目的:探討高齡白內障患者術前角膜內皮功能狀態。方法:對從2007年11月到2008年10月的66例年齡在80歲或以上的左眼白內障患者術前角膜內皮細胞形態及中央角膜厚度進行回顧性分析。分析參數包括角膜內皮細胞密度,內皮細胞平均面積,最大細胞面積和最小細胞面積,內皮細胞變異系數,面積標準差,六角形細胞比例及角膜中央厚度。結果:患者的角膜內皮細胞平均密度為(2720.3±324.6)個/mm2,平均細胞面積為(375.4±70.3)μm2,最大細胞面積(922.1±243.5)μm2,最小細胞面積(131.2±40.2)μm2,面積標準差(143.5±34.8)μm2,細胞變異系數(38.0±7.3)%,六角形細胞比例(52.8±10.1)%。中央角膜厚度與角膜內皮細胞密度之間無相關性。結論:高齡人白內障患者的角膜內皮細胞密度高,角膜功能基本正常，是保持角膜透明的基礎,為眼內手術或治療提供安全保障。
Objective To investigate the influence of undercorrected orthokeratology on myopia control, and the correlation between target and central corneal epithelial damage. Methods A retrospective study was conducted on 22 undercorrected orthokeratology lens wearers (37 eyes) from January 2016 to February 2017, and 25 full corrected wearers (47 eyes) during the concurrent period were randomly selected as the control group. The changes of axial length before and after orthokeratology lens wearing and the within-6-month central corneal epithelial damage after orthokeratology lens wearing were analyzed. Results The average annual increase of axial length was (0.13±0.15) mm in the undercorrected group, and (0.14±0.16) mm in the full corrected group, the difference was not statistically significant (P>0.05). Multiple linear regression analysis showed that there was no correlation between the axial growth and the undercorrection of the target (P>0.05), but a negative correlation between the axial growth and the age (P<0.01). After using orthokeratology, the average annual growth of the axial length in children aged 7-10 years was (0.25±0.16) mm, and (0.10±0.14) mm in children aged 11-15 years, the difference was statistically significant (P<0.01). The incidence of central corneal epithelial punctate staining in the (–4.25)-(–5.00) D target group was 27.08%, and that in the (–3.00)-(–4.00) D target group was 16.67%, the difference was not statistically significant (P>0.05). Conclusions The effect of orthokeratology on myopia growth is not affected by the undercorrected target, not related to the undercorrection of target, but negatively correlated with the age. Undercorrected orthokeratology can still be used for myopia control in high myopia patients. No correlation is found between the target and central corneal staining.
Objectives To assess the clinical effectiveness of laser in situ keratomileusis (LASIK) versus laser epithelial keratomileusis (LASEK) for the correction of myopia. Methods Randomised controlled trials (RCTs) were searched in PubMed, EMbase, The Cochrane Library (Issue 2, 2010), CNKI, VIP, and WangFang Data from January, 1990 to October, 2010. The RCTs were included in accordance with the Cochrane review’s methodology, the valid data were extracted, the quality was evaluated, and then the RevMan 5.0 software was used for statistical analyses. Results Seven RCTs involving 1 134 eyes with myopia were included. The results of meta-analyses showed that the efficacy (OR=1.23, 95%CI 0.73 to 2.07), accuracy (OR=1.73, 95%CI 0.74 to 2.53) and safety (OR=1.10, 95%CI 0.22 to 5.59) outcomes between LASIK and LASEK were comparable. Compared with LASIK, LASEK was higher in the incidence rate of postoperative eye pain (RR=0.13, 95%CI 0.08 to 0.22). Conclusion LASIK and LASEK have the same effectiveness for myopia, but LASEK induces more postoperative eye pains. A large number of strictly-designed multi-centred RCTs are required for further verifying this result because of the low quality and instable results of the included studies．
ObjectiveTo investigate whether the corneal shape recovered after discontinuation of long-term orthokeratology and whether orthokeratology increased the corneal astigmatism and ocular astigmatism.MethodsFrom December 2016 to April 2018, a retrospective study was conducted on 33 myopic patients who had undergone two times standard orthokeratology in the outpatient department of West China Hospital of Sichuan University, and had stopped wearing the first orthokeratology lens for one month before fitting the second orthokeratology lens. A total of 32 myopia frame glasses wearers were selected by simple random sampling as control. The changes of corneal flat meridian curvature (flat K), corneal steep meridian curvature (steep K), corneal astigmatism and ocular astigmatism before and after discontinuation of orthokeratology were analyzed.ResultsAmong the patients with baseline myopia diopter of ?0.25～?2.75 D, the average annual change of corneal flat K was (?0.03±0.21) D in the frame glasses group and (?0.24±0.14) D in the orthokeratology group, the difference was statistically significant (t=5.555, P<0.001). Among the patients with baseline myopia diopter of ?0.25～?2.75 D, the average annual change of corneal steep K was (0.20±0.42) D in the frame glasses group and (0.15±0.20) D in the orthokeratology group, the difference was not statistically significant (t=0.785, P=0.435). Among the patients with baseline myopia diopter of ?3.00～?5.75 D, the average annual change of corneal steep K was (0.29±0.39) D in the frame glasses group and (?0.01±0.20) D in the orthokeratology group, the difference was statistically significant (t=2.758, P=0.014). The average changes of corneal astigmatism were analyzed according to the difference of eyes, gender, age and baseline corneal astigmatism, the difference was not statistically significant (P>0.05), respectively. For patients with baseline astigmatism absolute value less than or equal to 0.50 D, the astigmatism annual change of the frame glasses group was 0.00 (0.50) D, and that of orthokeratology group was ?0.33 (0.48) D, the difference was statistically significant (Z=?2.301, P=0.021).ConclusionsThe flat K of the cornea becomes flatter and the steep K does not change after one month’s discontinuation of long-term orthokeratology. There was no difference in the increase of corneal astigmatism compared with those wearing frame glasses. When the baseline ocular astigmatism is less than or equal to 0.50 D, the increase of astigmatism may occur after discontinuation of orthokeratology.
目的 探討準分子激光上皮瓣下角膜磨鑲術（LASEK）后角膜上皮下霧狀混濁（Haze）的形成原因及防治措施。 方法 2004年2月－2011年12月期間采用LASEK治療近視患者345 例669 只眼，屈光度?3.50～?13.5 D，平均（?6.87 ± 2.92）D；散光?0.50～?4.00 D，平均（?1.83 ± 1.32）D 。根據患者術前屈光等效球鏡度數分為：中度近視組（?3.50～?5.75 D）120只眼，高度近視組（?6.00～?8.75 D）288只眼，超高度近視組（?9.00～?13.50 D） 261只眼。應用綜合措施防治Haze，術中用日夜配戴的高親水性繃帶型角膜接觸鏡覆蓋保護角膜上皮瓣，術畢頻點激素眼液4次，術后使用激素類聯合非甾體類抗炎眼液及降眼壓藥、抗生素眼液；隨訪6～12個月，觀察術后Haze的發生率，并按Fantes（1990）標準分級，分析相關原因。 結果 LASEK術后6個月時0.5級Haze發生率14.65%（98只眼），無1級Haze。各組0.5級Haze發生率分別為中度近視組2.5%（3只眼），高度近視組11.11%（32只眼），超高度近視組24.14%（63只眼）。 結論 LASEK術后Haze的發生與術眼的屈光度呈正比，與角膜上皮瓣的活性和完整性，術后紫外線照射等有關。術后采用激素類聯合非甾體類抗炎眼液及降眼壓藥等綜合防治措施，可減少、減輕Haze的發生，使LASEK技術更安全有效。
Objective To evaluate the relative factors of effect of vitrectomy on corneal endothelial cells. Methods Retrospective analysis of the results of corneal endothelium microscopy performed on 213 eyes of 213 patients undergone vetrectomy operations including single vitrectomy (78 eyes), vitrectomy combined with cataract extraction (135 eyes), silicone oil injection (34 eyes), and C3F8 injection (53 eyes) before and after 1 week, 1 and 3 moths of these surgical procedures. Results There was no significant difference between pre- and postoperative corneal endothelium density in single vitrectomy group and vitrectomy combined with cataract extraction with posterior capsule integrity group (Pgt;0.05). The corneal endothelium density significantly decreased postoperatively in C3F8or silicone oil injection group with broken posterior capsule (Plt;0.05). Conclusion C3F8 and silicone oil may damnify corneal endothelium in patients undergo vitrectom y combined with cataract extraction with broken posterior capsule. (Chin J Ocul Fundus Dis，2004，20：101-103)