简介:目的:探讨电脑验光和检影验光在儿童散瞳前后验光效果,了解电脑验光仪是否能在儿童中应用。方法:对我院进行验光的500例1000眼屈光不正儿童相关k料进行分析,患儿首先进行电脑验光,然后使用10g/L硫酸阿托品眼用凝胶滴眼,3d后分别进行电脑验光和检影验光,比较两种验光效果。结果:近视性屈光不正电脑验光组球镜度数为2.70±2.75DS、柱镜度数为1.54±1.10DC,均低于检影验光组(P〈0.05);两组轴位差异不显著(P〈0.05);远视性屈光不正电脑验光组球镜度数为-2.35±2.18DS、柱镜度数为-1.50±1.15DC,低于检影验光组(P〈0.05);两组轴位差异不显著(P〉0.05);散瞳前散光度为1.54±1.10D、散光轴为14.38±11.11度;散瞳后电脑验光散光度为1.45±1.21D、散光轴为12.78±10.31度,显著高于检影验光(P〈0.05);两种验光方法所测球镜绝对值的差值≤0.50D,占75%(350/500),≤1.00D的占77.4%(387/500),409例柱镜绝对值的差值≤0.50D,占81.8%。结论:儿童验光配镜关乎儿童视觉发育,电脑验光和检影验光均有利弊,且电脑验光不能取代检影验光可将其作为快速验光的辅助工具。
简介:目的探讨在巩膜扣带术中运用间接眼底镜进一步查找视网膜裂孔的意义.方法我科于2006年6月至2006年12月收治孔源性视网膜脱离患者中采用巩膜扣带手术治疗的病例共86例87眼,在术前查找视网膜裂孔的基础上,手术中运用间接眼底镜进一步查找视网膜裂孔,术后随访6-12个月.结果术后第3天视网膜下液吸收,视网膜完全复位83眼(95.4%),术前84眼检出裂孔(96.6%),在手术中有18眼(20.7%)检查出新视网膜裂孔.术中检出视网膜裂孔100%.结论在充分的术前检查基础上,强调在巩膜扣带术中运用间接眼底镜进一步查找视网膜裂孔,对眼底进行全面细致的检查是必要的,可以提高视网膜裂孔检出率和巩膜扣带术视网膜复位率.
简介:目的:探讨利用计算机图像技术虚拟再现患者三维的解剖结构,通过64层螺旋CT影像资料技术实现三维模型,用于手术前的设计和手术模拟,在重建技术下行眼眶下壁骨折的手术方法。方法:对经过筛选的30例眼眶下壁骨折患者进行计算机三维重建,并对其诊断结果进行分析、制定手术方案。结果:眶下壁骨折患者30例通过计算机三维重建后,3D影像显示骨折线的走行方向、骨折范围、位置、类型及骨折块的移位等空间信息像,对临床处理起着较明确的指导作用,手术均获得满意疗效。结论:计算机导航三维重建技术下行眶下壁骨折修复术术后重建效果良好,可显著提高手术的精确性与安全性,降低手术并发症。
简介:AIM:Toevaluatetheaccuracyofsphericalequivalent(SE)estimatesofadouble-passsystemandtocompareitwithretinoscopy,subjectiverefractionandatablemountedautorefractor.METHODS:Non-cycloplegicrefractionwasperformedon125eyesof65healthyadults(age23.5±3.0years)fromOctober2010toJanuary2011usingretinoscopy,subjectiverefraction,autorefraction(AutokeratorefractometerTOPCONKR-8100,Japan)andadoublepasssystem(OpticalQualityAnalysisSystem,OQAS,VisiometricsS.L.,Spain).Nineconsecutivemeasurementswiththedouble-passsystemwereperformedonasubgroupof22eyestoassessrepeatability.ToevaluatethetruenessoftheOQASinstrument,theSElaboratorybiasbetweenthedoublepasssystemandtheothertechniqueswascalculated.RESULTS:TheSEmeancoefficientofrepeatabilityobtainedwas0.22D.SignificantcorrelationscouldbeestablishedbetweentheOQASandtheSEobtainedwithretinoscopy(r=0.956,P<0.001),subjectiverefraction(r=0.955,P<0.001)andautorefraction(r=0.957,P<0.001).ThedifferencesinSEbetweenthedouble-passsystemandtheothertechniquesweresignificant(P<0.001),butlackedclinicalrelevanceexceptforretinoscopy;Retinoscopygavemorehyperopicvaluesthanthedouble-passsystem-0.51±0.50Daswellasthesubjectiverefraction-0.23±0.50D;Moremyopicvalueswereachievedbymeansofautorefraction0.24±0.49D.CONCLUSION:Thedouble-passsystemprovidesaccurateandreliableestimatesoftheSEthatcanbeusedforclinicalstudies.Thistechniquecandeterminethecorrectfocuspositiontoassesstheocularopticalquality.However,ithasarelativelysmallmeasuringrangeincomparisonwithautorefractors(-8.00to+5.00D),andrequirespriorinformationontherefractivestateofthepatient.
简介:目的:评价图形视觉诱发电位(patternvisualevokedpotentials,P-VEP)、眼底照相、视野和光学相干断层扫描(opticalcoherencetomography,OCT)对青光眼患者检查的可靠性。方法:对83例95眼青光眼患者应用眼科电生理仪、眼底照相、视野和OCT,根据P-VEP、眼底照相、OCT、视野检查结果的阳性率进行相关性分析。结果:患者83例95眼中,视野检查成功获取阳性病例图像73眼(76.8%),无法获取图像22眼(23.2%);眼底照像成功获取阳性病例图像75眼(78.9%),无法获取图像20眼(21.1%);获得P-VEP阳性病例47眼(49.5%),未见明显异常26眼(27.3%),无法采集图像22眼(23.2%);成功获取OCT阳性病例图像81眼(85.3%),无法获取OCT图像14眼(14.7%)。结论:视觉诱发电位、眼底照相、视野和光学相干断层图像结果对青光眼患者的视功能状况进行综合评估。
简介:目的:利用频域三维相干光学断层扫描(threedimensionalfrequencydomaincoherentopticaltomography,3D-OCT)评估准分子激光原位角膜磨镶术(laserinsitukeratomileusis,LASIK)对视网膜神经纤维层厚度(retinalnervefibrelayerthickness,RNFLT)的影响。方法:对83例83右眼接受LASIK治疗的受试者分别于术前及术后1d;1wk;1,3mo行3D-OCT检查,测量视乳头上方、下方、鼻侧、颞侧及12个钟点位RNFLT,利用重复测量方差分析及配对t检验对术前及术后的数据统计学处理。结果:术前及术后各时间点行重复测量方差分析显示,视乳头下方、颞侧、5:00~11:00位RNFLT均值无显著差异(P〉0.05),而视乳头上方、鼻侧、1:00~4:00位、12:00位RNFLT有显著差异(P〈0.05);进一步对术前及术后各时间点视乳头上方、鼻侧、1:00~4:00位、12:00位RNFLT分别行配对t检验得出,术后1d时视乳头上方、鼻侧及1:00~4:00位、12:00位RNFLT较术前变薄,差异有统计学意义(P〈0.05),术后1wk;1,3mo时以上各方位RNFLT较术前比较均无统计学差异(P〉0.05)。同时表明RNFLT变薄与屈光度及激光时间成正相关。结论:LASIK术后早期上方及鼻侧RNFLT变薄,但术后1wk恢复至正常水平,LASIK手术对RNFLT无长远影响。
简介:AIM:Toadaptthelowvision-relatedqualityoflife(LVQOL)instrumentintoTurkishlanguageandtoassessitsvalidityandreliability.METHODS:Thestudywasconductedin387patientsattendingtheCentreofLowVisionRehabilitation,FacultyofMedicine,AnkaraUniversity.Forstatisticalanalyses,theSpearman’scorrelationcoefficient,Cronbach’salphacoefficientandConfirmatoryFactorAnalysis(CFA)wereused.RESULTS:AccordingtoresultsofCFA,theiteminthe'Adjustment'subscalebecauseofhavingthefactorloadingbelow0.40,wasexcludedfromthequestionnaire.ThereliabilityofthequestionnairewasassessedaccordingtoCronbach’salphacoefficients.Thereliabilityofthe'DistanceVision,Mobility,andLighting'subscalewas?琢=0.863;ofthe'Adjustment'subscalewas?琢=0.694;'ReadingandFineWork'was?琢=0.791,and'ActivitiesofDailyLiving'was?琢=0.770.Sotheseresultsindicatethatthequestionnaireisreliabletomeasurethevisionrelatedqualityoflifeoflow-visionpatients.Thecorrelationsbetweenthesubscaleswerealsoanalyzed,andthecorrelationbetween'Adjustment'and'ReadingandFineWork'wasfoundtobethelowest(rs=0.336,P<0.001),whereasthestrongestcorrelationwasfoundbetweenthe'ReadingandFineWork',and'ActivitiesofDailyLiving'.Additionally,the'Adjustment'dimensionshowedthestrongestcorrelationwithonly'DistanceVision,Mobility,andLighting'dimension.CONCLUSION:Afterremovingthelastitemintheseconddimension,theTurkishadaptationofalldimensionsoftheLVQOLhasbeenshowntobereliable,validandsuitableforuseinpatientswithlowvisioninTurkey.
简介:目的:系统评价拉坦前列素(Latanoprost)滴眼液与噻吗心安(Timolol)滴眼液降眼压的有效性和安全性。方法:计算机检索PubMed,Medline,CNKI及中国生物医学文献数据库收录的,并辅以手工检索、因特网搜索的有关拉坦前列素与噻吗心安治疗原发性开角型青光眼和高眼压症的随机对照试验(RCT)。按照纳入和排除标准限定研究对象,通过Jadad评分量表进行文献质量评估后,针对眼压下降比例、药物不良反应2项内容,使用Cochrane协作网提供的RevMan5.0软件进行Meta分析。结果:共纳入9项RCT,合计555例患者。Meta分析结果显示:(1)拉坦前列素滴眼液与噻吗心安滴眼液降眼压效果,在2,6,12wk时差异均有统计学意义(P<0.01),加权平均差(WMD)分别为:在2wk[WMD=-0.76,95%CI(-1.32,-0.20)],在6wk[WMD=-1.15,95%CI(-1.68,0.63)]和12wk[WMD=-1.01,95%CI(-1.42,-0.61)]。(2)随访结束时,结膜充血、异物感为拉坦前列素的两种较为常见的不良反应,但其发生率拉坦前列素组与噻吗心安组比较,结膜充血的发生率[OR=2.25,95%CI(0.99,5.08)],异物感的发生率[OR=2.48,95%CI(1.02,6.03)],显示二者差异均无统计学意义。结论:治疗原发性开角型青光眼和高眼压症,拉坦前列素降眼压效果在用药12wk内较噻吗心安好;两者在12wk内引起结膜充血、异物感、虹膜色素加深、视野损害等的不良反应方面,差异不明显。由于纳入研究的样本量偏小,且方法学质量中等,致使本系统评价结果论证强度不高,因此还需要开展更多的高质量的临床随机对照研究,以便更客观、准确、全面地评价其疗效和安全性。
简介:AIM:Tofindouttheoutcomeoflaserphotocoagulationinclinicallysignificantmacularedema(CSME)byopticalcoherencetomography(OCT).·METHODS:Itwasaprospective,non-controlled,caseseriesstudyenrolling81eyesof64patientswithCSMEbetweenAugust2008andJanuary2010.AllpatientsreceivedmodifiedgridphotocoagulationwithfrequencydoubledNd:YAGlaser.Eachpatientwasevaluatedintermsofbest-correctedvisualacuity(BCVA)andregressionorprogressionofmaculopathyafterlasertherapyat1,3and6months.Spearman’scorrelationtestwasusedtoshowthecorrelationbetweenBCVAandtotalmacularvolume(TMV).Analysisofvariance(ANOVA)wasusedtocompareamonggroupsandindependentt-testwasusedtocompareineachgroup.·RESULTS:ThereishighcorrelationbetweenBCVAandTMV(P≤0.001).BCVAimprovedin50.6%,remainedstaticin39.5%anddeterioratedin9.9%patientsafter6monthoftreatment.TheBaselineTMV(meanandSD)were9.26±1.83,10.4±2.38,11.5±3.05,8.89±0.75and9.47±1.98mm3fordifferentOCTpatterns,ST(spongelikethickening),CMO(cystoidmacularedema),SFD(subfovealdetachment),VMIA(Vitreomacularinterfaceabnormality)andaverageTMVrespectively(P=0.04).After6monthsoflasertreatment,themeanTMVdecreasedfrom9.47±1.98mm3to8.77±1.31mm3(P=0.01).InSTtherewassignificantdecreaseinTMV,P=0.01,Furtherwithinthesegroupsat6months,theyweresignificantlydifferent,P=0.01.·CONCLUSION:OCTshowedthedifferentmorphologicalvariantofCSMEwhiletheresponseoftreatmentisdifferent.TMVdecreasedthemostandhenceshowedtheimprovementinvisionafter6monthsoflasertreatment.IntheeraofAntivascularendothelialgrowthfactors(VEGFs),efficacyoflaserseemstobeinshadowbutitisstillfirstlineoftreatmentindevelopingnationlikeNepalwhereantiVEGFsmaynotbeeasilyavailableandaffordable.