角膜磨镶术,激光原位

角膜磨镶术,激光原位的相关文献在2002年到2021年内共计317篇,主要集中在眼科学、内科学、临床医学 等领域,其中期刊论文317篇、专利文献417897篇;相关期刊54种,包括国际眼科纵览、临床眼科杂志、中华实验眼科杂志等; 角膜磨镶术,激光原位的相关文献由782位作者贡献,包括周行涛、李莹、王卫群等。

角膜磨镶术,激光原位—发文量

期刊论文>

论文:317 占比:0.08%

专利文献>

论文:417897 占比:99.92%

总计:418214篇

角膜磨镶术,激光原位—发文趋势图

角膜磨镶术,激光原位

-研究学者

  • 周行涛
  • 李莹
  • 王卫群
  • 王勤美
  • 余野
  • 张丰菊
  • 褚仁远
  • 夏英杰
  • 杨斌
  • 陈跃国
  • 期刊论文
  • 专利文献

搜索

排序:

年份

作者

    • 祁媛媛; 王淑涵; 黄悦; 赵少贞
    • 摘要: 目的 分析经上皮准分子激光角膜切削术(Trans-PRK)和飞秒激光制瓣准分子激光原位角膜磨镶术(FS-LASIK)术后角膜前表面非球面系数的变化特点.方法 回顾性研究.以天津医科大学眼科医院2018年7月至2019年12月行角膜屈光手术72例(144只眼)为研究对象,其中Trans-PRK组32例(64只眼)和FS-LASIK组40例(80只眼).术后随访3个月.比较两组角膜前表面的各项非球面性系数Q值及其差值(△Q)并分析其相关影响因素.结果 术后1个月直径6、7、8及9 mm范围角膜前表面Q值,Trans-PRK组分别为0.56±0.31、0.54±0.29、0.49±0.26及0.36±0.24;FS-LASIK组分别为0.63±0.27、0.62±0.26、0.55±0.24及0.42±0.22.两组手术前后不同时间Q值差异均有统计学意义(P<0.05),且Trans-PRK组△Q增加量均小于FS-LASIK组者.术后两组△Q值与术前等效球镜度、切削深度、切削比率均呈线性相关性(P<0.05).结论 两组术后均使角膜前表面Q值由负变正,同等屈光状态下Trans-PRK者术后△Q增加量小于FS-LASIK者.
    • 吴一峰; 邓珍
    • 摘要: 目的 探讨飞秒激光小切口角膜基质透镜取出术(SMILE)对近视患者角膜内皮细胞密度的影响.方法 选取杭州市余杭区第一人民医院(浙江大学附属第二医院余杭院区)2016年1月至2019年1月收治的行近视矫正治疗的患者92例为研究对象,按照治疗方式的不同将患者分为两组,对照组46例,采用半飞秒手术治疗;观察组46例,采用SMILE治疗,比较两组的治疗效果及角膜内皮细胞密度.结果 术后1个月、6个月,两组患者裸眼视力均差异无统计学意义(均P>0.05).术后1个月、6个月,对照组眼压改变率分别为(-29.33±1.02)%、(-27.03±4.03)%,观察组分别为(-27.10±1.04)%、(-24.04±3.94)%,两组均差异有统计学意义(t=10.383、3.598,均P<0.05);对照组中央角膜厚度改变率分别为(-17.80±2.08)%、(-15.59±1.02)%,观察组分别为(-14.54±2.05)%、(-13.39±1.00)%,两组均差异有统计学意义(t=7.571、10.446,均P<0.05).两组术前及术后1个月、术后6个月角膜内皮细胞密度均差异无统计学意义(均P>0.05).结论 予以近视患者SMILE及半飞秒手术治疗均可取得较为明显的效果,但相对于半飞秒手术,SMILE对患者术后角膜弹性及角膜内皮细胞密度的影响较小.
    • 黄德晗; 司方圆; 刘才远
    • 摘要: 目的 比较飞秒制瓣准分子激光原位角膜磨镶术(FS-LASIK)和机械刀辅助的前弹力层下激光角膜磨镶术(SBK)术后角膜前表面高阶像差的变化情况.方法 选择2015年9月至2016年8月在宣城市中心医院行角膜屈光手术病人112例,通过随机数字表法分为FS-LASIK的54例病人(54只眼)和行SBK术的58例病人(58只眼),其中每例病人随机数字表法选择1只眼.于术前及术后3个月利用眼前节全景仪(Pentacam HR)测量病人角膜前表面的高阶像差(主要包括总的高阶像差、水平彗差、垂直彗差及球差),高阶像差的描述采用Zernike多项式表示.结果 FS-LASIK组和SBK组术前病人在年龄、等效球镜度数(SE)、角膜前表面各高阶像差的比较均差异无统计学意义(P>0.05).FS-LASIK组术后3个月的角膜前表面总的高阶像差和球差较术前差异有统计学意义(P<0.001),水平及垂直彗差较术前均差异无统计学意义(P值分别为0.558和0.325).SBK组术后3个月角膜前表面总的高阶像差、球差(P<0.001)及垂直彗差(P=0.001)较术前差异有统计学意义,水平彗差较术前差异无统计学意义(P=0.428).FS-LASIK组和SBK组在术后3个月时的总的高阶像差、水平慧差及球差值均差异无统计学意义(P值分别为0.487、0.373和0.063),然而两组之间的垂直彗差差异有统计学意义[FS-LASIK:(-0.03±0.48)μm,SBK:(-0.21±0.42)μm;P=0.030].结论 FS-LASIK术组与SBK术组在角膜前表面的总高阶像差、水平慧差和球差之间均差异无统计学意义,然而FS-LASIK术后3个月的角膜前表面垂直彗差显著低于SBK组,可能表明在对称性、偏中心、倾斜等方面,飞秒激光制瓣优于机械板层角膜刀制瓣.
    • 李华; 陈敏; 田乐; 李德卫; 彭予苏; 张飞飞
    • 摘要: 目的 探讨飞秒激光辅助准分子激光原位角膜磨镶术(FS-LASIK)术后光学区的变化及Pentacam角膜地形图各模式测量值的特点.方法 回顾性病例研究.选取于青岛眼科医院角膜屈光科行FS-LASIK且术后随访≥6个月资料完整的近视眼及近视散光患者24例(41只眼),其中男性7例,女性17例,年龄18~ 42岁.应用Pentacam眼前节分析系统角膜地形图6种不同模式(单纯角膜轴向曲率图、单纯角膜切线曲率图、角膜轴向曲率差异图、角膜切线曲率差异图、角膜前表面高度图及角膜厚度差异图)联合自主研制的透明同心圆软件对患者术后光学区进行测量.手术后1、3、6个月不同角膜地形图模式测量的光学区直径比较采用重复测量方差分析,光学区实际测量值与理论设计值的比较采用两样本t检验.FS-LASIK术后光学区测量值与可能影响因素的相关性分析采用Spearman秩相关分析.结果 FS-LASIK术后1、3、6个月,单纯角膜轴向曲率图光学区测量值分别为(6.55±0.50)、(6.50±0.53)、(6.48±0.53) mm,差异无统计学意义(F=1.60,P>0.05);单纯角膜切线曲率图测量值分别为(5.44±0.46)、(5.46±0.52)、(5.44±0.50)mm,差异无统计学意义(F=0.17,P>0.05);角膜前表面高度图光学区测量值分别为(5.06±0.28)、(5.12±0.32)、(5.17±0.28)mm,仅术后3、6个月相比差异无统计学意义(F=6.14,P>0.05);角膜轴向曲率差异图光学区测量值分别为(6.51±0.37)、(6.45±0.41)、(6.41±0.40) mm,仅术后3、6个月相比差异无统计学意义(F=7.25,P>0.05);角膜切线曲率差异图光学区测量值分别为(5.21±0.23)、(5.16±0.19)、(5.17±0.20)mm,仅术后1、3个月差异有统计学意义(F=1.75,P<0.05);角膜厚度差异图光学区测量值分别为(6.53±0.40)、(6.39±0.43)、(6.41±0.47)mm,仅术后1、3个月差异有统计学意义(F=1.67,P<0.05).6种模式角膜地形图的光学区测量值与理论值(7.75 mm)相比均明显减小,差异均有统计学意义(t=16.79,31.91,66.44,22.76,69.98,20.09;P<0.01).结论 FS-LASIK术后光学区直径测量值在术后3个月趋于稳定.角膜地形图6种不同模式测量结果显示实际激光切削区与手术设计理论值相比均下降,其中单纯角膜切线曲率图、角膜切线曲率差异图、角膜前表面高度图测量值与理论设计值相差较大且边界清晰,对于偏心评估更有优势;而单纯角膜轴向曲率图、角膜轴向曲率差异图及角膜厚度差异图与理论设计值相对接近,此外角膜轴向曲率差异图边界更清晰更有利于光学区的测量.%Objective To explore the change of optical zone after femtosecond laser assisted laser in sitn keratomileusis(FS-LASIK) so as to provide the reference for measurement and design of clinical optical zone.Methods This retrospective case series study covers 41 eyes of 24 patients (7 males and 17 females,aged from 18 to 42 years old) with myopia and myopic astigmatism who have received FS-LASIK surgery at Corneal Refractive Department of Qingdao Eye Hospital and completed over 6 months of clinical follow-up.Pentacam system (with the application of 6 corneal topographic map modes including:the pure axial curvature topographic map,the pure tangential curvature topographic map,the axial curvature difference topographic map,the tangential curvature difference topographic map,the postoperative front elevation map and the corneal thickness difference topographic map),combined with transparent concentric software (a system independently developed by Qingdao Eye Hospital) was used to measure the optical zone at 1,3 and 6 months postoperatively,the optical zone diameters measurement results among different follow-up times in group were analyzed with the repeated measures analysis of variance,and the actual measured values and the theoretical design values of the optical zone were analyzed with independent-samples t-testing.Spearman correlation coefficient (rs) have been applied to evaluate the relationship between postoperative optical zone measurement values and the potential influencing factors.Results The optical zone diameters measured by pure axial curvature topographic map at 1,3 and 6 months after FS-LASIK showed (6.55± 0.50)mm,(6.50 ± 0.53)mm and (6.48 ± 0.53)mm respectively.The differences between values are of no statistical significance (F=1.60,P=0.21),the optical zone diameter measured by pure tangential curvature topographic map at 1,3 and 6 months after FS-LASIK showed (5.44±0.46)mm,(5.46 ± 0.52)mm and (5.44 ± 0.50)mm respectively,the differences between values are of no statistical significance (F=0.17,P=0.85).The optical zone diameters measured by postoperative front elevation map at 1,3 and 6 months after FS-LASIK showed (5.06±0.28)mm,(5.12±0.32)mm and (5.17±0.28)mm respectively.The differences between the values of 3 and 6 months postoperatively are of no statistical significance (F=6.14,P=0.15),the optical zone diameters measured by axial curvature difference topographic map at 1,3 and 6 months after FS-LASIK showed (6.51±0.37)mm,(6.45±0.41)mm and (6.41 ±0.40)mm respectively,and the differences between the values of 3 and 6 months postoperatively are of no statistical significance (F=7.25,P=0.05).The optical zone diameters measured by tangential curvature difference topographic map at 1,3 and 6 months after FS-LASIK showed (5.21 ± 0.23)mm,(5.16 ± 0.19)mm and (5.17 ±0.20) mm respectively,and the differences between the values of 1 and 3 months postoperatively are of statistical significance (F=1.75,P=0.04).The optical zone diameters measured by corneal thickness difference topographic map at 1,3 and 6 months after FS-LASIK showed (6.53±0.40)mm,(6.39±0.43)mm and (6.41± 0.47)mm respectively,and the differences between the values of 1 and 3 months postoperatively are of statistical significance (F=1.67,P=0.032).The actual measured optical zone values from the 6 different modes of Pentacam system are less than the theoretical design values (7.75 mm),and the differences were statistical significance (t=-15.42,-29.39,-59.27,-21.47,-81.69,-18.22,P<0.01).Conclusions The optical zone measurement values tend to be stable at 3 months after FS-LASIK.The actual measured values from all the 6 different modes of Pentacam system were less than the theoretical design values.The results from pure tangential curvature topographic map,the tangential curvature difference topographic map and the postoperative front elevation map showed greater variation with clear border,which was beneficial for eccentric research.The results from pure axial curvature topographic map,the axial curvature difference topographic map and the corneal thickness difference topographic map were close to the theoretically designed values.Furthermore,the axial curvature difference topographic map showed clearer border and less variation thus maybe more favorable for measuring optical zone in clinical application.
    • 张丰菊; 孙明甡
    • 摘要: 随着准分子激光设备和飞秒激光设备的不断研发和更新,多元化及个性化治疗已成为现代角膜屈光手术的必然趋势.但面对不同的手术设备,如何个性化选择手术方式并精准设计手术方案,以求术后获得高水平视觉质量,是临床医师和患者倍加关注的焦点问题.目前临床广泛开展的飞秒激光辅助准分子激光原位角膜磨镶术(LASIK)及飞秒激光小切口角膜基质透镜取出术孰优孰劣?应如何进行选择?本文以此为焦点,深入阐述两种术式的特点及其利弊,目的在于为临床理性地个性化选择角膜屈光手术方式,并合理及规范开展临床治疗工作提供参考.%With the development of excimer laser and femtosecond laser equipment,application of diversified and customized surgical decision in modern corneal refractive surgery has been an inevitable trend.However,how to make a personalized decision with an accurate surgical design to achieve better visual quality becomes the main focus in clinical applications.Small-incision lenticule extraction (SMILE) and femtosecond assisted laser in situ keratomileusis (FS-LASIK) have been commonly acknowledged as the mainstream of corneal refractive surgery for ametropia correction nowadays.Both methods have been verified by clinical practice for many years.This article compares and elaborates the different characteristics with advantages and disadvantages of the two methods so as to provide some reasonable treatment options for refractive surgery.
    • 王力翔; 李莹
    • 摘要: 目的 探讨经上皮的准分子激光角膜切削术(T-PRK)、飞秒激光制瓣的准分子激光原位角膜磨镶术(FS-LASIK)及飞秒激光小切口角膜基质透镜取出术(SMILE)后角膜神经纤维的恢复情况及其与主观视觉质量的关系.方法 前瞻性队列研究.选择于北京协和医院眼科就诊并自愿行屈光手术治疗屈光不正的患者共55例(109只眼),其中男性6例(12只眼),女性49例(97只眼);年龄(25.6±7.3)岁.根据患者术前检查结果、患者意愿及医师建议,分为SMILE组35例(男4例,女31例,共69只眼)、FS-LASIK组9例(男1例,女8例,共18只眼)及T-PRK组11例(男1例,女10例,共22只眼).由同一术者进行手术,于术前及术后7、30、90 d行角膜共聚焦显微镜检查,并填写主观视觉质量问卷.采用ACCMetrics软件对共聚焦显微镜照片神经纤维进行量化分析.3个组手术前后神经纤维各测量参数比较采用Kruskal-WallisH检验.对术后主观视觉质量与神经纤维测量参数的关系采用Pearson相关性分析.结果 3个组患者术后7d角膜神经纤维密度最低,术后7、30、90 d SMILE组在神经纤维密度[12.50(12.50),12.50(12.50),18.75(14.06)根/mm2,x2=6.54,9.02,7.01;P<0.05]、总神经分叉点密度[18.75(31.25),24.99(29.69),31.25(32.81)个/mm2,x2=10.23,7.63,10.01;P<O.05]及神经纤维长度[8.53(7.32),9.33(6.47),10.98(4.85) mm/mm2,x2=9.21,8.15,6.54;P<0.05]方面均优于其他两组.3个组患术前、术后7d、术后30 d及术后90 d主观视觉质量评分分别为(4.13±0.61)、(3.54±0.71)、(4.03±0.70)及(4.20±0.58)分,术后7d主观视觉质量评分最低(F=1.51;P=0.23),但3个组患者术后各时间点主观视觉质量评分组间差异无统计学意义(P> 0.05).术后7d主观视觉质量与神经纤维长度和神经纤维密度之间呈正相关(r=0.378,0.504;P<0.05),术后30及90 d主观视觉质量与角膜神经纤维参数未见相关性.结论 SMILE术后角膜神经纤维恢复较T-PRK及FS-LASIK更快,术后早期角膜神经纤维密度与主观视觉质量呈正相关.%Objective To explore nerve fiber regeneration and subjective visual quality of patients undergoing small incision lenticule extraction (SMILE) surgery,femtosecond laser-assisted in-situ keratomileusis (FS-LASIK) and transepithelial photorefractive keratectomy (T-PRK),and study their correlation.Methods This is a prospective cohort study including 55 patients (6 male,49 female,age 25.6±7.3,in total 109 eyes) who chose refractive surgery in Peking Union Medical College Hospital.They are subdivided into 3 groups:35 patients in SMILE (4 male,31 female),9 patients in FS-LASIK (1 male,8 female) and 11 patients in T-PRK (1 male,10 female).All surgeries were conducted by the same surgeon.Patients underwent confocal microscopy examinations and filled in subjective visual quality questionnaires before surgery and 7 days,30 days and 90 days after surgery.ACCMterics V.2 was used for nerve analysis.One-way analysis of variance,Kruskal-Wallis H test and Pearson correlation study was adopted for data analysis on SPSS 22.0.Results Corneal nerve fiber density is lowest at 7 days after surgery.The nerve fiber length (8.53 (7.32),9.33 (6.47),10.98 (4.85) mm/mm2,x2=9.21,8.15,6.54;P<0.05),density (12.50 (12.50),12.50 (12.50),18.75 (14.06)/mm2,x2=6.54,9.02,7.01;P<0.05) and total branch density (18.75 (31.25),24.99 (29.69),31.25 (32.81)/mm2,x2=10.23,7.63,10.01;P<0.05) of SMILE group are significantly higher than the other 2 groups at 7 days,30 days and 90 days after surgery.The subjective visual quality scores are (4.13±0.61),(3.54±0.71),(4.03±0.70) and (4.20±0.58) respectively at each visit,with 7 days being the lowest (F=1.51,P=0.23),but there is no statistically significant difference between each group at each visit.At 7 days after surgery,the nerve fiber length (CNFL) and nerve fiber density (CNBD) show strong positive correlation with overall subjective visual quality (r=0.378,0.504;P<0.05),while there exists no significant correlation between nerve fiber parameters and subjective visual quality 30 days and 90 days after surgery.Conclusions SMILE shows better results in corneal nerve fiber regeneration.Corneal nerve fiber density of early post-operational period is positively correlated with overall subjective visual quality.
    • 李军; 申华
    • 摘要: [目的]探讨两种准分子激光手术治疗近视术后的泪膜稳定性.[方法]选择2012年10月至2014年5月本院收治的280例近视患者,根据不同手术方式随机分为准分子激光原位角膜磨镶术(LASIK组)和前弹力层下准分子激光原位角膜磨镶术(SBK组),每组各140例.比较两组手术疗效及术后泪膜稳定性.[结果]SBK组术后各时间点视力均高于LASIK组,但差异无统计学意义(P>0.05);SBK组术后3个月、6个月屈光度回退低于LASIK组,差异有统计学意义(P<0.05);SBK组术后1个月、3个月基础泪液分泌量(SIT)和侵入性泪膜破裂时间(NIBUT)值低于LASIK组,差异均有统计学意义(P<0.05).SBK组术后1个月、3个月角膜着色和干眼眼数低于LASIK组,差异均有统计学意义(P<0.05).[结论]LASIK和SBK两种手术都可以安全有效的治疗近视,但是SBK术后屈光回退较低,泪膜稳定性恢复较快,干眼发生率较低,优于LASIK术.
    • 吴莹; 田磊; 王丽强; 葛梅; 黄一飞
    • 摘要: 目的 评估快速紫外线/核黄素角膜胶原交联(ACXL)联合准分子激光原位角膜磨镶术(LASIK)治疗近视术后6个月的临床效果.方法 前瞻性自身对照研究.选取18例(36眼)近视患者,先进行飞秒激光制瓣的LASIK,角膜瓣复位前用Vibex Xtra核黄素溶液浸润角膜基质床90 s后复位角膜瓣,应用辐照强度为30 mW/cm2的紫外光(KXL系统)照射角膜90 s,总能量为2.7 J/cm2,进行ACXL治疗.术后随访6个月以上.对术前和术后6个月的视力、屈光度、角膜形态参数、角膜内皮细胞密度(ECD)、角膜生物力学特征等进行比较.采用配对t检验比较手术前后各参数的变化情况.结果 术后6个月,裸眼视力(UCVA,IogMAR)从术前0.93±0.34提高到-0.05±0.08,等效球镜度(SE)从(-8.03±1.86)D减少到(-0.29±0.39)D,平均角膜曲率从(44.79±2.10)D减少到(37.96±2.32)D,角膜厚度从(524.6±25.2) μm减少到(437.7±27.0)μm,角膜最大屈膝峰距从术前(5.48±0.31)mm减少到(4.99±0.44)mm,最大压陷深度从术前(1.09±0.12)mm增加到(1.18±0.18)mm.除ECD和最大压陷曲率半径外,其余指标术前、术后差异均有统计学意义(t=-63.02~26.68,P<0.05).术后6个月随访期内,未见屈光回退、角膜扩张、感染和非感染性角膜炎等并发症.结论 ACXL联合LASIK能够有效矫正近视,术后6个月效果稳定,无明显并发症,但长期效果及临床适应证仍需进一步观察.%Objective To evaluate at six months after myopia surgery the clinical effects of laser in situ keratomileusis (LASIK) combined with accelerated UVA/riboflavin corneal collagen cross-linking (ACXL).Methods This was a prospective and self-controlled study that included 18 myopia patients (36 eyes).LASIK was performed using femtosecond and excimer lasers.Before the flap was reset,single-use Vibe Xtra riboflavin drops were instilled in the corneal stromal bed for 90 seconds.A KXL system (Avedro Inc.) was used to irradiate the cornea with UVA light,delivering 30 mW/cm2 of irradiance for 90 seconds.The total exposure dose was 2.7 J/cm2.Uncorrected visual acuity (UCVA),best corrected visual acuity (BCVA),spherical equivalent (SE),comeal topography,thinnest comeal thickness (TCT),and endothelial cell density (ECD) were evaluated preoperatively and six months postoperatively.Paired t-test were used for statistical analysis.Results Mean UCVA changed from 0.93±0.34 (logMAR) to-0.05±0.08,SE from-8.03±1.86 diopter (D) to-0.29±0.39 D,keratometry from 44.79±2.10 D to 37.96±2.32 D,TCT from 524.6±25.2 μm to 437.7±27.0 μm,corneal peak distance from 5.48±0.31 mm to 4.99±0.44 mm,and corneal deformation amplitude from 1.09±0.12 mm to 1.18±0.18 mm.Aside from the ECD and highest corneal concavity radius,changes in the remaining parameters between preoperative and six-month postoperative values were significant (t=-63.02~26.87,P<0.05).None of the patients developed signs of significant regression,ectasia,or keratitis during the follow-up period.Conclusion LASIK combined with ACXL can effectively correct refractive error in patients with myopia.There were no significant complications during the six-month follow-up.But the long-term effects and indications of LASIK combined with ACXL need to be further observed and studied.
    • 张莎莎; 桂四凤; 钱倩; 吴震宇; 余野; 黄逸青; 江露; 胡亮; 瞿佳
    • 摘要: Objective To investigate the effect of nerve growth factor (NGF) eye drops on central corneal nerve regeneration in rabbits after laser in situ keratomileusis (LASIK).Methods This was a experimental study.Fifteen New Zealand white rabbits were randomly assigned to one of three groups:NGF-treatment group,artificial tears hycosan-treatment group (positive control group),and normal saline-treatment group (negative control group) with five rabbits in each group,one drop every time and three times per day.The nerve density and the number of central corneal sub-basal and stromal cells were measured by confocal microscopy and were compared before surgery and at 1 week,1 month,and 3 months after surgery.Analysis of variance was used for comparing the differences at different time points and among the three groups.Results The respective preoperative sub-basal nerve densities (SNDs) in the negative control group,positive control group,and NGF treatment group were 10801±3331 μm/mm2,11 619±3 932 μm/mm2,and 12 299±2 622 μm/mm2.The number of corneal sub-basal nerve fibers were 12.2±3.4,11.6±2.7,and 13.1±9.7 in the respective groups.In the preoperative corneas,the comeal stromal nerve densities were 7 258±1 242 μm/mm2,8 148±2 462 μm/mm2,8 984±1 526 μm/mm2,and the number of corneal stromal nerve fibers were 8.5±1.4,8.9±2.6,10.1±2.1 in the respective groups.Compared with preoperative values,nerve parameters in all groups increased at 1 week postoperatively (P<0.01).Compared with 1 week postoperative,SNDs and corneal stromal nerve densities in the NGF group increased at 1 month,while the control groups increased at 3 months (P<0.01).The number of sub-basal corneal nerve fibers in all three groups increased at 3 months (P<0.05).The number of corneal stromal nerve fibers increased at 1 month compared with 1 week postoperative in the NGF group and the positive control group (P<0.05).However there were no significant changes in the number of corneal stromal nerve fibers between pre-and postoperative 1 and 3 months measurements.Conclusion NGF eye drops promote comeal nerve repair at different periods following LASIK in rabbit eyes.%目的 探讨神经生长因子(NGF)对兔眼准分子激光原位角膜磨镶术(LASIK)后角膜神经损伤再生修复的影响.方法 实验研究.将15只(30眼)薄瓣LASIK术后新西兰大白兔随机分为NGF组(NGF治疗)、阳性对照组(人工泪液玻璃酸钠滴眼液治疗)与阴性对照组(0.9%氯化钠溶液滴眼),每组各5只(10眼).利用共聚焦显微镜分别测量术前,术后1周、1个月、3个月中央角膜上皮下神经密度(SND)、上皮下神经数量及浅基质神经密度、浅基质神经数量,并进行比较.采用重复测量方差分析比较不同时间点及3组之间各神经参数的差异.结果 术前阴性对照组、阳性对照组、NGF治疗组SND分别为(10 801±3 331) μm/mm2、(11 619±3 932)μm/mm2、(12 299±2 622)μm/mm2,上皮下神经纤维数量分别为12.2±3.4、11.6±2.7、13.1±2.7,浅基质神经密度分别为(7258±1 242)μm/mm2、(8 148±2 462)μm/mm2、(8 984±1 526)μm/mm2,浅基质神经数量分别为8.5±1.4、8.9±2.6、10.1±2.1.与术前相比,3组所有的神经参数在术后1周均明显减少(P<0.01).与术后1周相比,NGF治疗组SND、浅基质神经密度在术后1个月均上升,而阴性对照组和阳性对照组的SND、浅基质神经密度在术后3个月才开始上升,差异有统计学意义(P<0.01);3组上皮下神经数量在术后3个月开始上升(P<0.05);NGF组和阳性对照组的浅基质神经数量在术后1个月上升(NGF组P<0.01,阳性对照组P<0.05),并且NGF组的浅基质神经数量在术后1个月恢复到术前水平.结论 NGF滴眼液对LASIK术后角膜神经的损伤再修复有明显促进作用.
    • 李华; 王雁; 窦瑞; 王璐; 徐路路; 李晓晶; 张佳媚
    • 摘要: Objective To evaluate the effects of side-cut angles on corneal biomechanical properties after femtosecond laser assisted-laser in situ keratomileusis (FS-LASIK). Methods In this clinical control study, 97 right eyes of 97 patients with myopia and myopic astigmatism undergoing FS-LASIK surgery were included randomly. Two types of side-cut angles were designed for the flap, 90° in 48 eyes and 130° in 49 eyes. The values of corneal resistance factor (CRF), cornea hysteresis (CH) and 37 biomechanical waveform parameters were measured using the ocular response analyzer preoperatively and at 1 and 3 months postoperatively. The comparison between the two groups at different follow-up time points was made with one-way analysis of variance, and the comparison among different follow-up time points in each group was performed with the repeated measures analysis of variance. Results The mean CRF, CH, p area, h, dive1, dive2 , w11 and w21 in both groups showed significant reduction at 1 month postoperatively (group 90°:CRF 10.49 vs. 6.85,CH 10.02 vs. 7.55,p1 area 3 537.54 vs. 1 918.07,h1 404.74 vs. 283.25, dive1 350.63 vs. 243.33 ,w11 10.50 vs. 7.58. group 130°:CRF 10.14 vs. 6.38 ,CH 9.93 vs. 7.13 ,p1 area 3 498.93 vs. 2 038.74,h1 411.93 vs. 304.49,dive1 352.51 vs. 265.12,w11 10.55 vs. 7.78. P<0.001). The mean CRF, CH, p area, w, h, dive1 and dive2 in both groups showed significant reduction at 3 months postoperatively (group 90°:CRF 10.49 vs. 6.60,CH 10.02 vs. 7.65,p1 area 3537.54 vs. 2042.91,h1 404.74 vs. 307.77,dive1 350.63 vs. 263.33,w11 10.50 vs. 7.58. group 130°:CRF 10.14 vs. 6.45,CH 9.93 vs. 7.67,p1 area 3 498.93 vs. 2 187.97,h1 411.93 vs. 327.39,dive1 352.51 vs. 284.26,w11 10.55 vs. 7.61. P<0.001). The mean path in both groups showed significant increase at 1 and 3 months postoperatively (group 90°:path1 23.14 vs. 30.50 vs. 30.79. group 130°:path1 24.12 vs. 32.18 vs. 31.49. P<0.001). The mean aplhf, bindex, dive2 and path2 between both groups at 1 month postoperatively showed significant difference (F=8.609, 7.482, 5.238, 4.885, P<0.05). The mean path11 between both groups at 3 months postoperatively showed significant difference (F=6.160, P<0.05). Conclusions Corneal biomechanical properties significantly decrease after FS-LASIK, and different side-cut angles have some effect on corneal biomechanical properties after FS-LASIK. The corneal deformation is more stable after flap creation with an obtuse side-cut angle making the cornea under stress. Combined with waveform parameters of the ocular response analyzer, more subtle changes of corneal biomechanical properties can be found.%目的:分析评价不同侧切角对飞秒激光辅助的LASIK(FS-LASIK)术后角膜生物力学的影响作用。方法临床对照研究。在2013年4月至2014年4月于天津市眼科医院屈光手术中心拟行角膜屈光手术的屈光不正患者中进行筛查,符合纳入标准的病例中采用随机数字表法随机抽取,选取自愿接受FS-LASIK手术的近视及近视散光患者97例(97只右眼)作为研究对象,设计两种侧角FS-LASIK 90°侧切角组48例,FS-LASIK 130°侧切角组49例。分别于术前及术后1和3个月用眼反应分析仪(ORA)测量观察术眼手术前后角膜阻力因子(CRF)、角膜滞后量(CH)及37个角膜生物力学波形参数值。两组间不同时间点比较采用单因素方差分析,组内各时间点变化采用重复测量方差分析法。结果两组术后1个月与术前相比CRF、CH及角膜生物力学波形参数parea、h、dive1、dive2、w11、w21均明显下降,差异有统计学意义(90°组:CRF 10.49、6.85,CH 10.02、7.55,p1area 3537.54、1918.07,h1404.74、283.25,dive1350.63、243.33,w1110.50、7.58;130°组:CRF 10.14、6.38,CH 9.93、7.13,p1area 3498.93、2038.74,h1411.93、304.49,dive1352.51、265.12,w1110.55、7.78,P<0.001);两组术后3个月与术前相比CRF、CH及角膜生物力学波形参数中parea、w、h、dive1、dive2均明显下降,差异有统计学意义(90°组:CRF 10.49、6.60,CH 10.02、7.65,p1area 3537.54、2042.91,h1404.74、307.77, dive1350.63、263.33,w1110.50、7.58;130°组:CRF 10.14、6.45,CH 9.93、7.67,p1area 3498.93、2187.97,h1411.93、327.39,dive1352.51、284.26,w1110.55、7.61,P<0.001);两组术后1和3个月与术前相比path均明显升高,差异有统计学意义(90°组:path123.14、30.50、30.79;130°组:path124.12、32.18、31.49,P<0.001)。术后1个月两组间aplhf、bindex、dive2、path2有差异,差异有统计学意义(F=8.609,7.482,5.238,4.885;P<0.05);术后3个月两组间path11有明显差异,差异有统计学意义(F=6.160,P=0.015)。结论 FS-LASIK术后除角膜生物力学明显下降外,不同侧切角对FS-LASIK术后角膜生物力学有一定影响,钝角侧切FS-LASIK术后角膜受力时变形更稳定,结合ORA波形参数可发现角膜生物力学更细微的变化。(中华眼科杂志,2017,53:23-32)
  • 查看更多

客服邮箱:kefu@zhangqiaokeyan.com

京公网安备:11010802029741号 ICP备案号:京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有
  • 客服微信

  • 服务号