LASIK手术对近视患者外隐斜的影响

目的 探讨LASIK手术对外隐斜的影响。方法 选取近视患者119例（238眼）,常规LASIK术前检查,应用遮盖法及三棱镜联合Maddox杆法术前术后分别测量患者裸眼及戴矫正眼镜时固视33cm及6m处点光源时的偏斜度,将所得数据应用t检验统计学方法处理。结果 119例近视患者中发现外隐斜82例（68.91%）,显性外斜视35例（29.41%）,内隐斜和内斜视各1例（1.68%）。术前患者在裸眼和配戴眼镜条件下,固视6m点光源时隐斜度相比无显著性差异（P〉0.05）,而固视33cm点光源时隐斜度相比差异有显著性（P〈0.05）;术后患者在裸眼固视33cm及6m处点光源时;的隐斜度与术前配戴眼镜矫正后相比差异无显著性（P〉0.05）;术前术后患者在裸眼情况下固视6m处点光源的隐斜度相比差异无显著性（P〉0.05）,固视33cm处点光源的隐斜度相比差异有显著性（P〈0.05）。结论 LASIK手术可以减少患者看近时的外隐斜度数而对看远时的外隐斜度数无影响。     

LASIK前后水平隐斜度的对比研究

目的 探讨LAISK对近视患者水平隐斜度的影响.方法 对行LASIK术患者45例(90只眼),应用综合验光仪用Von Grafefa法分别测量手术前、后视远及视近的水平隐斜度,将所得数据用单因素方法及t检验进行统计学分析.结果 术前戴镜与术后1月、3月裸眼的水平隐斜度比较,差异均无显著性(P＞0.05).术前戴镜视近时,中、低度近视组与高度近视组相比较,水平隐斜度差异有显著性(P＜0.05).结论 LASIK手术对患者的视远及视近水平隐斜度无明显影响.     

近视患者LASIK术后AC/A变化观察

目的:探讨近视患者屈光矫正后AC/A的变化.方法:选取近视眼患者119例(238眼),常规LASIK术前检查,应用遮盖法及三棱镜联合Maddox杆法术前术后分别测量患者裸眼及配戴矫正眼镜时固视33cm及6m处点光源时的偏斜度,并计算AC/A值,将所得数据应用t检验统计学方法处理.结果:近视患者119例中发现外隐斜82例(68.9%),显性外斜视35例(29.4%),内隐斜和内斜视各1例(1.7%).所有患者术前裸眼平均AC/A为3.24±2.01,术前佩戴矫正眼镜平均AC/A为4.20±1.97,术后裸眼平均AC/A为4.01±1.66,术前裸眼平均AC/A与术前佩戴矫正眼镜平均AC/A相比t=3.72,术前裸眼平均AC/A与术后裸眼AC/A相比t=3.22,差异有显著性意义(P＜0.01).结论:近视患者经LASIK手术后比术前裸眼时的AC/A高;配戴框架眼镜和角膜屈光手术后对AC/A值影响一致.     

近视患者准分子激光原位角膜磨镶术后调节性集合与调节比值的变化

目的　探讨近视患者准分子激光原位角膜磨镶术 (laserinsitukeratomileusis,LASIK)后调节性集合 (accommodativeconvergence ,AC)与调节 (accommodation ,A)比值的变化及其影响因素。方法使用同视机测定 135例不同程度近视患者LASIK术前裸眼、术前配戴框架眼镜 (戴镜 )及术后裸眼的AC/A值 ,并进行统计学比较和分析。结果　全部患者术前裸眼、术前戴镜及术后裸眼的AC/A值分别为 ( 0 72 4± 0 5 87) △/D、( 2 75 4± 1 5 6 5 ) △/D及 ( 1 6 18± 1 0 2 7) △/D ,两两比较差异均有非常显著意义 (P <0 0 0 1)。不同程度近视患者术前裸眼AC/A值比较差异有显著意义 (P <0 0 1) ,术前戴镜和术后裸眼AC/A值比较差异均无显著意义 (P >0 0 5 )。LASIK术后裸眼AC/A值与术前戴镜AC/A值和屈光度数呈正相关 (P <0 0 0 5 ) ,与患者年龄和眼轴长度呈负相关 (P <0 0 0 2 )。术后裸眼AC/A值 (Y)与患者年龄 (X1)、眼轴长度 (X2 )及术前戴镜AC/A值 (X3)建立多元回归方程为Y =4 0 80 0 - 0 0 318X1- 0 0 971X2 +0 32 5 0X3(P <0 0 0 1)。结论　近视患者AC/A值LASIK术后裸眼高于术前裸眼 ,低于术前戴镜 ;LASIK术后AC/A值受术前戴镜AC/A值、患者年龄及眼轴长度的影响。     

LASIK和ORK治疗近视性高度散光的疗效对比

目的:探讨准分子激光原位角膜磨镶术(laser in situkera-tomileusis,LASIK)与角膜波面像差引导的准分子激光个体化屈光手术(optimized refractive keratectomy customized ablation manager,ORK)治疗近视性高度散光的临床效果和优点。方法:2005/2009年近视性高度散光(散光度≥2.00D)行LASIK和ORK治疗各44眼,观察2种手术方法术后1mo散光度的矫正效果。观察指标包括术后裸眼视力、散光度、眼压、裂隙灯检查及角膜地形图。结果:术后1moORK和LASIK术后裸眼视力较术前均明显提高,ORK术后裸眼视力为0.92±0.18,LASIK术后裸眼视力为0.85±0.18,两术式间相比较差异无统计学意义(t=1.82,P=0.07)。ORK术后球镜度为0.12±0.98,LASIK术后为0.16±1.24(t=1.87,P=0.07),两术式间差异无统计学意义。ORK术后散光度为-0.61±1.12,LASIK术后为-1.10±1.00(t=2.12,P=0.04),两术式间差异有统计学意义,即ORK的矫正效果更好。结论:ORK手术治疗近视性高度散光效果良好。     

1CU可调节人工晶状体眼拟调节力临床分析

目的:探讨1CU可调节人工晶状体植入眼内后术眼拟调节能力.方法:通过对2003-06至今我院行白内障超声乳化联合可调节人工晶状体1CU术后对术眼裸眼远、近视力,矫正视力,矫正远视力下的近视力进行测量,并运用主觉近点法、离交法、动态视网膜检影法以及A超测量10 g/L匹罗卡品点眼前后前房深度,检测术眼拟调节能力,同期以单焦人工晶状体Acrysof作为临床对比,评价可调节人工晶状体1CU临床应用效果.结果:1CU组的裸眼近视力和矫正远视力下的近视力好于Acrysof组;带状光检影测量1CU组的调节力为0.99±0.45D,Acrysof组的调节力为0.25±0.22D,两组差异有显著性意义(t=5.623,P＜0.05);主觉近点法测量1CU组的调节力为1.60±0.55D,Acrysof组的调节力为0.42±0.22D,两组差异有显著性意义(t=2.147,P＜0.05);离焦法测量1CU组的调节力为1.46±0.52D,Acrysof组的调节力为0.52±0.35D,两组差异有显著性意义(t=2.647,P＜0.05);滴用匹罗卡品眼药水后分别测量1CU组和Acrysof组前房深度(ACD)变化,两组比较有显著性差异(t=4.374,P＜0.05).结论:1CU可调节人工晶状体可以明显提高近视力,使白内障患者术后获得一定的调节力.     

Monovision LASIK的临床研究

目的:研究Monovision LASIK的临床疗效。方法:回顾性分析来我院接受LASIK手术屈光不正的患者110例(220眼),年龄40岁以上,术后随访1a,术后接受问卷评估。分析术前及术后1a的裸眼视力(远视力、近视力)、屈光等数据,结合问卷评估结果进行统计学分析。结果:78例接受Monovision LASIK手术,32例患者接受双眼完全矫正手术。Monovision组和完全矫正组患者术后裸眼远视力分别为1.21±0.13,1.19±0.15,两者比较统计学上差异无显著性(P=0.35)。Monovision组术后裸眼近视力(0.68±0.25)好于完全矫正组(0.43±0.21,P=0.04),两组术后屈光参差分别为1.41±0.26D,0.12±0·11D,两两比较统计学上具有显著性差异(P=0.03)。术后满意度Monovision组与完全矫正组分别为87%与85%,统计学上无显著性差异(P=0.65)。术后驾车、行走、运动等不戴镜分别为91.5%,97.2%,差异无统计学意义(P=0.55)。术后近距离工作从不佩戴老视眼镜分别为48.6%,15.6%(P=0.03),差异具有统计学意义。结论:Monovision LASIK是一种矫治老视的有效方法。     

近视眼LASIK术后AC/A比率的变化

目的研究近视眼患者准分子激光原位角膜磨镶（laser in sfiu keratomileusis，LASIK）后调节性集合（accommodative convergence,AC）与调节（accommodation,A）比率的变化。方法将230眼按近视屈光度等效球镜值-1．50～-3．00D、-3．25～-6．00D和-6．25～-11．00D分为A、B、C3个组行LASIK手术。采用同视机测定患者术前戴镜、术后1个月、3个月裸眼Ac／A值，并进行统计学分析。结果A、B、C3组术前戴镜AC／A值分别为3．02±0．79、3．03±0．69和2．71±0．47；术后1个月裸眼AC／A值分别为2．77±0．33、2．40±0．33和2．49±0．40；术后3个月裸眼AC／A值分别为3．04±0．74、2．79±0．58和2．74±0．60。术后1个月裸眼AC／A值明显低于术前戴镜和术后3个月，有显著性差异（P〈0．01）；术后3个月裸眼Ac／A值与术前戴镜Ac／A值比较无显著性差异（P〉0．05）；不同近视程度间各组AC／A值比较术前戴镜、术后1个月和术后3个月均无统计学差异（P〉0．05）。结论对于长期戴镜患者。近视程度对术前戴镜、术后裸眼Ac／A值均无影响；不同近视程度患者LASIK术后裸眼AC／A值的变化趋势相同，即均表现为先下降。后上升，至术后3个月时基本恢复到术前戴镜水平。[眼科新进展21107；27（2）：120-122]     

角膜塑型镜在LASIK术后的应用

目的探索用角膜塑型镜技术矫正准分子激光原位角膜磨镶术（laser in situ keratomileusis,LASIK）后残留屈光不正的效果。方法收集LASIK术后近视残留患者35例（52眼）,入选标准：LASIK术前患眼的等效球镜度≤-5.50D,散光〈-2.00D[根据问诊和查阅之前病历（部分）所得],LASIK术后半年以上。其中17例（25眼）无提高裸眼视力要求的患者作为对照组,期间不做任何处理,定期复查。其余18例（27眼）有改善裸眼视力要求的患者为戴镜组,用角膜塑型镜试戴片进行配适,夜间配戴试镜片,白天取下,1周后和1个月复查,进行裸眼视力、残留屈光度数、角膜地形图及裂隙灯检查。对配戴角膜塑型镜前后结果进行配对t检验,对两组间结果采用两组独立样本t检验。结果配戴角膜塑型镜前、1周后、1个月后戴镜组裸眼视力分别为4.76±0.12、4.97±0.12、4.98±0.14,戴镜后与戴镜前相比,差异有统计学意义（P〈0.05）;配戴角膜塑型镜前、1周后、1个月后的屈光度变化戴镜组为（-0.78±0.20）D、（-0.17±0.38）D、（-0.13±0.36）D,戴镜后与戴镜前相比,差异有统计学意义（P〈0.05）;配戴角膜塑型镜前、1周后、1个月后角膜地形图平均曲率变化,戴镜组为（39.58±1.88）D、（38.52±1.60）D、（38.48±1.63）D,戴镜后与戴镜前相比,差异有统计学意义（P〈0.05）,中央区曲率变平坦,角膜得到重新塑型。结论角膜塑型镜矫正准分子激光术后残留近视,短期内效果良好。     

近视患者准分子激光原位角膜磨镶术后隐斜和聚散功能变化

目的 探讨准分子激光原位角膜磨镶术(laser in situ keratomileusis,LASIK)前后患者隐斜和聚散功能变化.方法 von Grade法测定36例(72眼)近视患者LASIK前、后隐斜和正、负融像性储备,统计分析并比较各测定值差异.结果 术前戴镜远、近距隐斜分别为(-2.3871±2.0888)△、(-7.5161±4.5180)△,术后1个月裸眼远、近距隐斜分别为(-2.4355±1.4705)△、(-9.798 4±4.3867)△,术前戴镜与术后1个月裸眼近距隐斜差异有显著统计学意义(t=-3.822,P<0.01):而术前戴镜与术后1个月裸眼远距隐斜差异无统计学意义(t=0.142,P>0.05).手术前、术后1个月远距正融像性储备分别是(13.2581±7.5805)△、(10.6774±7.3184)△,负融像性储备分别为(9.8710±4.3030)△、(9.967 7±3.8777)△,近距正融像性储备分别是(21.2258±8.6283)△、(16.9032±6.9683)△,负融像性储备分别为(22.3871±5.4692).、(22.516 l±4.972 4).,手术前、术后1个月近距正融像性储备差异有显著统计学意义(t=2.937,P<0.01),其余指标变化差异均无统计学意义(均为P>0.05).结论 LAsIK术后1个月,近距外隐斜增大,正融像性储备减低,LASIK术前全面进行双眼视功能检查,评估用眼疲劳,必要时进行训练,可以提高手术后患者用眼舒适度.     

Strabisme Alternant - Etude clinique - traitement

The author defines motor and sensory alternation: the term alternation should not be used in isolation, it should always be accompanied by the name of the parameter concerned. Sensory alternation is always found together with motor alternation but the reverse is not true.The examining criteria for a diagnosis of sensory alternation are given, sensory alternation must not be confused with alternating inhibition. Working from clinical observations of cases of motor alternating strabismus, the author selects 2 types of binocular sensory relations which allow one to differentiate between:- cases of primary alternating strabismus- cases of secondary alternating strabismusThese forms will develop in different ways; in both cases a cure is possible providing that the right treatment is prescribed and once prescribed carefully followed, etc. It is always a case of serious forms of strabismus whose developmental period is spread over several years.According to the authors, the frequency of cases of true primary strabismus is from 1–3%, the frequency of cases of secondary alternating strabismus varies according to the type of therapy practised on cases of monocular strabismus with amblyopia. These latter will become cases of alternating strabismus under the influence of certain types of therapy carried out over several years (penalization, rocking, alternated occlusion, etc...).Experimental data on kittens confirm clinical data; kittens placed in abnormal environments during the sensitive period will show modification in the distribution of cortical cells and the absence of binocular cells (either because the excitation of the two eyes was not simultaneous, or not identical: artificial strabismus, occlusion, opaque glasses). This disturbances become irreversible after a certain period of exposure (a function of age, length of exposure, etc...).It is thus necessary to bear in mind: 1) the iatrogenic risks of certain orthoptic treatments, 2) the necessity for a binocular form of treatment as soon as possible, as once a certain stage is passed, cortical plasticity diminishes and the elaboration of normal binocular relations becomes impossible.

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Current Thoughts on the Aetiology of Ocular Changes during Contact Lens Wear

ABSTRACT: Contact lenses are known to produce changes to the ocular tissues, and this review attempts to give a comprehensive assemblage of the knowledge on the aetiology of such changes. To achieve this result, the changes are categorized by structure and function, and discussed according to the temporal nature of occurrence where appropriate. Although assessment of the importance of a particular tissue change is difficult, this overview enables some degree of judgement to be made on the aetiology of the major side-effects of contact lens wear. This gives a basis on which to modify aspects of contact lens wear to ultimately increase the success rate.     

The detection of motion in chromatic stimuli: first-order and second-order spatial structure

This study provides evidence for the existence of a low-level chromatic motion mechanism and further elucidates the conditions under which its operation becomes measurable in an experimental stimulus. Observers discriminated the direction of motion of amplitude modulated (AM) gratings that were defined by luminance or chromatic variation and masked with spatiotemporally broadband luminance or chromatic noise. The size and retinal location of the stimuli were varied and the effects of broadband noise and grating masks were both compared with the cohort of stimuli. Some significant disparities in the published literature were well explained by the results. In conclusion, evidence for a chromatically sensitive motion mechanism that evades the, detrimental effects of a luminance mask was found only at the fovea and only when the stimulus was small and centrally placed.     

Local chemotherapeutic agents for the treatment of ocular malignancies

We critically analyze available peer-reviewed literature, including clinical trials and case reports, on local ocular cancer treatments. Recent innovations in many areas of ocular oncology have introduced promising new therapies, but, for the most part, the optimal treatment of ocular malignancies remains elusive.