目的:评价实时虹膜识别技术应用在波前引导准分子激光原位角膜磨镶术(laser in situ keratomileusis,LASIK)治疗中高度近视性散光中的准确性、稳定性。方法:采用随机对照研究,接受实时虹膜识别联合波前引导LASIK手术的近视性散光患者57...目的:评价实时虹膜识别技术应用在波前引导准分子激光原位角膜磨镶术(laser in situ keratomileusis,LASIK)治疗中高度近视性散光中的准确性、稳定性。方法:采用随机对照研究,接受实时虹膜识别联合波前引导LASIK手术的近视性散光患者57例104眼作为试验组,接受常规波前引导LASIK手术的近视性散光患者58例107眼作为对照组,对两组患者术后1,3,6mo的裸眼视力、最佳矫正视力、散光度、散光轴向、波前像差等进行比较。结果:静态虹膜识别检测出眼球旋转偏移角度为2.61°±2.08°,动态虹膜识别检测眼球旋转变化范围为0°～5°。术后6mo时,试验组裸眼视力≥术前最佳矫正视力的患者(96眼,92.3%)多于对照组(78眼,72.9%),差异有统计学意义(P<0.01);试验组的平均散光(-0.28±0.26D)低于对照组(-0.44±0.35D),差异有统计学意义(P<0.05)。术后6mo,试验组无散光眼(49眼,47.1%)多于对照组(31眼,29.0%),差异有统计学意义(P<0.01)。当瞳孔直径为6mm时,试验组彗差的增加少于对照组,差异有统计学意义(P<0.01)。结论:实时虹膜识别技术能够有效校正LASIK术前和术中的眼球旋转偏差及瞳孔中心移位,使散光度数和轴向的治疗更加精确,同时提高视觉质量。展开更多
目的观察虹膜定位联合波前像差引导的准分子激光原位角膜磨镶术(laser in situ keratomileusis,LASIK)术中眼球旋转的特点与规律。方法选择行虹膜定位联合波前像差引导的LASIK的近视患者560例(1117眼),其中,右眼558眼,左眼559眼。采用Zy...目的观察虹膜定位联合波前像差引导的准分子激光原位角膜磨镶术(laser in situ keratomileusis,LASIK)术中眼球旋转的特点与规律。方法选择行虹膜定位联合波前像差引导的LASIK的近视患者560例(1117眼),其中,右眼558眼,左眼559眼。采用Zywave波前像差仪(美国博士伦公司)采集患眼在暗室瞳孔自然散大状态下及明光小瞳孔时的虹膜数据及波前像差数据,通过网络传输,在切削角膜瓣后掀开角膜瓣前,启动虹膜定位功能,记录眼球旋转类型和度数(系统默认顺时针旋转角度为正值,逆时针旋转角度为负值)。结果双眼的外旋发生率明显大于内旋,差异均有统计学意义(均为P=0.000),右眼外旋377眼(占33.75%),左眼外旋373眼(占33.40%);双眼的旋转度:右眼-0.1°^-11.4°(平均-3.33°±2.28°),左眼0.1°~14.1°(平均3.03°±2.26°)。双眼内、外旋转度≤5.0°者共950眼(占85.05%),其中右眼内旋169眼,外旋304眼;左眼内旋170眼,外旋307眼。结论角膜行屈光手术时,从坐位的术前检查到仰卧位的屈光手术,眼球会发生内、外旋转,虹膜定位联合波前像差引导的LASIK,能将眼球内、外旋转进行准确定位。展开更多
AIM: To analyse previous literature and to formulate a management strategy for iris microhaemangiomas (IMH).METHODS:Areview of the literature in English language articles on IMH.RESULTS: Thirty five English language a...AIM: To analyse previous literature and to formulate a management strategy for iris microhaemangiomas (IMH).METHODS:Areview of the literature in English language articles on IMH.RESULTS: Thirty five English language articles fulfilled the criteria for inclusion to the study and based on the contents on these articles a management strategy was formulated. Age at presentation ranged from 42 to 80 years with no sex or racial predisposition. Most patients with IMH have no systemic disease but a higher incidence had been reported in patients with diabetes mellitus, myotonic dystrophy, chronic obstructive pulmonary disease (COPD) and several other systemic and ophthalmic co-morbidities. Most patients remained asymptomatic until they experienced a sudden blurring of vision due to a hyphaema. Some patients only develop a self-limiting single episode of hyphaema and therefore the laser or surgical photocoagulation of iris should be reserved for the cases complicated with recurrent hyphaema. In some patients, several laser photoco-agulation sessions may be needed and the recurrent iris vascular tufts may require more aggressive treatment. Iris fluorescein angiography (IFA) is useful in identifying the true extent of the disease and helps to improve the precision of the laser treatment. Surgical excision (iridectomy) should only be considered in patients who fail to respond to repeated laser treatment. In some cases IMHs has been initially misdiagnosed as amaurosis fugax, iritis and Posner-Schlossman syndrome.CONCLUSION: Owing to its scarcity, there is no good quality scientific evidence to support the management of IMH. The authors discuss the various treatment options and present a management strategy based on the previous literature for the management for this rare condition and its complications.展开更多
Background For some high myopic patients with posterior iris bowing, laser periphery iridectomy should be performed pre-operation to prevent pupil block glaucoma if these patients would have phakic intraocular lens im...Background For some high myopic patients with posterior iris bowing, laser periphery iridectomy should be performed pre-operation to prevent pupil block glaucoma if these patients would have phakic intraocular lens implantation to correct high myopia. So we had the opportunity to analysis the influence of laser iridectomy on posterior iris bowing. Methods Eighteen high myopic patients with posterior iris bowing （11 males and 7 females） were involved in the study in Beijing Tongren Eye Center from March 2008 to July 2008. Phakic intraocular lens were implanted to correct their ametropia. The mean age was （32＋6） years （range, 25-40 years）. The center anterior chamber depth, the pupil diameter, the posterior iris bowing depth and the anterior chamber angle were measured with anterior segment coherence tomography （AS-OCT） under the normal condition, myosis condition induced by 2% pilocarpine, laser periphery iridectomy after myosis, and 2% pilocarpine eluting condition respectively. Results There was no significant difference of center anterior chamber depth under the four conditions （P=0.512）. The pupil constricted after pilocarpine （P=0.001）. After＇ laser iridectomy performed and pilocarpine eluted, posterior iris bowing depth reduced more than that in normal condition （P=0.003）. The anterior chamber angle reduced significantly after laser periphery iridectomy and pilocarpine eluted （P=0.012）. Conclusion Laser periphery iridectomy can reduce the posterior iris bowing, which might be due to the change in aqueous circulate pathway.展开更多
文摘目的:评价实时虹膜识别技术应用在波前引导准分子激光原位角膜磨镶术(laser in situ keratomileusis,LASIK)治疗中高度近视性散光中的准确性、稳定性。方法:采用随机对照研究,接受实时虹膜识别联合波前引导LASIK手术的近视性散光患者57例104眼作为试验组,接受常规波前引导LASIK手术的近视性散光患者58例107眼作为对照组,对两组患者术后1,3,6mo的裸眼视力、最佳矫正视力、散光度、散光轴向、波前像差等进行比较。结果:静态虹膜识别检测出眼球旋转偏移角度为2.61°±2.08°,动态虹膜识别检测眼球旋转变化范围为0°～5°。术后6mo时,试验组裸眼视力≥术前最佳矫正视力的患者(96眼,92.3%)多于对照组(78眼,72.9%),差异有统计学意义(P<0.01);试验组的平均散光(-0.28±0.26D)低于对照组(-0.44±0.35D),差异有统计学意义(P<0.05)。术后6mo,试验组无散光眼(49眼,47.1%)多于对照组(31眼,29.0%),差异有统计学意义(P<0.01)。当瞳孔直径为6mm时,试验组彗差的增加少于对照组,差异有统计学意义(P<0.01)。结论:实时虹膜识别技术能够有效校正LASIK术前和术中的眼球旋转偏差及瞳孔中心移位,使散光度数和轴向的治疗更加精确,同时提高视觉质量。
文摘目的观察虹膜定位联合波前像差引导的准分子激光原位角膜磨镶术(laser in situ keratomileusis,LASIK)术中眼球旋转的特点与规律。方法选择行虹膜定位联合波前像差引导的LASIK的近视患者560例(1117眼),其中,右眼558眼,左眼559眼。采用Zywave波前像差仪(美国博士伦公司)采集患眼在暗室瞳孔自然散大状态下及明光小瞳孔时的虹膜数据及波前像差数据,通过网络传输,在切削角膜瓣后掀开角膜瓣前,启动虹膜定位功能,记录眼球旋转类型和度数(系统默认顺时针旋转角度为正值,逆时针旋转角度为负值)。结果双眼的外旋发生率明显大于内旋,差异均有统计学意义(均为P=0.000),右眼外旋377眼(占33.75%),左眼外旋373眼(占33.40%);双眼的旋转度:右眼-0.1°^-11.4°(平均-3.33°±2.28°),左眼0.1°~14.1°(平均3.03°±2.26°)。双眼内、外旋转度≤5.0°者共950眼(占85.05%),其中右眼内旋169眼,外旋304眼;左眼内旋170眼,外旋307眼。结论角膜行屈光手术时,从坐位的术前检查到仰卧位的屈光手术,眼球会发生内、外旋转,虹膜定位联合波前像差引导的LASIK,能将眼球内、外旋转进行准确定位。
文摘AIM: To analyse previous literature and to formulate a management strategy for iris microhaemangiomas (IMH).METHODS:Areview of the literature in English language articles on IMH.RESULTS: Thirty five English language articles fulfilled the criteria for inclusion to the study and based on the contents on these articles a management strategy was formulated. Age at presentation ranged from 42 to 80 years with no sex or racial predisposition. Most patients with IMH have no systemic disease but a higher incidence had been reported in patients with diabetes mellitus, myotonic dystrophy, chronic obstructive pulmonary disease (COPD) and several other systemic and ophthalmic co-morbidities. Most patients remained asymptomatic until they experienced a sudden blurring of vision due to a hyphaema. Some patients only develop a self-limiting single episode of hyphaema and therefore the laser or surgical photocoagulation of iris should be reserved for the cases complicated with recurrent hyphaema. In some patients, several laser photoco-agulation sessions may be needed and the recurrent iris vascular tufts may require more aggressive treatment. Iris fluorescein angiography (IFA) is useful in identifying the true extent of the disease and helps to improve the precision of the laser treatment. Surgical excision (iridectomy) should only be considered in patients who fail to respond to repeated laser treatment. In some cases IMHs has been initially misdiagnosed as amaurosis fugax, iritis and Posner-Schlossman syndrome.CONCLUSION: Owing to its scarcity, there is no good quality scientific evidence to support the management of IMH. The authors discuss the various treatment options and present a management strategy based on the previous literature for the management for this rare condition and its complications.
文摘Background For some high myopic patients with posterior iris bowing, laser periphery iridectomy should be performed pre-operation to prevent pupil block glaucoma if these patients would have phakic intraocular lens implantation to correct high myopia. So we had the opportunity to analysis the influence of laser iridectomy on posterior iris bowing. Methods Eighteen high myopic patients with posterior iris bowing （11 males and 7 females） were involved in the study in Beijing Tongren Eye Center from March 2008 to July 2008. Phakic intraocular lens were implanted to correct their ametropia. The mean age was （32＋6） years （range, 25-40 years）. The center anterior chamber depth, the pupil diameter, the posterior iris bowing depth and the anterior chamber angle were measured with anterior segment coherence tomography （AS-OCT） under the normal condition, myosis condition induced by 2% pilocarpine, laser periphery iridectomy after myosis, and 2% pilocarpine eluting condition respectively. Results There was no significant difference of center anterior chamber depth under the four conditions （P=0.512）. The pupil constricted after pilocarpine （P=0.001）. After＇ laser iridectomy performed and pilocarpine eluted, posterior iris bowing depth reduced more than that in normal condition （P=0.003）. The anterior chamber angle reduced significantly after laser periphery iridectomy and pilocarpine eluted （P=0.012）. Conclusion Laser periphery iridectomy can reduce the posterior iris bowing, which might be due to the change in aqueous circulate pathway.
