准分子激光原位角膜磨镶术的护理体会

准分子激光原位角膜磨镶术（LASIK）是目前安全性、准确性、稳定性以及疗效的预测性都较好的一种屈光不正矫治术．是目前治疗近视及近视散光首选的屈光手术之一。其原理是用显微板层成形系统掀开一个角膜瓣．在瓣下角膜基质层上用准分子激光根据近视、远视和散光度数进行精确切削。我院于2008年2月从德国引进世界上先进的第八代爱丽丝智能高速扫描准分子激光治疗系统。自4月份开展该术以来。共有212例（408只眼）患者要求手术,通过术前资料评估及术前检查．筛查确定出198例进行LASIK术。通过术前的心理护理、术中密切配合以及术后的详细指导及定期复查随访．疗效满意．现将护理体会总结如下。     

国产板层角膜成形系统（LASIK微型角膜刀）实验研究

目的：评价国产ＬＡＳＩＫ微型角膜刀角瓣制作技术的安全性,稳定性及易学性。方法：采用ＫＮ－５０００国产板层角膜成形系统（ＬＡＳＩＫ微型角膜刀）。１．动物实验：充立新刀组（初级组）进口刀具组作对照,验证瓣厚度预测性、稳定性、边缘完整性及异常瓣发生率;扫描电镜观察切面及切缘的光滑度。２．观察学习情况,结果：动物实验证明国产ＬＡＳＩＫ微型角膜刀制瓣厚度预测性,稳定性及光滑度与对照组一致,新刀具易于学习和使     

角膜屈光手术后屈光回退的手术治疗进展*

屈光回退是角膜屈光手术后的并发症之一,其治疗方法主要为药物治疗和手术治疗。对于需要再次手术的患者,应根据初次手术方式、距离初次手术时间、回退度数,在充分评价角膜情况后合理选择增效术,确保手术的安全性和有效性。目前,准分子激光原位角膜磨镶术和飞秒激光小切口角膜基质透镜取出术是治疗近视和近视散光的主要手术方式。本文就两者术后屈光回退手术治疗的适应症、不同增效术的优缺点及注意事项作一综述。     

准分子激光双面式切削原位角膜磨镶术的研究进展

准分子激光双面式切削原位角膜磨镶术(Both-sided LASIK,BSL)是准分子激光原位角膜磨镶术(laser in situ keratomileusis, LASIK)的改良,BSL将部分激光切削分布在角膜瓣基质面,因而减少了对角膜基质床的切削,最大限度的保留了角膜基质床的剩余厚度,为降低术后角膜膨出提供可能,对屈光度相对偏高和/或角膜相对偏薄的患者,尽量增加手术的安全性,并为LASIK术后屈光回退的增强手术提供了一种新的方法。本文对近年BSL的研究进展作一综述。     

新疆阿尔泰山驼鹿的初步考察

新疆阿尔泰山驼鹿的初步考察ＡＰＲＥＬＩＭＩＮＡＲＹＩＮＳＰＥＣＴＩＯＮＯＮＴＨＥＥＬＫ（ＡＬＣＥＳＡＬＣＥＳ）ＩＮＸＩＮＪＩＡＮＧＡＬＴＡＩＭＯＵＮＴＡＩＮＫｅｙｗｏｒｄｓＸｉｎｊｉａｎｇ;Ｅｌｋ（Ａｌｃｅｓａｌｃｅｓ）１９９４年７－８月,我们受新疆...     

角膜屈光手术消融精度影响因素的分析

论述了眼球角膜屈光不正和准分子激光消融角膜的原理,分析了Lasik屈光手术中角膜消融精度的一些关键影响因素,并结合自己研制的准分子激光眼科治疗仪的特点,逐一对这些影响因素加以分析和解决。     

中华姬鼠种群生态的初步分析

中华姬鼠种群生态的初步分析ＴＨＥＰＲＥＬＩＭＩＮＡＲＹＡＮＡＬＹＳＩＳＯＮＴＨＥＰＯＰＵＬＡＴＩＯＮＥＣＯＬＯＧＹＯＦＣＨＩＮＥＳＥＦＩＥＬＤＭＯＵＳＥ（ＡＰＯＤＥＭＵＳＤＲＡＣＯ）ＫｅｙＷｏｒｄｓＣｈｉｎｅｓｅＦｉｅｌｄＭｏｕｓｅ（Ａｐｏｄｅｍｕｓ...     

准分子激光原位角膜磨镶术前术后客观验光和主观验光的比较

目的比较准分子激光原位角膜磨镶术前后客观验光和主观验光的准确性和相关性。方法对在我中心接受LASIK手术69例123眼,在术前和术后一个月进行客观验光(NIDEKARK-700)和主观验光(RODENSTOCK综合验光头),对获得的数据进行相关分析。结果LASIK术后,客观验光的准确性较术前下降,客观验光和主观验光测量结果的差值明显增加;术前近视度越高,术后客观验光和主观验光测量结果的差别越大。在测量散光中,术后1月,客观验光和主观验光测量散光的差值明显增加,客观验光不能准确测量散光的量和轴向。结论LASIK术前用自动验光仪进行的客观验光可靠性较高,与主观验光法测量屈光不正的结果接近;术后,客观验光的准确性较术前下降,不能有效评判屈光不正的性质和量。     

棉酚对金鱼生殖机能影响的研究

棉酚对金鱼生殖机能影响的研究富惠光,叶继丹,卢彤岩,张良（中国水产科学研究院黑龙江水产研究所,哈尔滨１５００７０）关键词棉酚,金鱼,生殖ＥＦＦＥＣＴＯＦＧＯＳＳＹＰＯＬＯＮＲＥＰＲＯＤＵＣＴＩＯＮＯＦＧＯＬＤＦＩＳＨ（ＣＡＲＡＳＳＩＵＳＡＵＲＡＴＵＳ...     

植物胚胎发育后期富集(LEA)蛋白的研究进展

植物胚胎发育后期富集（ＬＥＡ）蛋白的研究进展汤学军傅家瑞（中山大学生命科学学院,广州５１０２７５）ＰＲＯＧＲＥＳＳＯＦＴＨＥＳＴＵＤＹＯＮＬＡＴＥＥＭＢＲＹＯＧＥＮＥＳＩＳＡＢＵＮＤＡＮＴ（ＬＥＡ）ＰＲＯＴＥＩＮＳＩＮＰＬＡＮＴＳＴａｎｇＸｕｅ－Ｊ...     

Comparison of different presbyopia treatments: refractive lens exchange with multifocal intraocular lens implantation versus LASIK monovision

There are several methods for presbyopia treatment. Refractive lens exchange (RLE) followed by multifocal intraocular lens (MFIOL) implantation enables high rate of spectacle independence but have some visual disturbances. Laser in Situ Keratomileusis (LASIK) monovision gives patient ability to have good distant vision with dominant eye and good near vision with nondominant eye. In this prospective randomized study we wanted to compare clinical outcomes in patients who underwent either of the mentioned procedures. The first group included 50 patients (N = 100 eyes) who underwent RLE with MFIOL implantation and the second group included 50 patients (N = 100 eyes) who underwent LASIK monovision as presbyopia treatment. Uncorrected distant, near and intermediate visual acuity, patient's subjective satisfaction and visual disturbances were measured. Follow up was 6 months. Patients in RLE group had better near uncorrected visual acuity (UCVA) and patients in LASIK monovision group had better distant and intermediate vision. Patients in RLE group reported visual disturbances (halo, glare). Patients satisfaction and spectacle independence was high in both groups. Refractive lens exchange with multifocal intraocular lens implantation and LASIK monovision are effective methods for presbyopia treatment. LASIK monovision with -0.50D - 1.25D of residual dioptry at nondominant eye in patients under 50 years enables good vision at all distances without affecting stereovision. Patient selection and preoperative counseling are key to success.     

Successful management of retinal tear post-laser in situ keratomileusis retreatment

PURPOSE: To report a successful case management of a retinal tear post-Laser in situ Keratomileusis (LASIK) and retreatment. RESULTS: A patient with the history of ocular trauma underwent LASIK procedure for myopic astigmatism. Three months post-LASIK, she received additional excimer laser treatment for a symptomatic persistent central island. One month later; the patient experienced a flap tear at the edge of a prior chorioretinal scar. Retinal tear repair was successfully accomplished by indirect application of photocoagulation laser without damage to the corneal flap. CONCLUSIONS: To date, no definitive causal relationship has been established between retinal tear(s) and corneal refractive surgery. This report describes a retinal tear and repair, post-LASIK retreatment. The use of the indirect binocular argon laser alleviates the need to compress the LASIK flap and minimizes the potential for creating flap folds and striae, especially in the early post operative period. Clinicians should be on alert to consider this possible complication, post-LASIK and excimer laser; especially within a population whose clinical findings place them at greater risk.     

New Instruments for Lenticule Extraction in Small Incision Lenticule Extraction (SMILE)

Small incision lenticule extraction (SMILE) is an alternative to Laser-Assisted in situ Keratomileusis (LASIK) for correction of myopia. In cases where surgeons inadvertently dissect the posterior surface first, identification of the anterior surface and subsequent removal become difficult since the anterior surface of the lenticule is compacted against the anterior stromal surface. This may result in incomplete lenticule removal, and a remnant of intrastromal lenticule in SMILE may lead to visual sequelae. In order to aid surgeons in lenticule removal, we have designed and developed 5 novel SMILE lenticule strippers to locate and extract the lenticules more easily. The aim of this study was to investigate and compare the efficacy and quality of these lenticule strippers in assisting SMILE. Thirty porcine eyes were used. The ease of extraction and removal of the lenticule with different strippers was graded by an experienced SMILE surgeon, the extracted lenticule circularity was evaluated by calculating the lenticule circularity, and the intactness of the extracted lenticule edge was assessed using scanning electron microscopy. We found these novel strippers can be of great help to improve the safety and quality of SMILE surgery, particularly in those cases of difficult lenticule extraction.     

近视眼LASIK术后眼高阶像差变化

探讨近视眼LASIK术后眼波阵面像差高阶像差各项的变化。方法:采用NIDEK OPD-Scan ARK-1000型波前像差扫描系统对LASIK治疗近视的62只眼在术前术后眼的波前像差进行了评估。在术前、术后10天、术后一个月分别测量眼的波阵面像差。比较6mm瞳孔下高阶像差各项的变化。结果:在全部接受检查的病例中,总的高阶像差(RMSh)均有所增加。从Zernik各项绝对值来看,球差C12变化最大。术后10天比术前增加6．7742倍(P=0．0001)。其次是彗差C7 C8(X轴、Y轴上的彗差),分别增加了4．883倍(P=0．0001)、3．7523倍(P=0．0001)。结论:LASIK术后眼的总的高阶像差均方根值(RMSh)明显增加,尤其是球差和彗差;但在恢复过程中高阶像差有下降的趋势。用像差仪来指导和评估LASIK等屈光手术可以更全面、更准确。     

Long-term evaluation of corneal sub-basal nerve recovery after photorefractive keratectomy and influence of pars plana vitrectomy

The corneal sub-basal nerve (SBN) plexus is destroyed during photorefractive keratectomy (PRK) and its recovery is still a matter of debate. In vivo confocal microscopy (IVCM) was used to evaluate SBN plexus in 23 patients at a distance of 10–25 years (mean 15.6 years) from myopic PRK. Because 8 out of the 23 PRK patients underwent pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment, IVCM was also performed on those patients 6 months after PPV. Thirteen patients matched for age and myopia served as controls (non-PRK). SBN plexus was markedly reduced after PRK compared with non-PRK eyes and showed a slow, continuous but incomplete recovery up to the end of our follow-up (range 10–25 years). PRK and non-PRK eyes showed a marked reduction in SBN density 6 months after PPV, thus demonstrating a detrimental effect exerted by PPV on SBN plexus.     

LASIK following Small Incision Lenticule Extraction (SMILE) Lenticule Re-Implantation: A Feasibility Study of a Novel Method for Treatment of Presbyopia

Presbyopia remains a major visual impairment for patients, who have previously undergone laser refractive correction and enjoyed unaided distance vision prior to the onset of presbyopia. Corneal stromal volume restoration through small incision lenticule extraction (SMILE) lenticule re-implantation presents an opportunity for restoring the patients’ non-dominant eye to previous low myopia to achieve a monovision. In this study, we investigated the feasibility of performing LASIK after lenticule re-implantation as a method to create presbyopic monovision. A -6.00D SMILE correction was performed in 9 rabbit eyes. The lenticules were cryopreserved for 14 days and re-implanted. Five weeks later, 3 of these eyes underwent LASIK for -5.00D correction (RL group); 3 underwent LASIK flap creation, which was not lifted (RN); and no further procedures were performed on the remaining 3 eyes. These groups were compared with 3 eyes that underwent standard LASIK for a -5.00D correction (LO); 3 that underwent creation of non-lifted flap (LN); and 3 non-operated eyes. Rabbits were euthanized 1 day post-surgery. Tissue responses were analyzed by immunohistochemistry, slit lamp and in vivo confocal microscopy (IVCM). Intrastromal irregularities and elevated reflectivity levels of the excimer-ablated plane were observed on slit lamp and IVCM, respectively in the RL group. The results were comparable (P = 0.310) to IVCM findings in the LO group. RL and LO groups showed similar fibronectin expression levels, number of CD11b-positive cells (P = 0.304) and apoptotic cells (P = 0.198). There was no difference between the RN and LN groups in reflectivity levels (P = 0.627), fibronectin expression levels, CD11b-positive cells (P = 0.135) and apoptotic cells (P = 0.128). LASIK can be performed following lenticule re-implantation to create presbyopic monovision. The tissue responses elicited after performing LASIK on corneas that have undergone SMILE and subsequent lenticule re-implantation are similar to primary procedure.     

Detection of refractive photokeratectomy traces during eye banking: impossible with organ culture but possible with an active storage machine: case report

Cell and Tissue Banking - The detection of corneas operated on for refractive surgery [LASIK or photorefractive keratectomy (PRK)] will become a major concern for eye banks in the coming years...     

人眼波前像差表示、测量及矫正研究

目的:波前像差引导的准分子激光角膜消融是屈光手术的新方法,研究人眼波前像差的测量原理、方法、表示、人眼波前像差准分子激光矫正的原理,以此理论用于准分子激光人眼像差矫正系统。方法:采用理论研究、计算机模拟、实验室实验等手段。分析人眼像差的概念和产生的原因,用数学的Zern ike多项式来表示像差,理论上定量分析Zern ike多项式表示的波前像差与角膜切削深度的关系,研究准分子激光切削角膜的机理,研究准分子激光进行矫正人眼像差的原理框图。结果:通过计算机模拟和实验室实验,用准分子激光矫正低阶和高阶像差是可行的。结论:用波前像差来引导屈光手术,使人眼的视力能够达到20/10上,并能避免当前PRK、LASIK屈光手术前后像差增大而引起的对视觉质量的影响。     

Laser Refractive Surgery: Technological Advance and Tissue Response

Photorefractive keratectomy (PRK) and laser assisted in situ keratomileusis (LASIK), using an excimer laser, are the currently popular techniques of correcting refractive errors. Since these techniques work by selective ablation of corneal stroma, the tissue healing response plays a great role in the ultimate outcome of surgery. Also, various methods of wound healing modulation can be used to achieve better results. While these procedures do lead to a decrease in dioptric power and increase in unaided visual acuity, higher visual functions like contrast sensitivity can sometimes be compromised after the surgery.