【摘要】 目的 探討雙眼散光軸向的關系。 方法 隨機選取2010年1—12月預行準分子激光原位角膜磨鑲術（laser in situ keratomileusis，LASIK）手術患者200例400只眼（散光gt;-0.50 D），收集全眼散光和角膜散光軸向，定性和定量分析雙眼散光軸向的關系。 結果 ①定性分析：雙眼全眼散光性質相同病例在電腦驗光儀結果中占92.5%，在綜合驗光儀結果中占95.0%；雙眼角膜散光性質相同病例在電腦驗光儀結果中占95.5%，在角膜地形圖結果中占97.5%。②定量分析：雙眼全眼散光在電腦驗光儀結果中對稱者為36.5%，近似對稱為25.0%，非對稱為38.5%；在綜合驗光儀結果中對稱者為50.5%，近似對稱為19.5%，非對稱為30.0%。雙眼角膜散光在電腦驗光儀結果中對稱者為37.0%，近似對稱為31.5%，非對稱為31.5%；在角膜地形圖結果中對稱者為43.0%，近似對稱為32.0%，非對稱為25.0%。雙眼散光軸向對稱性指數的中位數在4種檢查結果中分別為：8、6、8、6。 結論 雙眼的全眼和角膜散光在軸向方面都具有同質性，并且具有對稱或近似對稱趨勢。【Abstract】 Objective To analyze the relationship between binocular astigmatism axes. Methods This study included 400 eyes of 200 patients treated by laser in situ keratomileusis (LASIK) between January and December 2010, whose astigmatic degrees were greater than -0.5 D. We collected astigmatic axles coming from either whole eye or cornea. The relationship between binocular astigmatism axes was analyzed qualitatively and quantitatively. Results ① Qualitative analysis: cases of total astigmatism axis with similar quality in autorefraction took up 92.5%, and 95% in subjective refraction. Cases of cornea astigmatism axis with similar quality in autorefraction took up 95.5%, and 97.5% in cornea topography. ② Quantitative analysis: in autorefraction, cases of total astigmatism axes were symmetrical in 36.5%, approximately symmetrical in 25%, and dissymmetrical in 35% of the subjects. In subjective refraction, 50.5% showed symmetry, 19.5% approximate symmetry, and 30% dissymmetry. In autorefraction, cases of cornea astigmatism axis were symmetrical in about 37%, approximately symmetrical in 31.5%, and dissymmetrical in 31.5% of the patients. In cornea topography, 43% of the cases were symmetrical, about 32% were approximately symmetrical, and 25% were dissymmetrical. The middle numbers of the symmetrical index for the four kinds of examinations were respectively 8, 6, 8, and 6. Conclusion The total astigmatism axis and the binocular astigmatism axis of cornea have the characteristic of homogeneity, also the trend of symmetry.
目的 評價24小時眼壓監測對原發性開角型青光眼的診斷價值。 方法 前瞻性連續納入2012年1月至2015年5月行24小時眼壓監測的372例受試對象，其中青光眼組137例（271眼），對照組235例（470眼）。分別采用視野、OCT及房角鏡等金標準與24小時眼壓監測比較兩組的診斷準確性和特異性。采用SPSS 13.0軟件分析數據，應用Kappa檢驗診斷結果的一致性。 結果 24小時眼壓監測診斷青光眼的敏感度和特異度分別為97%和78.7%，且與金標準的診斷結果具有一致性（k值=0.707）（P < 0.000?1）。與對照組相比，青光眼組在各監測時段眼壓均值均更高，差異有統計學意義（P < 0.001）。青光眼組的眼壓在早上6點和10點出現兩個峰值。女性患者的夜間眼壓值波動幅度（尤其夜晚22點時）高于男性（t=2.064，P=0.04）。 結論 24小時眼壓監測是一種有效和便捷的檢測手段，可單獨或聯合其他診斷工具用于早期原發性開角型青光眼疑診患者的輔助診斷。