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.
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.
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.
BJO专栏

原发性疾病和角膜血管化对角膜移植排斥反应和存活率的差异影响

Differential effects of primary disease and corneal vascularisation on corneal transplant rejection and survival

:715-729
 
目的:旨在研究按移植指征分类以及移植前角膜血管形成对手术后5年内排斥反应和移植物失败率的相对风险。方法:分析1999—2017年间,英国移植登记处记录的所有因圆锥角膜(keratoconus,KC)、人工晶状体大泡性角膜病(pseudophakic bullous keratopathy,PBK)或既往感染(病毒/细菌/真菌/原生动物)而首次进行角膜移植的成年人。统计移植前受体角膜血管化象限的数量、血管化类型、移植后排斥反应的间隔时间(如果有的话)以及移植后5年的结果。通过多变量风险调整Cox回归法进行排斥反应和移植失败的危险因素建模。结果:KC、PBK和感染患者的角膜血管形成率分别为10%、25%和67%。只有当存在浅表和(或)深部血管形成时(HR分别为1.3和1.4,P=0.004),存在两个以上象限的血管形成时,PBK患者移植排斥反应的风险才会增加(HR=1.5,P=0.0004)。因既往感染而接受移植的个体在四个象限的血管形成中发生排斥反应的风险增加(HR=1.6,P=0.003)。在任何一组中,经过风险调整后,与血管形成有关的移植失败率并未上升。对于含有血管的受体角膜,相对于穿透性KC和PBK移植,没有充分的证据显示板层移植在降低排斥反应或失败风险方面存在优势。结论:血管化是5年内角膜移植排斥反应的危险因素。移植的适应证对这种风险的具有临床意义。
Objective: To investigate the relative risk of pretransplant corneal vascularisation on rate of rejection and graft failure within 5 years of surgery when categorised by indication for transplantation. Methods: We analysed all adults recorded in the UK transplant registry who had a first cornea transplant for keratoconus (KC), pseudophakic bullous keratopathy (PBK) or previous infection (viral/bacterial/fungal/protozoan) between 1999 and 2017. We analysed the number of quadrants of the recipient cornea vascularised before transplant and type of vascularisation, the interval posttransplant to rejection, if any, and the outcome at 5 years post-transplant. Risk factors for rejection and transplant failure were modelled by multivariable risk-adjusted Cox regression. Results: Corneal vascularisation was recorded in 10%, 25% and 67% of patients with KC, PBK and infection, respectively. Individuals with PBK had an increased hazard of transplant rejection only when there were more than two quadrants of vascularisation (HR 1.5, p=0.004) when either superficial and/or deep vascularisation was present (HR 1.3 and 1.4, respectively, p=0.004). Individuals who had a transplant for previous infection had an increased hazard of rejection with four quadrants of vascularisation (HR 1.6, p=0.003). There was no risk-adjusted increase in transplant failure associated with vascularisation in any group. There was weak evidence of reduction in risk of rejection and/or failure associated with lamellar compared with penetrating transplantation in KC and PBK in vascularised recipient corneas. Conclusion: Vascularisation is a risk factor for corneal allograft rejection within 5 years. The indication for transplantation has a clinically significant effect on the magnitude of this risk.
论著

角膜营养不良家系的共焦显微镜观察研究

Observational study of a corneal dystrophy family with confocal microscope

:734-738
 
目的:采用角膜激光共焦显微镜观察研究颗粒状角膜营养不良家系患者的角膜状况。方法:采用角膜激光共焦显微镜对4例(6只眼)颗粒状角膜营养不良患者的角膜进行扫描检测,对比裂隙灯及普通显微镜观察分析检查情况。结果:颗粒状角膜营养不良患者的病变角膜裂隙灯下呈现面包屑样的灰白色混浊,在苏木精-伊红(hematoxylin-eosin,HE)染色中呈现出伊红染的颗粒,沉积于基质板层之间,在共焦显微镜下则为中高反光的团块,相互融合,并取代了基质细胞。结论:颗粒状角膜营养不良患者角膜病变从裂隙灯到普通HE染色下的显微镜,乃至高倍的共焦显微镜观察到的沉积物,分布情况相吻合,印证角膜病变发展的状况,有利于了解该病变的发展情况。
Objective: To observe and study the corneal in patients of family with granular corneal dystrophy by confocal laser scanning microscopy. Methods: The corneas of 4 patients (6 eyes) with granular corneal dystrophy were scanned by laser confocal microscopy, and the results were compared with those observed by slit lamp and ordinary microscope. Results: The image were gray and white bread-crumb-like opacity under the slit-lamp of cornea in patients of family with granular corneal dystrophy, were eosin-stained granules deposited between stroma layers in hematoxylin-eosin (HE) stain under the microscopy, were high reflective masses under the confocal laser scanning microscopy, which fused with each other. Conclusion: The image of the corneal in patients of family with granular corneal dystrophy were clearer and clearer by from Slit Lamp and microscopy to the confocal laser scanning microscopy. The distribution of sediments was consistent with each other. It can be a good understanding of the development of the disease.
论著

硅油填充术后眼压对角膜内皮细胞的影响及变化特点

Effect of intraocular pressure on corneal endothelial cells after silicone oil tamponade

:495-502
 
目的:评估硅油填充术后眼压对角膜内皮细胞的影响及变化特点。方法:选取2019年1月1日至9月30日在佛山市第二人民医院眼科中心行玻璃体切除联合硅油注射的患者共131名,分为高眼压组(n=80)和正常眼压组(n=51)。高眼压组术后任意一次测眼压>21 mmHg,正常眼压组术后眼压均≤21 mmHg。比较填充硅油前与取硅油时的角膜内皮细胞参数测量值。结果:高眼压组的平均眼压为20.79 mmHg,正常眼压组的平均眼压为14.70 mmHg(P<0.001)。取硅油时,两组角膜内皮细胞密度(corneal endothelial cell density,ECD)均明显减少,平均内皮细胞面积均明显增大(P<0.05),高眼压组内皮细胞大小变异系数(coefficient of variation of endothelial cell size,CV)明显变大(P<0.05)。高眼压组ECD丢失率(6.3%)高于正常眼压组(3.5%);其中,高眼压组中术后1~6周内的眼压升高(7.1%)、眼压≥40 mmHg(7.3%)对角膜内皮细胞影响最大。ECD丢失与眼压变化有显著相关性(r=0.176,P=0.044)。结论:硅油填充后高眼压是角膜内皮细胞丢失的重要危险因素。
Objective: To evaluate the effect of intraocular pressure (IOP) on corneal endothelial cells after silicone oil tamponade. Methods: Patients (n=131) received vitrectomy with silicone oil injection in Ophthalmology Center in Second People’s Hospital of Foshan City from January 1st to September 30th 2019 were divided into the high IOP group (n=80) and normal IOP group (n=51). IOP was >21 mmHg at any time in the high IOP group and was ≤21mmHg in the normal IOP group after surgery. The values of corneal endothelial cells before filling with silicone oil and before removing silicone oil were compared.Results: The average IOP was 20.79 mmHg in the high IOP group, and 14.70 mmHg in the normal IOP group (P<0.001). The number of endothelial cells (ECD) was reduced, but the average endothelial cell area was increased (P<0.05) in both groups. The coefficient of variation of endothelial cell size in high IOP group was increased (P<0.05). ECD loss rate was 6.3% in the high IOP group and 3.5% in normal IOP group. Increased IOP within 1–6 weeks after surgery (7.1%) and IOP ≥40 mmHg (7.3%) had the greatest impact on ECD. ECD loss was correlated with IOP (r=0.176, P=0.044). Conclusion: High intraocular pressure after silicone oil filling is an important risk factor for the loss of corneal endothelial cells.Keywords intraocular pressure; corneal endothelium; silicone oil; vitrect
病例报告

1例复杂性角膜盲治疗体会

Experience in the treatment of a case of complex corneal blindness

:380-383
 
角膜病是眼科常见疾病,治疗主要以病因治疗为主。角膜疾病治疗不及时会发展为角膜云翳、角膜斑翳、角膜白斑甚至丧失视力。本例患者主要是一例因外伤形成角膜白斑致使视力低下,于三峡大学附属仁和医院行自体穿透性角膜移植(autologous penetrating keratoplasty,APK)的特殊病例。
Keratoconus is a common disease in ophthalmology and treatment is mainly based on etiology. Untreated corneal diseases can develop into corneal clouding, corneal macula, corneal leukoplakia or even loss of vision. This is a special case of a patient who underwent autologous penetrating keratoplasty (APK) in our hospital for low vision due to traumatic formation of corneal leukoplakia.
综述

角膜神经性疼痛研究新进展

New progress in the study of neuropathic corneal pain

:356-363
 
角膜神经性疼痛(neuropathic corneal pain,NCP)的患者具有眼部及躯体症状,但临床体征不典型,治疗效果不理想。随着干眼诊治的规范化程度不断提升,NCP的患者日益增多。NCP与全身慢性疼痛综合征相互交织。角膜共聚焦显微镜及活体印迹细胞检测可以发现特征性神经形态及相关蛋白改变。NCP的治疗应基于个体化、多学科联合的原则。本文综述近年来,NCP的病因学、病理生理学、综合治疗等取得新的进展以指导临床及转化医学研究。
Patients with neuropathic corneal pain (NCP) have local and physical symptoms, but the clinical signs are atypical,and the treatment is not effect. With the improvement of standardization of diagnosis and treatment of dry eye, the number of patients with NCP has been increasing. The NCP is intertwined with systemic chronic pain syndrome.Corneal confocal microscope and in vivo blot cytology can find the signs of morphology and associated proteins variation. The treatments of NCP should be based on the principle of individualized, multidisciplinary treatment (MDT). This article reviews recent advances in the etiology, pathogenesis, and comprehensive treatment of NCP to guide clinical translational medicine research.
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
    浏览
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