Journal of refractive and corneal surgery最新文献

英文中文

Role of topical corticosteroids and nonsteroidal antiinflammatory drugs in the etiology of stromal infiltrates after excimer photorefractive keratectomy. 外用皮质类固醇和非甾体类抗炎药在准分子光屈光性角膜切除术后间质浸润的病因学中的作用。

Journal of refractive and corneal surgery

Pub Date : 1994-09-01

N A Sher, R R Krueger, P Teal, R G Jans, D Edmison

引用次数: 0

Accommodation of an endocapsular silicone lens (Phaco-Ersatz) in the aging rhesus monkey. 在老化的恒河猴体内调节内囊硅胶晶体(Phaco-Ersatz)。

Journal of refractive and corneal surgery

Pub Date : 1994-09-01 DOI: 10.3928/1081-597X-19940901-13

E. Haefliger, J. Parel

BACKGROUNDAfter accommodative changes of endocapsular silicone lenses in presenile nonhuman primates had been confirmed by several authors, this pilot study was designed to evaluate the ability of an artificial lens to restore accommodation in the senile eye of a rhesus monkey that had previously lost most of its accommodative capability.METHODSAn injectable silicone lens was implanted in one eye of six rhesus monkeys who were older than 17 years. Accommodation was documented as the amount of decrease of anterior chamber depth after pilocarpine stimulation.RESULTSFour months after surgery, the decrease of anterior chamber depth was higher in the operated eye with the silicone intraocular lens in the two monkeys who had marked presbyopic changes in the natural lens. One monkey was kept for more than 4 years, retaining a decrease of at least 0.5 mm with the silicone lens, whereas the natural lens failed to show any accommodative change.CONCLUSIONSThese findings support recent reports that presbyopia is primarily a consequence of lenticular aging rather than ciliary muscle factors. A pliable injected lens may therefore have the potential to restore accommodation in the senile primate eye.

背景:在几位作者证实了硅树脂内囊性晶状体在非人类灵长类动物中的适应性变化之后，本初步研究旨在评估人工晶状体在恒河猴的老年性眼睛中恢复适应性的能力，恒河猴之前已经失去了大部分的适应性能力。方法对6只17岁以上的恒河猴单眼植入可注射硅胶晶体。调节记录为匹罗卡品刺激后前房深度的减少量。结果2只自然晶状体有明显老花眼变化的猴子，术后4个月硅胶人工晶状体手术眼前房深度下降幅度较大。一只猴子被养了4年多，在硅胶透镜的作用下，它的瞳孔至少缩小了0.5毫米，而在自然透镜的作用下，它的瞳孔却没有任何变化。这些发现支持了最近的报道，即老花眼主要是晶状体老化的结果，而不是睫状肌因素。因此，柔韧的注射晶状体可能具有恢复老年灵长类眼睛适应性的潜力。

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引用次数: 78

Potential pitfall of the duo-trak style diamond knife. 双轨迹式钻石刀的潜在陷阱。

Journal of refractive and corneal surgery

Pub Date : 1994-09-01 DOI: 10.3928/1081-597X-19940901-21

J. Nightingale

引用次数: 0

Misalignment of videokeratoscope produces pseudo-keratoconus suspect. 视频角镜不对准产生伪圆锥角膜可疑。

Journal of refractive and corneal surgery

Pub Date : 1994-07-01

C M Silverman

引用次数: 0

Prostaglandin E2 production after lamellar keratectomy and photorefractive keratectomy. 板层角膜切除术和屈光性角膜切除术后前列腺素E2的产生。

Journal of refractive and corneal surgery

Pub Date : 1994-07-01 DOI: 10.3928/1081-597X-19940701-06

K. Szerenyi, M. Campos, P. McDonnell

PURPOSETo compare the levels of prostaglandin E2 (PGE2) in corneal tissue after 193-nanometer excimer laser keratectomy and mechanical keratectomy with a microkeratome.METHODSFour rabbits underwent 193-nanometer excimer laser phototherapeutic keratectomy on one eye, and lamellar keratectomy with the microkeratome on the fellow eye. The corneas were harvested at 10 hours after the treatment and quantitated for PGE2 levels using an enzyme-linked immune assay. Control levels of PGE2 in untreated corneas were obtained from a previous study.RESULTSUnoperated control corneas had low levels of PGE2 (1.79 +/- 1.0 pg/mL). Both surgical techniques resulted in a significant (p < .01) increase in PGE2. Corneas ablated mechanically with the microkeratome had an average PGE2 level of 15.48 +/-5.36 pg/mL, which represented an 8.6-fold increase compared to control; there was an additional 330% mean increase in PGE2 concentration in the laser-ablated corneas (51.29 +/- 36.08 pg/mL) compared to the corneas treated with mechanical lamellar keratectomy (p = .014).CONCLUSIONSMechanical and photochemical superficial keratectomies induce production of an inflammatory mediator, PGE2. The 193-nanometer excimer laser irradiation causes a greater increase of PGE2 production in the corneal tissue than does keratectomy with the microkeratome; this observation may support a role for cyclo-oxygenase inhibitors in postoperative therapy.

目的比较193纳米准分子激光角膜切除术与机械角膜切除术后角膜组织中前列腺素E2 (PGE2)的水平。方法4只兔单眼行193纳米准分子激光光疗角膜切除术，另一只眼行微角膜瓣板层角膜切除术。在治疗后10小时收获角膜，并使用酶联免疫测定法定量测定PGE2水平。未经治疗的角膜中PGE2的对照水平来自先前的研究。结果对照组角膜PGE2水平较低(1.79 +/- 1.0 pg/mL)。两种手术方式均导致PGE2显著升高(p < 0.01)。用微角膜刀机械消融的角膜平均PGE2水平为15.48 +/-5.36 pg/mL，比对照组增加8.6倍;与机械板层角膜切除术相比，激光消融角膜中PGE2浓度平均增加330% (51.29 +/- 36.08 pg/mL) (p = 0.014)。结论机械和光化学角膜浅表切除术可诱导炎症介质PGE2的产生。193纳米准分子激光照射导致角膜组织中PGE2产生的增加比微角膜切开术更大;这一观察结果可能支持环加氧酶抑制剂在术后治疗中的作用。

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引用次数: 17

Surgical results of penetrating keratoplasty in essential iris atrophy. 穿透性角膜移植术治疗原发性虹膜萎缩的疗效。

Journal of refractive and corneal surgery

Pub Date : 1994-07-01 DOI: 10.3928/1081-597X-19940701-09

B. DeBroff, R. Thoft

BACKGROUNDResults of penetrating keratoplasty in iridocorneal endothelial syndrome have been considered favorable based on past studies; however, documented results in eyes specifically with essential iris atrophy are lacking.METHODSA retrospective study was performed to evaluate all patients at the University of Pittsburgh with essential iris atrophy who had undergone penetrating keratoplasty for corneal decompensation over 21 years (1971-1992).RESULTSPenetrating keratoplasty had been performed on six eyes with essential iris atrophy for corneal decompensation. All eyes postoperatively had evidence of persistent anterior uveitis resistant to corticosteroid treatment with one or more episodes of graft reaction. Five of the six eyes (83.3%) ultimately went on to graft failure. Two of the six eyes (33.3%) rejected grafts on two separate occasions.CONCLUSIONSPenetrating keratoplasty in essential iris atrophy was frequently associated with chronic anterior uveitis and immunologic graft failure.

背景:根据过去的研究，穿透性角膜移植术治疗虹膜角膜内皮综合征的结果被认为是有利的;然而，缺乏专门针对虹膜萎缩的研究结果。方法回顾性分析1971-1992年在匹兹堡大学接受穿透性角膜移植术治疗角膜失代偿的原发性虹膜萎缩患者。结果对6例原发性虹膜萎缩患者行穿透性角膜移植治疗。术后所有的眼睛都有持续的前葡萄膜炎，对皮质类固醇治疗有抵抗性，并伴有一次或多次移植物反应。6只眼中有5只(83.3%)最终移植失败。6只眼睛中的2只(33.3%)在两次不同的情况下排斥移植物。结论穿透性角膜移植术治疗原发性虹膜萎缩常伴有慢性前葡萄膜炎和免疫移植失败。

引用次数: 10

Topical diclofenac following excimer laser: effect on corneal sensitivity and wound healing in rabbits. 准分子激光后局部双氯芬酸对兔角膜敏感性和创面愈合的影响。

Journal of refractive and corneal surgery

Pub Date : 1994-07-01

N Loya, S Bassage, S Vyas, M del Cerro, S B Park, J V Aquavella

Background: Diclofenac is a nonsteroidal antiinflammatory drug (NSAID) that is widely used systemically and topically. We studied the effect of diclofenac on corneal reepithelialization and corneal sensitivity after excimer laser treatment in rabbits.

Methods: Twelve New Zealand white rabbits were divided into four groups (A, B, C, and D). Groups A and B received diclofenac four times and eight times daily, respectively, following a central 5-millimeter epithelial debridement. Groups C (control) and D (diclofenac four times daily) underwent excimer laser ablation (30-micrometer depth) following manual debridement. Wound healing was compared between groups A and B and groups C and D. Sensitivity was recorded preoperatively and postoperatively 1 to 5 and 14 days in groups C and D until normal values were reestablished.

Results: Total time for corneal wound healing and epithelial migration rates was not delayed in any group receiving diclofenac (A, B, and D). Sensitivity after laser ablation reached a minimum of 15% to 20% in both groups C and D by day 2 and returned to normal (100%) by day 8. The decrease in sensitivity between group C, the controls, and group D, receiving diclofenac four times daily, was not statistically significant.

Conclusions: Diclofenac can be used up to eight times daily in the rabbit without causing changes in corneal wound healing or epithelial migration rate. There was no significant, long-term reduction of sensitivity, and recovery was not affected by diclofenac.

背景:双氯芬酸是一种非甾体抗炎药(NSAID)，广泛应用于全身和局部。研究双氯芬酸对兔准分子激光治疗后角膜再上皮化和角膜敏感性的影响。方法:将12只新西兰大白兔分为A、B、C、D 4组，A组和B组分别给予双氯芬酸4次和8次，每日5毫米中心上皮清创。C组(对照组)和D组(双氯芬酸每日4次)在手工清创后行准分子激光消融(30微米深度)。比较A、B组、C、D组创面愈合情况。C、D组术前、术后1 ~ 5、14 D敏感性恢复正常。结果:任何接受双氯芬酸治疗的组(A、B和D组)角膜创面愈合的总时间和上皮细胞迁移率均未延迟。C组和D组激光消融后的敏感性在第2天至少达到15%至20%，并在第8天恢复正常(100%)。C组、对照组和D组(每天服用双氯芬酸4次)之间的敏感性降低无统计学意义。结论:双氯芬酸可以在家兔中每天使用8次，而不会引起角膜伤口愈合或上皮迁移率的变化。没有明显的、长期的敏感性降低，双氯芬酸不影响恢复。

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引用次数: 0

Frown incision in the cornea. 皱眉头角膜切口。

Journal of refractive and corneal surgery

Pub Date : 1994-07-01

E G Pohlhausen

引用次数: 0

Corneal sensation following excimer laser photorefractive keratectomy in humans. 准分子激光屈光性角膜切除术后的角膜感觉。

Journal of refractive and corneal surgery

Pub Date : 1994-07-01 DOI: 10.3928/1081-597X-19940701-07

T. Ishikawa, S. B. Park, C. Cox, M. D. del Cerro, J. Aquavella

BACKGROUNDFor the correction of myopia, small amounts of corneal tissue--including corneal nerves--are removed, resulting in flattening of the central cornea.METHODSWe studied the changes in corneal sensation in five regions of the cornea following photorefractive keratectomy at varying depths. We examined and compared the recovery of sensation in 17 sighted myopic eyes, with preoperative refractive ranges from -1.00 to -7.25 D. Eyes were divided into shallow (0 to 30 microns) or deep (31 to 70 microns) ablation groups depending on the attempted laser correction. Corneal sensation was measured in the central ablated area and the temporal, inferior, nasal, and superior unablated regions preoperatively and at 1, 3, and 6 months postoperatively.RESULTSCentral and inferior sensation were significantly reduced in the deep ablations at 1 month and continued in the central cornea 6 months postoperatively. There were no overall differences in the sensations in the unablated nasal, temporal, and superior regions between either group or over time. There was a significant second order trend (p = .034) in these three regions, indicating a sharper increase in sensation from baseline in the deeper group at 1 month than the gradual upward trend of the shallow group.CONCLUSIONSCorneal sensation of both the central ablated area and the unablated peripheral cornea is decreased after deep anterior stromal excimer laser ablations and does not recover within 1 month. Although the deeper group showed isolated areas in the periphery of significant second order trends in sensation, the overall trends were not large, indicating no significant anesthetic effect. Fluctuations in sensation can be detected in the five regions even 6 months after excimer laser keratectomy. The clinical importance of these data remain to be defined.

背景:为了矫正近视，少量的角膜组织(包括角膜神经)被切除，导致中央角膜变平。方法观察角膜屈光切除术后角膜5个区域角膜感觉的变化。我们检查并比较了17只视力正常的近视眼睛的感觉恢复情况，术前屈光范围为-1.00至-7.25 d。根据尝试激光矫正的程度，将眼睛分为浅(0至30微米)或深(31至70微米)消融组。术前、术后1、3、6个月分别测量中央消融区和颞、下、鼻、上未消融区角膜感觉。结果角膜深部消融术后1个月中央感觉和下感觉明显降低，术后6个月中央感觉继续降低。在两组之间或随着时间的推移，未肿胀的鼻腔、颞部和上部区域的感觉没有总体差异。这三个区域有显著的二阶趋势(p = 0.034)，表明在1个月时，较深组的感觉从基线增加的幅度比较浅组的逐渐上升的趋势更大。结论深前间质准分子激光消融后，中央消融区和未消融的周围角膜的角膜感觉均下降，且1个月内不恢复。虽然深度组在外围孤立区域出现明显的二级感觉趋势，但总体趋势不大，说明没有明显的麻醉作用。准分子激光角膜切除术后6个月仍可检测到5个区域的感觉波动。这些数据的临床重要性仍有待确定。

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引用次数: 41

Rotating brush for fast removal of corneal epithelium. 旋转刷用于快速去除角膜上皮。

Journal of refractive and corneal surgery

Pub Date : 1994-07-01 DOI: 10.3928/1081-597X-19940701-11

I. Pallikaris, A. Karoutis, S. Lydataki, D. Siganos

BACKGROUNDA simple new device is proposed for safe and very fast epithelial removal of the cornea. This is a rotating plastic brush that removes the corneal epithelium within a few seconds under irrigation, without causing any mechanical damage to the stromal surface.METHODSComparative SEM and TEM studies on rabbit corneas were carried out following epithelial removal by rotating brush and by a Beaver knife blade. Epithelial removal time and reepithelialization time after photorefractive keratectomy were evaluated in a series of 40 human sighted eyes treated with the brush.RESULTSThe rotating brush-abraded surface was smoother compared to the blade-abraded one. Additionally, the brush provoked no damage to the basal lamina of the rabbit corneal epithelium. In human photorefractive keratectomy, the mean time needed for removal of the corneal epithelium by the rotating brush was only 3 sec (range, 2-5 sec). Reepithelialization time following photorefractive keratectomy did not exceed 3 days.CONCLUSIONExperimental and preliminary clinical studies suggest that the new rotating plastic brush is a safe and fast method for removing the corneal epithelium.

背景:提出一种简单、安全、快速的角膜上皮切除新装置。这是一种旋转的塑料刷，可以在冲洗下几秒钟内清除角膜上皮，而不会对基质表面造成任何机械损伤。方法采用旋转毛刷法和海狸刀对兔角膜上皮进行去除后的扫描电镜和透射电镜对比研究。对40只视力正常的人眼进行光屈光性角膜切除术后上皮细胞去除时间和再上皮化时间的评估。结果旋转刷磨表面比刀片磨表面光滑。此外，刷对兔角膜上皮基底层无损伤。在人类光屈光性角膜切除术中，旋转刷去除角膜上皮的平均时间仅为3秒(范围2-5秒)。光屈光性角膜切除术后再上皮化时间不超过3天。结论实验和初步临床研究表明，新型旋转塑料刷是一种安全、快速的角膜上皮清除方法。

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引用次数: 39

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