and its therapeutic action on corneal alkali burns.
Methods: Alkali burn was produced in 60 corneas from 30 rabbits. Two groups were randomly divided. One group was treated with TGF-β1 solution (200 ng /ml) topically 3 times one day within the first 7 days, the other group was treated with phosphate-
buffered saline (PBS) solution. The injured eyes were photographed after the fluorescence staining with a digital camera and the pictures were analyzed with computer-aided picture analysis system to calculate the rate of corneal epithelial healing. The expression of integrin β1 was investigated in the point 6 h, 1 d, 3 d, 7 d, 14 d after the injury by means of immunohistochemical analysis.
Results: On the 4th, 10th, 11st, 12nd and 14th days after the burning, the rate of corneal epithelial healing of TGF-β1 groups was markedly higher than that of the PBS group (P < 0.05) . The expression of integrin β1 in the cornea epithelial cells gradually increased during the wound healing. On the 7th and 14th days after the burning, the expression of integrin β1 in the cornea epithelial cells of TGF-β1 group was remarkably  higher than that of the PBS group(P < 0.05) .
Conclusions: TGF-β1 could up-regulate integrin β1 in vivo corneal alkali burn model, which could stimulate the cornea epithelial cells to migrate and adhere to the cornea stroma, that can reduce the cases of the epithelial cells_detachment from the cornea stroma and sustain the corneal reepithelization. 

bFGF、EGF和NGF对人角膜内皮细胞生长调控的实验研究

A Study on Effect of bFGF、EGF and NGF on Growth of Cultured Human Corneal Endothelial Cells

:9-12
 
目的:探讨碱性成纤维细胞生长因子(Basic fibroblast growthfacfor, bFCF),表皮细胞生长因子(Epidermal growth factor, EGF)和神经细胞生长因子(Nerve growth factor, NGF)对体外培养的人角膜内皮细胞的生长调控作用。
方法:将相同数量的人角膜内皮细胞接种于96孔板。加人浓度分别为0 ng/ml、1 ng/ml、3 ng/ml、10 ng/ml、30 ng/ml、100 ng/ml的 EGF、bFGF 和 NGF 进行培养。5 天后 MTT法用检测增殖情况。
结果:在0 ng/ml、1 ng/ml、3 ng/ml、10 ng/ml、30 ng/ml、100 ng/ml 浓度下 bFGF 组的平均 OD 值分别为: 0.224±0.045、0.239±0.040、0.262±0.0342、0.278±0.0319、0.281±0.0324、0.260±0.0310 EGF组的平均 0D 值分别为: 0.228±0.0304、0.245±0.0418、0.267±0.0454、0.275±0.0347、0.271±0.0449、0.250±0.0253。NGF 组的平均 OD 值分别为:0.216±0.0187、0.228±0.0226、0.231±0.0225、0.242±0.0279、0.245±0.0294、0.247±0.0349。
结论:bFGF在 30 ng/ml范围内对内皮细胞生长有促进作用,并具有剂量依赖性。高于100 ng/ml时促生长作用降低。EGF在10 ng/ml范围内对内皮细胞生长有促进作用,并具有剂量依赖性。高于30 ng/ml 时促生长作用降低。NGF本次实验剂量范围内对角膜内皮细胞生长无明显作用。
Purpose: To investigate effect of bFGF, EGF and NGF on growth of cultured humancorneal endothelial cells.
Methods: Cultured human corneal endothelial cells were seeded into individual wellsof 96-well tissue culture plate with the same culture media containing separately bFCF, EGF or NGF with a serial of concentrations of 0 ng/ml、1 ng/ml 、3 ng/ml、10 ng/ml 、30 ng/ml and 100 ng/ml and then cultured for 5 days. Then MTT method wasused to detect the growth of the cells.
Results: The averaged OD values of the cell wells containing bFCF with a serial of concentrations of 0 ng/ml、1 ng/ml、3 ng/ml、10 ng/ml、30 ng/ml and 100 ng/ml were 0.224±0.045, 0.239±0.040, 0.262±0.0342, 0.278±0.0319, 0.281±0.0324, 0.260±0.0310. The averaged OD values of EGF group and NGF group were separately 0.228±0.0304,0.245±0.0418, 0.267±0.0454, 0.275±0.0347, 0.271±0.0449, 0.250±0.0253 and 0.216±0.0187, 0.228±0.0226, 0.231±0.0225, 0.242±0.0279, 0.245±0.0294,0.247±0.0349.
Conclusion: bGFC can promote the growth of human corneal endothelial cells in adose dependent manner while with concentration lower than 30 ng/ml. bFGF withconcentration that is higher than 100ng/ml will weaken this effect. EGF can alsopromote proliferation of human corneal endothelial cells demonstrating a linear dosedependent effect when its concentration is lower than 10 ng/ml and this effect decreasedwhen its concentration was higher than 30 ng/ml, NGF showed no effect on the growthof human cornea endothelial cells in this study.
论著

未行准分子激光角膜屈光手术的原因分析

Analysis of reasons for not performing laser refractive keratomileusis in refractive surgery candidates

:15-19
 

目的:分析有意愿接受准分子激光角膜屈光手术治疗近视的患者在术前检查后未行手术的原因。方法:选取20151月至20176月在安徽医科大学附属第一医院眼科激光中心检查的近视患者,分析其中未行激光手术的原因。结果:2 875例患者准备接受准分子激光角膜屈光手术,其中821(28.6%)检查后未进行手术,男462(56.3%),女359(43.7%),年龄18~51(23.69±5.85)岁。821例中社会心理因素影响484(59.0%),角膜薄或角膜厚度不足182(22.2%),超高度近视(>10.00 D)100(12.2%),高眼压19(2.3%),弱视13(1.6%),角膜曲率异常11(1.3%),眼底病变7(0.9%),角膜变性3(0.4%),其他2(0.2%)结论:近视治疗术前检查后未进行准分子激光角膜屈光手术的原因多种多样,其中社会心理因素及角膜厚度不足是最主要的原因。术前详细检查,严格掌握手术适应证和禁忌证以及充分医患沟通是手术安全的保障。

Objective: To analyze the reasons for not performing laser refractive keratomileusis surgery among refractive surgery candidates under regular preoperative examination. Methods: The patients with myopia examined in the Center of Ophthalmology in the First Affiliated Hospital of Anhui Medical University Laser between January 2015 and June 2017 were selected, the reasons for not performing laser refractive keraomileusis after regular preoperative examination were analyzed. Results: A total of 2 875 patients requested refractive surgery and 2 054 (71.4%) of them received refractive surgery. Among 821 (28.6%) patients who did not get laser refractive keratomileusis, 462 (56.3%) were male and 359 (43.7%) were female, aged 1851 years (range, 23.69±5.85 years). The most common reason for not offering refractive surgery were social psychological factors (59.0%), low central corneal thickness (22.2%), high myopia (12.2%), high intraocular pressure (2.3%), poor corrected visual acuity (1.6%), corneal topography anomaly (1.3%), retinal disease (0.9%), corneal (0.4%) and other diseases (0.2%). Conclusion: Reasons for not performing refractive surgery are quite diverse. Social psychological factors and inadequate corneal thickness were the most common reasons in the present study. Careful preoperative examination, strictly mastering indications and contraindications and full doctor-patient communication should be done for the safety of surgery.

论著

飞秒激光辅助角膜内皮移植术治疗大泡性角膜病变的患者围手术期护理

Perioperative nursing of femtosecond laser-assisted corneal endothelial transplantation in the treatment of patients with bullous keratopathy

:6-9
 
目的:探讨大泡性角膜病变(bullous keratopathy,BK)患者行飞秒激光辅助的角膜内皮移植术(endothelium keratoplasty,EK)的围手术期护理。方法:回顾性分析在南京总医院眼科行飞秒激光辅助角膜内皮移植的BK20例患者,分析并总结患者术前的心理疏导、术前准备、眼科检查、术中如何配合医生、术后特殊体位、高眼压的护理及如何正确用药和出院健康教育等。结果:患者得到及时、有效的护理,术后视力均有所提高,内皮贴伏好,无排斥反应及其他并发症的发生。结论:通过对患者围手术期的护理,可提高护理质量,缩短患者住院时间。
Objective: To observe the perioperative nursing of femtosecond laser-assisted corneal endothelial transplantation in the treatment of patients with bullous keratopathy. Methods: A retrospective analysis of 20 patients with bullous keratopathy with femtosecond laser-assisted corneal endothelial transplantation in our department. The preoperative psychological counseling, preoperative preparation, ocular examination, how to cooperate with the doctors in operation, nursing of special position, high intraocular pressure after surgery, how to use eye drops correctly and health education after discharge were summarized. Results: Nursing were performed to the patients timely and effectively. Postoperative visual acuity of all the patients were improved, the endothelial and corneal stroma bed are well combined and no graft rejection and other complications occurred in the patients postoperatively. Conclusion: We concluded that the quality of nursing was improved and the time of hospitalization was shortened after perioperative nursing.
综述

角膜屈光手术对角膜生物力学影响的研究进展

Research progress on the effect of corneal refractive surgery on corneal biomechanics

:266-274
 
角膜屈光手术是目前屈光手术的主流术式,随着全飞秒、全激光手术方式的发展,手术变得更加安全精准,不仅角膜创伤小,术后恢复时间也进一步缩短。角膜具有屈光特性和典型的生物软组织力学特性,角膜力学特性不仅参与维持角膜形态,影响角膜手术尤其屈光手术的效果及预后,而且还与部分角膜疾病的发生和发展密切相关。近年来生物力学研究发展迅速,其在眼部疾病的诊疗中发挥着越来越重要的作用。角膜生物力学的变化与术前角膜的形态、不同手术方式的选择、术后角膜厚度的改变等多种因素相关,但手术导致的角膜自身形态改变是不可逆的,若术后角膜生物力学的变化较大,可能会引起医源性角膜扩张、继发性圆锥角膜等并发症的发生。为了规避术后角膜扩张风险和指导个性化的术式选择,了解角膜生物力学特性的影响至关重要。文章对角膜的基础结构、角膜生物力学特性、生物力学测量方法和不同术式及不同角膜瓣厚度术后生物力学变化的研究进展进行综述,为近视患者的个性化精准治疗提供理论指导。
Corneal refractive surgery is currently main stream of refractive surgery. With the development of femtosecond and laser surgery, the surgery has become safer and more accurate, resulting in less corneal trauma and a shorter postoperative recovery time. In recent years, biomechanics research has rapidly progressed, and its clinical application has gradually increased. The cornea not only possesses refractive properties but also exhibits typical biological soft tissue mechanical properties. Corneal mechanical properties not only play a role in maintaining corneal morphology but also influence the outcome and prognosis of corneal surgery, especially refractive surgery, and are closely related to the occurrence and development of some corneal diseases. Corneal refractive surgery involves cutting the cornea according to the patient's diopter, which disrupts the integrity of the cornea and inevitably affects its biomechanical stability. Changes in corneal biomechanics are associated with various factors, such as preoperative corneal morphology, the selection of different surgical methods, and postoperative changes in corneal thickness. However, the self-morphology changes caused by surgery are irreversible. If the postoperative changes in corneal biomechanics are significant, it may lead to complications such as postoperative corneal dilation and secondary keratoconus. To avoid postoperative iatrogenic corneal dilation and guide personalized surgical choice, it is crucial to understand the limits of influence of corneal biomechanical properties. This article reviews the research progress regarding corneal biomechanical properties and changes associated with corneal refractive surgery.
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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