LASIK 术中实际角膜切削深度的临床研究

A Clinical Study of Actual Corneal Ablation Depthin Laser in Situ Keratomileusis

:11-15
 
目的:观察 NIDEK EC5000 准分子激光治疗系统准分子激光原位角膜磨镶术(Laser in sitkeratomileusis, LASIK) 角膜切削深度的可预测性。
方法采用 NIDEK EC5000 准分子激光系统对 79 例近视和(或)近视散光患者进行标准 LASIK 手术,术中使用超声角膜测厚仪分别测量制瓣后和激光切削后的剩余角膜床厚度,计算实际角膜切削深度,比较实际角膜切削深度同理论预测角膜切削深度的差异。
结果LASIK 术中实际切削深度(92.32±29.86) μm,预测切削深度(74.16±25.95) μm,两者差值(18.16 ± 14.71) μm 有统计学意义(< 0.001)。实际切削深度与预测切削深度具有较好的相关性相关系数为0.87 (< 0.001)其直线回归方程为= 18.06 + 1.001X。按术前角膜 K 值、术前等效球镜绝对值及术前中央角膜厚度值分组的实际切削深度与预测切削深度的差值均有统计学意义。实际切削深度与术前等效球镜有关与术前中央角膜厚度和 K 值无关。实际切削深度与预测切削深度差值同 K 值、等效球镜术前中央角膜厚度均无关。
结论NIDEK EC5000 准分子激光系统 LASIK 术中实际角膜切削深度比预测角膜切削深度高 (18.16±14.71) μm,在手术设计时要考虑实际切削与机器标示值存在偏差,应尽可能多的预留剩余角膜基质床厚度,以提高手术安全性。
Purpose: To assess the predictability of corneal ablation depth in LASIK using NIDEK EC5000 excimer laser.
Method: Standard LASlK surgery was performed in 79 myopic patients with or without astigmatism with the NDEK EC5000 excimer laser system. Ultrasonic cornealpachymetry was performed immediately after flap creation and after laser ablation during LASIK procedure, by which the actual corneal ablation depth was calculated.The values of actual and predicted ablation depth were compared.
Results: The actual ablation depth was (92.32+29.86) μm, the predicted ablationdepth was (74.16+25.95) μm. The differences between them (18.16+14.71) μm were statistically significance (< 0.001 ). Linear regression suggested that the actual ablation depth correlated closely with the predicted ablation depth (r = 0.87 , < 0.001 ). The regression model was = 18.06+1.001X. The differences remained statistically significant 
and were independent of the levels of preoperative corneal keratometry, absolute preoperative spherical equivalent and the preoperative central cornea thickness.
Conclusion: The actual ablation depth was about (18.16+14.71) μm thicker than thepredicted ablation depth in the NlDEK EC5000 excimer laser system. We may have totake into account this deviation in order to ensure sufficient thickness of residualstromal bed.

论著

胆固醇对人视网膜色素上皮细胞钙转运通道表达的影响

Effect of cholesterol exposure on the expression of calcium transport channels in human retinal pigment epithelial cells

:770-775
 
目的:玻璃膜疣主要成分胆固醇对人视网膜色素上皮细胞ARPE-19中细胞膜钙ATP酶1(plasma membrane Ca2+ ATPase 1,PMCA1)、L型电压依赖性钙离子通道(L-type voltage-dependent calcium channel,LVDCC)和细胞膜钠钙交换蛋白1(sodium calcium exchange protein 1,NCX1)表达的影响。方法:体外培养ARPE-19细胞,将细胞分为对照组和胆固醇处理组(2.5 mg/mL),取样时间为0、6、12、24、48、72 h。通过实时定量PCR检测PMCA1、LVDCC和NCX1 mRNA的表达水平,用蛋白质印迹法检测蛋白质的表达水平。结果:主要负责细胞内钙离子外排的PMCA1的mRNA和蛋白表达水平在胆固醇处理下出现下调。在胆固醇处理下,钙流入通道LVDCC和钙稳态调控蛋白NCX1的mRNA和蛋白表达明显增多,并且呈现时间依赖性,都是在24 h或48 h表达最多后出现回落。其中LVDCC表达上调倍数较大。结论:玻璃膜疣主要成分胆固醇可以影响人视网膜色素上皮细胞中钙转运通道蛋白的表达,PMCA1的表达受到胆固醇抑制, LVDCC和NCX1的表达受到胆固醇处理上调。这可能会影响细胞内钙离子外排,引起钙离子内流,是否能进一步导致细胞内钙超载而引起细胞凋亡,值得探讨。
Objective: To study the effects of cholesterol, the main component of drusen, on the expression plasma membrane Ca2+ ATPase 1 (PMCA1), L-type voltage-dependent calcium channel (LVDCC) and cell membrane sodium calcium exchange protein 1 (NCX1) of ARPE-19 cells. Methods: The ARPE-19 cell line was cultured in vitro, and the cells were divided into a control group and a cholesterol treatment group (2.5 mg/mL). The treatment time was 0, 6, 12, 24, 48, 72 hours. Real-time quantitative PCR was used to detect the expression of PMCA1, LVDCC and NCX1 at the mRNA level, and western blot was used to detect the expression at the protein level. Results: The mRNA and protein expression levels of PMCA1 which mainly responsible for the efflux of intracellular calcium ions, was down regulated under cholesterol treatment. Meanwhile, the expression of the mRNA and protein of the calcium inflow channel LVDCC and calcium stability regulatory protein NCX1 were significantly increased, and the time-dependency was present, which was up expressed to 24 or 48 h and then fell back. Among them, the LVDCC expression had a large number of times. Conclusion: Cholesterol, the main component of drusen, can affect the expression of calcium channels in human retinal pigment epithelial cells. The expression of PMCA1 was suppressed by cholesterol, and expression of LVDCC and NCX1 were up-regulated with cholesterol treatment, which may affect intracellular calcium efflux then cause calcium influx. Whether it can further cause intracellular calcium overload and cell death is worth exploring.
论著

玻璃膜疣主要成分胆固醇对人视网膜色素上皮细胞金属硫蛋白表达的影响

Effect of cholesterol exposure on the expression of metallothionein in human retinal pigment epithelial cells

:128-132
 
目的:研究玻璃膜疣主要成分胆固醇对人视网膜色素上皮细胞ARPE-19中金属硫蛋白表达的影响。方法:体外培养ARPE-19细胞,将细胞分为对照组和胆固醇处理组(2.5 mg/mL),取样时间为0,6,12,24,48,72h。通过实时定量PCR检测hMT1a,hMT2a和hMT3在转录水平的表达,用蛋白质印迹法检测总金属硫蛋白的表达。结果:在转录水平上hMT1a,hMT2a和hMT3受到胆固醇影响mRNA表达上调,且hMT3上调倍数最大;总金属硫蛋白的蛋白表达随着胆固醇处理时间延长明显增多。结论:玻璃膜疣主要成分胆固醇可以上调人视网膜色素上皮细胞中金属硫蛋白的表达,提示金属硫蛋白表达可受到玻璃膜疣形成起始阶段的刺激,其检测是否能用于年龄相关性黄斑变性的早期发现及早期诊断还需深入探讨。
Objective: To study the effects of cholesterol, the main component of drusen, on the expression of metallothionein of ARPE-19 cells. Methods: The ARPE-19 cell line was cultured in vitro, and the cells were divided into a control group and a cholesterol treatment group (2.5 mg/mL). The treatment time was 0, 6, 12, 24, 48, 72 hours. Real- time quantitative PCR was used to detect the expression of hMT1a, hMT2a and hMT3 at the mRNA level, and Western blot was used to detect the expression at the protein level. Results: The mRNA expression of hMT1a, hMT2a and hMT3 were up-regulated by cholesterol and the protein expression of total MTs was increased with cholesterol treatment. Conclusion: Cholesterol, the main component of drusen, can up-regulate the expression of metallothionein in human retinal pigment epithelial cells, suggesting that the expression of metallothionine can be stimulated by the initial stage of drusen formation. However, whether its detection can be used for the early detection and early diagnosis of age-related macular degeneration or not still needs to be further explored.
论著

玻璃膜疣主要成分胆固醇对人视网膜色素上皮细胞金属硫蛋白表达的影响

Effect of cholesterol exposure on the expression of metallothionein in human retinal pigment epithelial cells

:128-132
 
目的:研究玻璃膜疣主要成分胆固醇对人视网膜色素上皮细胞ARPE-19中金属硫蛋白表达的影响。方法:体外培养ARPE-19细胞,将细胞分为对照组和胆固醇处理组(2.5 mg/mL),取样时间为0,6,12,24,48,72 h。通过实时定量PCR检测hMT1a,hMT2a和hMT3在转录水平的表达,用蛋白质印迹法检测总金属硫蛋白的表达。结果:在转录水平上hMT1a,hMT2a和hMT3受到胆固醇影响mRNA表达上调,且hMT3上调倍数最大;总金属硫蛋白的蛋白表达随着胆固醇处理时间延长明显增多。结论:玻璃膜疣主要成分胆固醇可以上调人视网膜色素上皮细胞中金属硫蛋白的表达,提示金属硫蛋白表达可受到玻璃膜疣形成起始阶段的刺激,其检测是否能用于年龄相关性黄斑变性的早期发现及早期诊断还需深入探讨。
Objective: To study the effects of cholesterol, the main component of drusen, on the expression of metallothionein of ARPE-19 cells. Methods: The ARPE-19 cell line was cultured in vitro, and the cells were divided into a control group and a cholesterol treatment group (2.5 mg/mL). The treatment time was 0, 6, 12, 24, 48, 72 hours. Real-time quantitative PCR was used to detect the expression of hMT1a, hMT2a and hMT3 at the mRNA level, and Western blot was used to detect the expression at the protein level. Results: The mRNA expression of hMT1a, hMT2a and hMT3 were up-regulated by cholesterol and the protein expression of total MTs was increased with cholesterol treatment. Conclusion: Cholesterol, the main component of drusen, can up-regulate the expression of metallothionein in human retinal pigment epithelial cells, suggesting that the expression of metallothionine can be stimulated by the initial stage of drusen formation. However, whether its detection can be used for the early detection and early diagnosis of age-related macular degeneration or not still needs to be further explored.
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  • 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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