目的 探讨A超和IOL Master测量人工晶状体度数的精确性,为白内障手术提供客观的临床数据。方法 选取300例300眼老年性白内障患者,术前采用A 超和IOL Master测量眼轴长度、自动验光仪测量角膜曲率,A超组利用自动验光仪的角膜曲率数据,IOL Master组利用仪器自带的角膜曲率数据,均使用SRK-T公式计算需要植入的人工晶状体度数,观察术后3 m的屈光状态,使用自动验光仪检测患者屈光状态并分析。结果 所有被列入研究的患眼随机分为A超组和IOL Master组, A超组测得的平均眼轴长度为(23.21±0.59)mm,IOL Master组测得的眼轴长度为(23.22±0.59)mm,两组数据对比差异无统计学意义(P>0.05);利用自动验光仪测量的术前平均角膜曲率为(44.01±1.79)D,利用IOL Master测量的术前平均角膜曲率为(44.13±1.62)D,两者比较差异无统计学意义(P＞0.05);A超组和IOL Master组术后的平均绝对屈光误差(mean absolute refractive error,MAE)分别为(0.43±0.26)D、(0.42±0.17)D,两组比较差异无统计学意义(P>0.05)。结论 IOL Master在操作上略优于A超,但在人工晶体度数测量上与A超比较没有发现明显优势,不能完全取代A超,两者结合更能确保人工晶体度数测量的精确性。

Objective By discussing the accuracy of A-scan and IOL Master in intraocular lens power measurement, to offer Objective clinical data for cataract surgery.Methods Three hundred patients(300 eyes)with age-related cataract were included in the study. Before surgery,axial length was measured by A-scan and IOL Master respectively and corneal curvature was measured by auto refractometer. A-scan group used the corneal curvature data of the auto refractometer. IOL Master group used the corneal curvature data from the instrument. Intraocular lens power was calculated according to the SRK-T formula.We observed the refractive state of 3m after operation, detected and analyzed the patient's refractive data by the auto refractometer.Results All patients who were included in the study were randomly divided into A-scan group and IOL Master group.The mean axial length was (23.21±0.59) mm measured by A-scan, the mean axial length was (23.22±0.59) mm measured by IOL Master. There was no significant difference between them (P>0.05). The preoperative mean corneal curvature measured by the auto refractometer was (44.01±1.79)D. The preoperative mean corneal curvature measured by IOL Master was (44.13±1.62)D. There was no statistically significant difference between them (P＞0.05). The mean absolute refractive error ( MAE) in A－scan group was (0.43±0.26)D and in IOL Master group was (0.42±0.17)D. There was no statistically significant difference between them (P＞0. 05).Conclusion IOL Master group operated slightly better than A-scan group, but we did not find a significant advantage in intraocular lens power measurement with A-scan group. IOL Master may not completely replace A-scan. The combination of the two ensures the accuracy of the measurement in intraocular lens power.

目的 运用Sirius系统对准分子术前患者的前房参数以及角膜中央厚度进行检测,探讨上述因素之间的相关性、规律性,以及性别、年龄对其的影响。方法 分组:对210例近视眼患者(420只眼)根据屈光度分为低度近视组,中度近视组、高度近视组。采用Sirius系统对三组检测眼进行角膜中央厚度、中央前房深度、前房容积、颞侧及鼻侧房角宽度进行测量,并采用相关性分析,单因素方差分析对检测数据进行统计学分析。结果 屈光度数绝对值与颞侧房角呈正相关,中央前房深度与前房容积呈正相关、与颞侧及鼻侧房角宽度均呈正相关。颞侧与鼻侧房角宽度亦呈正相关。年龄与中央前房深度呈负相关。不同屈光度度数组别之间颞侧房角宽度存在统计学差异性。男性中央前房深度及颞侧房角宽度明显大于女性。结论 Sirius系统可以作为一种便捷、准确且无创的角膜厚度及前房参数的测量工具。近视眼患者的前房参数与屈光度数、中央角膜厚度、年龄、性别存在一定的相关性性、规律性。

Objective To analyze the correlation and principle of anterior chamber parameter and central cornea thickness, the influence by the sexual and age in the pre-operative patients with excimer laser by using Sirius system. Methods 210 patients (410 eyes)were divided into 3 groups based on refractive status:low myopia,moderate myopia and high myopia.Central cornea thickness(CCT),anterior chamber depth(ACD),anterior chamber volume(ACV),temporal(T) and nasal anterior chamber width(N) were measured by Sirius system. The results are analyzed by correlation and one-way anova of statistics. Results A positive correlation was found in the absolute value of diopter and temporal anterior chamber width, the anterior chamber depth(ACD) and anterior chamber volume(ACV), temporal(T) and nasal anterior chamber width(N), and also in the temporal and nasal anterior chamber width. There was a negative correlation between age and temporal and nasal anterior chamber width. There were significantly statistics differences in the temporal anterior chamber width between different diopter groups. The anterior chamber depth(ACD) and temporal anterior chamber width of males were obvious deeper than females. Conclusion The Sirius system may be used as a convenient, precise and noninvasive technique in cornea thickness and anterior chamber parameter measurement. There is a definite correlation and principle in the anterior chamber parameter and diopter, central cornea thickness, age and sexual.

目的 观察尝试采用激素替代疗法(hormonereplace menttherapy,HRT)治疗更年期疾病的干眼症的临床疗效。方法 将80例(160眼)干眼症患者随机分成2组,治疗组40例(80眼)在滴人工泪液的基础上采用激素替代疗法(HRT)口服治疗。对照组40例(80眼)单纯采用人工泪液滴眼液滴双眼。两组同时给予综合护理。3个月后观察疗效。结果 治疗组总有效率82.5%,对照组总有效率60%,两组总有效率比较差异有统计学意义(P<0.05),治疗组疗效优于对照组。结论 在人工泪液滴眼液滴双眼的基础上尝试采用激素替代疗法(HRT)治疗更年期疾病的干眼症患者,效果优于单纯应用人工泪液点眼。

Objective To investigate the role of hormone replace menttherapy (HRT) in treating xerophthalmia among patients with climacteric disease. Methods Eighty xerophthalmia patients (160 eyes) were randomly divided into two groups. Forty patients in the treatment group (80 eyes) were treated using combined HRT and artificial drops. Forty patients in the control group (80 eyes) were treated using artificial drops alone. All patients were provided comprehensive nursing. The evaluation of clinical effects was performed after 3 months of treatment. Results The total effective rate of both groups was 82.5% in the treatment group and 60% in the control group, respectively (P<0.05). Conclusion Combined HRT and artificial drops is more effective in treating climacteric disease-related xerophthalmia than using artificial drops only.

飞秒激光辅助的SMILE因其微创、准确性、安全性、可预测性、稳定性好的特点越来越受患者和术者的欢迎,随着大家对手术的期望值增加,视觉质量成为反应手术效果极其重要的因素之一,而高阶像差又是评定视觉质量尤为重要的指标。本文对飞秒激光SMILE的眼高阶像差及其影响因素进行综述。

Femtosecond laser-assisted SMILE is more and more popular with patients and the operators because of the minimal invasion, efficacy, safety, predictability and stability. But with the increase of people's expectations of the surgery, visual quality become one of the important factors which reacts operation effect extremely, and higher-order aberration is an especially important index when evaluate the visual quality. In this paper, the higher-order aberration and its influence factors of femtosecond laser-assisted SMILE were summarized.

目的 探讨Sirius与A超对不同程度近视患者中央角膜厚度(CCT)的测量差异。方法 对225例(450眼)拟行角膜屈光手术的近视患者,按低、中、高度近视分三组,依次用Sirius和A超测量CCT。 测量结果行配对t检验、 Pearson相关及 Bland-Altman分析。结果 低、中、高度近视组中,Sirius所测CCT均数分别为(542.61±29.19)μm、(543.96±27.02)μm、(547.25±22.53)μm;A超CCT均数分别为(538.51±29.12)μm、(540.98±26.56)μm、(542.19±21.64)μm。不同近视组中,Sirius测量值均略大于A超值,且两者高度正相关,差异有统计学意义(P<0.05)。Bland-Altman分析,不同近视组中,两种仪器测量CCT的一致性较好。结论 Sirius在绝大多数情况下能够替代传统的A超角膜测厚仪,但对拟行激光手术的高度近视患者应该综合考虑两种仪器测量结果。

Objective To study the measurement differences of central corneal thickness(CCT) in different degree of myopia by Sirius and ultrasound pachymetry(UP). Methods 225 myopic subjects(450 eyes)were recruited and divided into three groups according to the degree of refractive errors. The CCT were obtained from the eyes for each subjects using the Sirius and UP. Data were compared by using paired t-tests and the Pearson correlations. Bland- Altman analysis of all pairs were determined. Results The mean CCT in low myopic group obtained from Sirius and UP were (542.61±29.19)μm and(538.51±29.12)μm,respectively. The mean CCT in medium myopic group by Sirius and UP were(543.96±27.02)μm and(540.98±26.56)μm.The measured mean CCT in high myopic group were(547.25±22.53)μm and(542.19±21.64)μm by Sirius and UP. The mean CCT measurements between the two instruments were high correlated and statistically different(P<0.05) in the three groups respectively. In different myopia groups Sirius has good coincidence with UP in measuring CCT according to the Bland-Altman plot. Conclusion In vast majority of cases,Sirius can replace traditional UP in measuring CCT. But for the preopreative examination of the high myopia patients, we need to think twice about the difference between the two measurements.

目的 观察葛根素对新西兰白兔视网膜缺血/再灌注损伤组织中细胞凋亡的保护作用。方法 新西兰白兔30只随机分为缺血再灌注对照组和葛根素治疗实验组,各组右眼应用前房灌注加压法建立视网膜缺血再灌注模型,分别于再灌注后第12、24、72 h处死动物,摘除眼球,制作石蜡切片,用TUNEL法检测细胞凋亡,计算凋亡指数。结果 对照组缺血再灌注12 h在神经节细胞层和内核层可见凋亡细胞;24 h神经节细胞层细胞数有所减少,视网膜神经节细胞层、内核层及外核层均见凋亡细胞明显增多;72 h神经节细胞层细胞数明显减少,神经节细胞层、内核层及外核层仍见凋亡细胞,但较24 h有所减少。葛根素治疗视网膜的凋亡细胞在各个时间段的表达规律与对照组相似,但凋亡细胞计数在12 h,24 h,72 h均较对照组明显减少,两组间差异有统计学意义。结论 葛根素能减轻缺血-再灌注损伤的视网膜细胞凋亡,对视网膜有保护作用。

Objective To observe the protective effects of Puerarin on apoptosis of ischemic injury in rabbit retina. Methods Retinal ischemia was induced in rabbits by increasing intraocular pressure to 120 mmHg for 60 minutes. TdT-mediated biotin-dUTP nick end labelling(TUNEL) staining technique was used to examine the apoptosis of retinal ganglion cells in the control group and the puerarin treatment group. Results The number of apoptotic cells in 12, 24 and 72h after reperfusion in the puerarin treatment group was obvious lower than that in the control group(P<0.05). Conclusion Puerarin has protective effects in protecting against apoptosis in ischemia reperfusion injury of rabbit retina.