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世界核心医学期刊文摘（眼科学分册） 2005年第2期1卷 49-50页

作者： Watson S.L. Ramsay A. Dart J.K.G. 张磊 Corneal and External Di seases Moorfields Eye Hospital London United Kingdom

Objective To compare the therapeutic outcomes after deep lamellar keratoplasty (DLK) and penetrating keratoplasty (PK)in patients with keratoconus. Design Ret rospective case-control study. Participants We reviewed the clinical notes of 4 7 patients diagnosed clinically with keratoconus who had received DLK (26 eyes o f 25 patients) or PK (25 eyes of 22 patients) at Moor-fields Eye Hospital or th e Royal Shrewsbury Hospital between 1994 and 2001. The patients in the 2 groups were matched for severity of their keratoconus by preoperative visual acuity. Me thods Deep lamellar keratoplasty was performed with the Melles technique in 7 ey es and the technique described by Sugita and Kondo in 19 eyes. Penetrating kerat oplasty was performed with a standard technique using a Hessburg-Barron trephin e. A single continuous 16-bite 10-0 nylon suture was placed and adjusted in bo th groups. Main outcome measures Best-corrected visual acuity (BCVA), refractiv e results, surgical techniques for DLK, and complication rates were analyzed. Re sults The 25 patients with keratoconus who underwent DLK had a mean age of 32.6 years and a median follow-up of 28 months. The mean age of the 22 patients who underwent PK for keratoconus was 34 years. This group was followed up for a medi an time of 55 months. The median final BCVA of patients in the DLK group was 6/9 and in the PK group 6/6 (no statistical significance). The median result for th e final spherical equivalent power in both groups was mild myopia, although the DLK group had more myopia, and the median astigmatism was less than 5.00 d iopters cylinder for both groups. Complication rates were similar for DLK and PK , although the nature of the complications varied. Conclusions Penetrating kerat oplasty is no longer an automatic choice for the surgical treatment for keratoco nus; DLK seems to be a safe alternative. Best-corrected visual acuity, refracti ve results, and complication rates are similar after DLK and PK. Deep lamellar

关键词：穿透角膜移植术圆锥角膜等量球镜矫正视力排斥反应屈光力连续缝合眼科医院轻度近视尼龙线

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视盘椭圆度作为视盘倾斜指数及其与近视和视野的联系

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世界核心医学期刊文摘（眼科学分册） 2005年第7期1卷 6-7页

作者： Tay E. Seah S.K. Chan S.- P. 陈立军 Singapore National Eye Centre 11 Third Hospital Avenue Singapore 168751 Singapore

Purpose: To examine the association of optic disk ovality with myopic refractive error, axial length, and the visual field. Design: Prospective observational case series. Methods: The study included 150 randomly recruited male subjects with myopia. In all cases, one eye was randomly selected, and subjective refraction, slit- lamp examination, applanation tonometry, gonioscopy, A- scan ultrasonography, funduscopy, and color optic disk stereo photography were performed. Disk ovality was assessed using the ratio of minimum to maximum disk diameter (index of tilt). A ratio of ≤ 0.8 was considered as significant disk tilt. Visual fields were tested using static automated threshold perimetry with two methods of optical correction: trial lenses and contact lenses. Results: Of the total sample, 137 subjects completed the study. Mean age was 21.2± 1.1 year, and mean spherical equivalent was- 6.36± 3.56 diopters. Mean ovality ratio was 0.83± 0.09;55 subjects (40.2% ) had significant tilted optic disks. Greater optic disk ovality (tilt) correlated with greater myopia (P=.009) and longer axial length (P =.009); 95.6% of subjects had normal visual fields with both methods of optical correction. Using multiple linear regression analysis, greater tilt was independently related to a higher mean defect on testing with trial lenses (P< .01). Conclusions: Increased optic disk tilt was associated with higher myopia and reduced sensitivity on field testing. These factors are important in the assessment of glaucoma in patients with myopia.

关键词：椭圆度前房角镜检查眼轴长度等量球镜屈光检查裂隙灯检查屈光不正眼底检查接触镜立体成像

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有髓视网膜神经纤维相关性弱视的视力预后

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世界核心医学期刊文摘（眼科学分册） 2005年第7期1卷 7-8页

作者： Kee C. Hwang J.- M. 陈立军 Department ofOphthalmology Seoul Natl. Univ. Coll. of Medicine Seoul Natl. Univ. Bundang Hospital 300 Gumi- dong Sungnam Gyeong- gi463- 707 South Korea

Purpose: To investigate the visual prognosis of amblyopia associated with anisomyopia and myelinated nerve fibers. Design: Retrospective noncomparative case series. Methods: Twelve children with amblyopia associated with anisomyopia and myelinated nerve fibers were treated with spectacle correction after cycloplegic refraction and occlusion therapy for amblyopia. Their visual acuity was measured at each visit to the clinic. The patients were divided into three groups according to their final visual acuity, and statistical analyses were performed to evaluate the differences among these groups in terms of the initial age, spherical equivalent, anisometropia, the area of myelination, final age, and follow- up period. Results: The mean refractive error of the 12 children in spherical equivalents was- 8.16 diopters (range- 1.50 to approximately- 13.00 diopters). The mean age at the initiation of therapy was4.2 years (range 2.1 to 8.6) and the mean follow- up period was 2.6 years (range 0.5 to5.1). After the occlusion treatment, visual acuity improved to 20/30 in four patients, and to 20/60 in one patient. In the remaining six patients, visual acuity remained at 20/200 or worse. The amount of anisometropia and the area of myelination were significantly different between the group with a final visual acuity of 20/40 or better and the group with a final visual acuity of worse than 20/200. Conclusion: The visual acuity of about one third of the amblyopes with myelinated nerve fibers improved to 20/30. The prognostic factors for the visual improvement were the amount of anisometropia and the area of myelination.

关键词：视网膜神经屈光参差遮盖疗法等量球镜睫状肌麻痹戴镜矫正治疗髓鞘病例研究正度

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基于人群的6岁龄儿童屈光参差和双眼散光不等的患病率及其关联性研究

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世界核心医学期刊文摘（眼科学分册） 2006年第10期2卷 19-20页

作者： Huynh S.C. Ip J. P.Mitchell 王海燕 Centre for Vision Research Department of OphthalmologyUniversity or SydneyHawkesbury RoadWestmeadNSW2145Australia Dr.

Aim:To study the distribution of anisometropia and anisoa-stigmatismin young Australian children,togetherwith clinical and ocular biometry ***:The Sydney Myopia Study examined 1765 predominantly 6 year old children from 34 randomly selected Sydney schools during ***,cycloplegic autorefraction,and questionnaire data were ***:Spherical equivalent(SE)anisometropia(≥ 1 dioptre)prevalence was 1.6%(95% confidence interval(CI)-1.1% to 2.4%).Aniso-astigmatism(≥ 1D)prevalence was 1.0%(CI:0.6% to 1.6%).Both conditions were significantly more prevalent among moderately hyperopic(SE ≥ 2.0D)thanmildly hyperopic(SE 0.5-1.9D)*** children(SE ≤-0.5D)had higher anisometropia *** condition varied by age,sex,or *** multivariate analyses,anisometropia was significantly associated with amblyopia,odds ratio(OR)29,(CI:8.7 to 99),exotropia(OR 7.7,CI:1.2 to 50),and neonatal intensive care unit(NICU)admission(OR 3.6,CI:1.1 to 12.6).Aniso-astigmatism was significantly associated with amblyopia(OR 8.2,CI:1.4 to 47),maternal age > 35 years(OR 4.0,CI:1.3 to 11.9),and NICU admission(OR 4.6,CI:1.2 to 17.2).Anisometropia resulted from relatively large interocular differences in axial length(p < 0.0001)and anterior chamber depth(p=0.0009).Aniso-astigmatism resulted from differences in corneal astigmatism(p < 0.0001).Conclusion:In this predominantly 6 year old population,anisometropia and aniso-astigmatism were uncommon,had important birth and biometry associations,and were strongly related to amblyopia and strabismus.

关键词：儿童屈光参差关联性研究中度远视等量球镜外斜视睫状肌麻痹角膜曲率角膜散光生物统计学眼

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远视与原发性高血压的关系

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世界核心医学期刊文摘(眼科学分册) 2006年第1期 8-9页

作者： Karadayi K. Akin T. Ciftci F. 陈立军 Emin Onat sk 7/4 34710 Moda-stanbul Turkey Dr

PURPOSE: To explore the relationship between the refractive state of the eye and high blood pressure in a representative population. DESIGN: Case-control study. METHODS: Three hundred twenty-one patients with essential hypertension (mean age 53.9± 15.5 years) and 188 age-matched and sex-matched healthy control subjects (mean age 50.9± 7.3 years) from the same regional Health Maintenance Organization were consecutively included for the study (P > .05 for age and sex). The refractive state of the eyes was identified objectively by an autorefractometer and retinoscopic examination, recording the autorefractometer values. Spherical equivalents between-0.50 (included) and+ 0.50 (included) diopters were regarded as emmetropia. Values below or above this interval were regarded as either myopia or hypermetropia. Mean spherical equivalents of the groups were compared using independent samples t test; distributions of refraction were compared with χ 2 test. RESULTS: The mean spherical equivalent of the patients with essential hypertension was+ 0.88± 1.34 diopters (range-3.75 to+ 6.38 diopt-ers), whereas the mean spherical equivalent of the control subjects was-0.26± 1.12 diopters (range-5.00 to + 3.38 diopters) (P< .0001). Whereas 61.4% of hypertensive patients were hypermetropic, 18.1% of normotensive patients were hypermetropic (P < .0001). CONCLUSIONS: There is a strong association of essential arterial hypertension with hypermetropia, which has not been previously reported. Given the findings of this study, we recommend that patientswho have hypermetropia and have had no recent systemic examination should at least have their blood pressure checked.

关键词：等量球镜原发性高血压患者

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早产儿视网膜病变3期治疗后和阈下3期自然转归的比较:对3个月和3年病变活动性、屈光力和解剖学变化的研究

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世界核心医学期刊文摘（眼科学分册） 2005年第6期1卷 23-24页

作者： Sahni J. Subhedar N.V. Clark D. 王永强 Department of Ophthalmology Walton Hospital Rice Lane Liverpool L9 IAE United Kingdom

Aim: To compare the visual acuity (VA), spherical equivalent refractive error, motility, and anatomical outcomes in children with treated regressed threshold stage3 retinopathy of prematurity (ROP) and those with spontaneously regressed subthreshold stage3 ROP. Method: 6 month and 3 year data collected from infants examined between 1989 and 1999 with regressed stage3 ROP, with or without treatment were retrospectively reviewed. Results: 85 infants were included in this study. 40 eyes received cryotherapy, 81 eyes laser photocoagulation, and 34 eyes had spontaneously regressed subthreshold stage3 ROP. Grating acuity score ≥ 2 cycles/degree (c/d) at 6 months was predictive of optotype acuity ≥ 6/9 in 69% of eyes and a score < 2 c/d at 6 months was predictive of acuity < 6/9 in 88% of eyes. Eyes with subthreshold stage3 ROP were twice as likely to haveVA of 6/9 or better at 36 months than the treated eyes. The mean spherical equivalent refractive error at 36 months was-6.5 dioptres (D) (-21.5D to + 1.38D) in cryotherapy treated eyes,-2.4D (-13D to + 4D) in the laser group, and-0.22D (-9D to + 2.25D) in the subthreshold group. Eyes within the treated groups were more myopic than the eyes within the spontaneously regressed group (P=0.005). At 36 months, 42 out of the 85 infants (that is, 49% ) had strabismus (44% in the cryotherapy group, 26% in the laser group, and 25% in the subthreshold group). There was a statistically significant association between the presence of strabismus and anisometropia (P=0.016) and strabismus and intraventricular haemorrhage (IVH) (P=0.005). There was a statistically significant difference in the incidence of strabismus between mild and moderate and severe grade IVH (P=0.01). Eight out of 40 eyes in the cryotherapy group and six out of the 81 eyes in the laser group developed macular ectopia. None of the eyes in the spontaneously regressed group had macular dragging. Conclusions: In this study, the grating acuity at 6 months was a good pred

关键词：病变活动屈光力自然转归激光治疗组黄斑异位等量球镜激光光凝术近视程度屈光不正屈光参差

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新加坡学龄儿童角膜厚度检测与联系

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世界核心医学期刊文摘（眼科学分册） 2005年第4期1卷 41-42页

作者： Saw S.-M. Siak J.-K. 王媛

PURPOSE. To determine the central cornea thickness (CCT) in Singaporean children and to examine the possible relationship between intraocular pressure (IOP) and other biometric factors and CCT. METHODS. This was a cross- sectional study. The subjects (n=652) were obtained from the Singapore Cohort Study of the Risk Factors for Myopia (SCORM). The subjects’ ages ranged from 9 to 11 years. There were 485 Chinese, 92 Malayan, and 75 Asian Indian children. Measurement procedures included air- puff tonometry, noncontact slit lamp optical pachymet- ry, cycloplegic autorefraction, and autokeratometry. RESULTS. The mean CCT was 543.6± 32.0 μ m. Chinese children had thicker corneas than Malayan or Indian children (P=0.002). The boys had thicker corneas than girls (P=0.011), but the mean difference was only 6.4 μ m. There was high correlation of CCT (r=0.98) and IOP (r=0.88) between right and left eyes. IOP was correlated with CCT (r=0.45, P 0.05) associated with CCT: age, family income, father s education, axial length, and spherical equivalent. CONCLUSIONS. The mean CCT in Singaporean children aged 9 to 11 years was 543.6 μ m and showed ethnic and gender variation. CCT affected measured IOP and correlated weakly with corneal curvature. Compared with data in adults, a change in CCT was associated with a greater difference in measured IOP.

关键词：角膜厚度角膜曲率半径眼轴长度自动验光仪等量球镜非接触眼压计角膜曲率计生物因素光学厚度队列研究

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远视儿童调节性内斜视的危险因素

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世界核心医学期刊文摘（眼科学分册） 2005年第7期1卷 26-27页

作者： Birch E.E. Fawcett S.L. Morale S.E. 王大江 Retina Foundation of the Southwest 9900 N. Central Expressway Dallas TX 75231 United States

PURPOSE. Identification of risk factors for accommodative esotropia may help to determine which children with hyperopia may benefit from early spectacle correction or preventive therapy. METHODS. Participants in the family history study were 95 consecutive patients, aged 18 to 60 months, with accommodative esotropia. Participants in the binocular sensory function study were a subgroup of 41 children enrolled in the family history study within 1 month of onset, while the esodeviation was still intermittent. Participants in the hypermetropia study were 345 consecutive patients, ages 12 months to 8 years, with refractive error of + 2.00 D or greater and no esodeviation before age 12 months. RESULTS. In the family history study, 23% of children with accommodative esotropia had an affected first- degree relative, and 91% had at least one affected relative. In the binocular sensory function study, random- dot stereoacuity was abnormal in41% of children, whereas an abnormal motion VEP, Worth4- dot, or positive4- PD base- out prism responses were present in4% or less of the children. In the hypermetropia study, patients with a mean spherical equivalent of<+ 3.00 D and significant anisometropia had a 7.8- fold increased risk for accommodative esotropia over nonanisometropic patients. CONCLUSIONS. A positive family history, subnormal random- dot stereopsis, and hypermetropic anisometropia each pose a significant risk for the development of accommodative esotropia. Assessment of these risk factors in conjunction with refractive screening should help to identify those children who are most likely to benefit from early spectacle correction or preventive treatment.

关键词：调节性内斜视间歇性内斜视等量球镜屈光不正屈光参差预防性治疗视觉异常一级亲属感觉功能远视性

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单眼视减缓了青少年单侧近视的进展

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世界核心医学期刊文摘（眼科学分册） 2005年第12期1卷 40-41页

作者： Phillips J.R 王海燕 Department of Optometry and Vision Science University of Auckland Private Bag 92019 Auckland New Zealand.Dr

Aim: To evaluate the acceptability, effectivity, and side effects of amonovision spectacle correction designed to reduce accommodation and myopia progression in schoolchildren. Methods: Dominant eyes of 11 year old children with myopia (- 1.00 to - 3.00 D mean spherical equivalent)were corrected for distance; fellow eyes were uncorrected or corrected to keep the refractive imbalance < 2.00 D. Myopia progression was followed with cycloplegic autorefraction and A-scan ultrasonography measures of vitreous chamber depth (VCD) for up to 30 months. Dynamic retinoscopy was used to assess accommodationwhile reading. Results: All children accommodated to read with the distance corrected (dominant) eye. Thus, the near corrected eye experienced myopic defocus at all levels of accommodation. Myopia progression in the near corrected eyes was significantly slower than in the distance corrected eyes (intereye difference=0.36 D/year (95% CI: 0.54 to 0.19, p=0.0015, n=13); difference in VCD elongation=0.13 mm/year (95% CI: 0.18 to 0.08, p=0.0003, n=13)). After refitting with conventional spectacles, the resultant anisometropia returned to baseline levels after 9- 18 months. Conclusions: Monovision is not effective in reducing accommodation in juvenile myopia. However, myopia progression was significantly reduced in the near corrected eye, suggesting that sustained myopic defocus slows axial elongation of the human eye.

关键词：视力矫正光学离焦睫状肌麻痹等量球镜眼轴自动验光仪对侧眼矫正镜片玻璃体腔时用

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准分子激光角膜原位磨镶术治疗不同程度近视

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世界核心医学期刊文摘（眼科学分册） 2005年第8期1卷 10-11页

作者： Tsai Y.-Y. 陈立军 Department of Ophthalmology China Medical University Hospital No. 2 Yuh-Der Road Taichung 404 Taiwan

Purpose: To determine the efficacy, predictability, stability and safety of la ser in situ keratomileusis (LASIK) in treating patients with different degrees o f myopia. Methods: We enrolled 386 eyes of 200 consecutive patients who underwen t LASIK and divided them into four groups according to their degree of preoperat ive spherical equivalent (SE). Group 1 eyes ranged between-1.00 and-3.99 diopt res (D) (low myopia). Group 2 eyes ranged between-4.00 and-5.99 D (moderate my opia). Group 3 eyes ranged between-6.00 and-9.99 D (high myopia). Group 4 eyes were over-9.99 D (extreme myopia). Follow-up was at 1 day, 1 we ek and 1, 3, 6, 12 and 18 months postoperatively. Results: Our study included 38 6 eyes of 200 patients with SE ranging from-3.00 to-16.00 D (mean-7.14±2.87 D). All eyes were seen at 1 day postoperatively. A total of 360 eyes (93%) were examined at 1 week, 330 eyes (85%) at 1 month, 281 eyes (73%) at 3 months, 24 7 eyes (64%) at 6 months, 199 eyes (52%) at 12 months and 142 eyes (37%) at 1 8 months. The postoperative data from 1 day to 12 months were used because of th e low follow-up rate at 18 months postoperatively. Group 1 consisted of 30 eyes . The mean SE was-3.52±0.43 D preoperatively and-0.40±0.58 D at 1 month,-0. 46±0.60 D at 6 months and-0.42±0.50 D at 12 months postoperatively. Uncorrect ed visual acuity (UCVA) was 20/40 or better in 95%of eyes at 1 day and in 100% of eyes at 6 and 12 months postoperatively. Group 2 consisted of 151 eyes. The m ean SE was-5.36±0.67 D preoperatively and-0.54±0.78 D at 1 month,-0.56±0.9 0 D at 6 months and-0.55±0.82 D at 12 months postoperatively. Uncorrected VA w as 20/40 or better in 95%of eyes at 1 day and in 100%of eyes at 6 and 12 month s postoperatively. Group 3 consisted of 167 eyes. The mean SE was-8.15±0.94 D preoperatively and-0.58±0.90 D at 1 month,-0.67±1.00 D at 6 months and-0.64 ±0.95 D at 12 months postoperatively. Uncorrected VA was 20/40 or better in 90 %of eyes at 1 day and in 98%of eyes at 6 an

关键词：未矫正视力游离瓣等量球镜总并发症切割技术计算方法

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