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。     

影响人眼视觉质量的光学因素

人眼作为一种光学器官,存在着一些光学缺陷,从物理学的角度分析了小瞳孔的衍射效应、眼球光学系统的像差、瞳孔尺寸、照明度和光学散射等对人眼视觉质量的影响。重点分析了由眼球的屈光介质引入的光学像差对人眼视觉质量的影响。     

新型准分子激光角膜屈光矫正系统

小光斑高速飞点扫描的准分子激光系统以其具有的治疗时间短、矫正精度高、角膜切削表面极其光滑,易于集成波前像差技术实现“个体化切削”方案等优点,成为眼科屈光矫正激光手术发展趋势。本文从理论基础、光学系统等方面综述了具有自主知识产权的飞点扫描式激光系统,此系统已经在临床动物实验和盲眼实验中取得了非常好的效果。     

基于Hartmann—Shack传感器的人眼波前像差重建技术

阐述了人眼波前像差的概念及其Zernike多项式表示方法,着重讨论了Hartmann—Shack传感器测量人眼像差的机理和人眼波前像差重建的方法,并对人眼波前像差重建系统进行了详细设计。该技术给人眼像差的校正以及角膜“个体化切削”的实现带来了新契机。     

准分子激光眼科治疗机中激光器控制实现

准分子激光眼科治疗机可以用来进行近视、远视、散光等屈光不正的矫正手术。其中激光器的控制为手术提供能量稳定的激光脉冲,是对手术安全性、可靠性的重要保证。本文简述了一准分子激光眼科治疗机的整体组成部分,并详细描述了激光器的控制部分:计算机与激光器的通信控制、激光发射停止控制、充换气流程控制。目前,这种准分子激光治疗机已经应用于临床,并取得了良好的效果。     

超连续谱激光可见谱段致人眼眩目效应研究

本文采用超连续谱激光光源滤除其红外部分仅输出可见谱段部分,在不超过国家安全标准允许的最大辐照量条件下,以正入射方式照射人眼后,记录并分析在明、暗适应条件下中心极限视力恢复时间、中心近极限视力恢复时间和视觉后像持续时间,明确超连续谱激光可见谱段对人眼的眩目效果。明适应下激光照射0.1 s导致人眼中心极限视力恢复时间为31~119 s,中心近极限视力恢复时间为19~76 s;暗适应下激光照射0.1 s导致人眼中心极限视力恢复时间为26~223 s,中心近极限视力恢复时间为13~123 s;明、暗适应下导致人眼眩目效应的最小功率密度值分别为0.055 mW/cm^2和0.005 mW/cm^2。结果表明,超连续谱激光可见谱段对人眼有良好的眩目效果,可导致数十秒至数百秒的中心视力下降,随着照射功率密度增高,眩目效应增强,显示出较好的量效关系,且相同功率密度时暗适应下人眼的眩目效果优于明适应。该研究探究了明、暗适应条件下超连续谱激光对人眼眩目效应,明确了超连续谱激光与人眼眩目的量效关系。     

屈光不正对儿童视觉皮层神经元活动影响的功能磁共振研究

目的：利用血氧水平依赖性功能性磁共振成像（BOLD-fMRI）技术及非金属MRI专用眼镜,分析探索屈光不正对儿童大脑皮层视觉功能区神经元活动的影响。方法：以1．5T磁共振成像系统采集8例屈光不正眼儿童屈光矫正前后枕叶视皮层兴趣区BOLD—fMRI数据,及8例正常眼凸透镜离焦前后枕叶视皮层兴趣区BOLD—fMRI数据,进行对比分析,比较屈光不正眼及其矫正后、正常眼及其离焦后皮层视觉功能区神经元活动的不同,分析其改变特点及原因。结果：屈光不正眼儿童矫正屈光后皮层视觉功能区神经元活动范围明显增加（P〈0．05）;正常眼离焦后皮层视觉功能区神经元活动范围明显减小（P〈0．05）。结论：屈光不正会明显降低儿童皮层视觉功能区的神经元活动。屈光不正患儿应尽早配镜矫正,以免影响视觉皮层功能发育。     

LASIK术后高阶像差对视觉质量影响的研究进展

随着屈光手术的发展,过去人们所追求的单纯裸眼视力的提高逐渐被追求视觉质量的提高所代替。LASIK术后患者低阶像差减小,高阶像差进一步增加,虽然裸眼视力提高,但是对比敏感度下降,尤其是暗环境下和有眩光时视觉质量不能达到理想效果,因为高阶像差是影响视网膜成像的重要因素,对比敏感度是评价视网膜成像质量好坏的重要指标之一,所以探讨不同成分高阶像差以及它们之间适当组合对视觉质量的影响和LASIK术后各频段对比敏感度的变化,研究各项高阶像差与对比敏感度之间的关系可以为临床外科屈光医生提供一定的理论指导,进而解决LASIK术后的眩光、星形放射、暗视力差等问题。本文通过概括LASIK术后高阶像差和对比敏感度的变化,对它们之间关系的研究现状和进展作一综述。     

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。     

PRK,LASIK技术在中国的应用

准分子激光屈光性角膜切削术（ＰＲＫ）和准分子激光原位角膜磨镶术（ＬＡＳＩＫ）是一种治疗眼球屈光不正的新技术,美国、德国、日本和中国（台湾）等国发展了多种准分子激光屈光治疗机以及相应的手术器械及软件,我国从１９９３年引进第一台ＰＲＫ机以来,已引进近百台机器,治疗屈光不正病例已超过十万。作者通过问卷调查和专家访问,对ＰＲＫ、ＬＡＳＩＫ技术在中国的应用状况进行了调查,在调查的基础上进行了分析,并对ＰＲＫ     

准分子激光切削角膜的数学模型与切削技术研究

本文在分析国内外研究人眼角膜的数学模型的基础上,提出了能够用于进行近视、远视、散光等屈光手术的数学模型,并就准分子激光的切削原理和“飞点扫描”技术进行了研究,本文的研究成果直接用于准分子激光眼科治疗机,取得了满意的手术效果。     

Radial averages of astigmatic TEM images

The Contrast Transfer Function (CTF) of an image, which modulates images taken from a Transmission Electron Microscope (TEM), is usually determined from the radial average of the power spectrum of the image (Frank, J., Three-dimensional Electron Microscopy of Macromolecular Assemblies, Oxford University Press, Oxford, 2006). The CTF is primarily defined by the defocus. If the defocus estimate is accurate enough then it is possible to demodulate the image, which is popularly known as the CTF correction. However, it is known that the radial average is somewhat attenuated if the image is astigmatic (see Fernando, K.V., Fuller, S.D., 2007. Determination of astigmatism in TEM images. Journal of Structural Biology 157, 189-200) but this distortion due to astigmatism has not been fully studied or understood up to now. We have discovered the exact mathematical relationship between the radial averages of TEM images with and without astigmatism. This relationship is determined by a zeroth order Bessel function of the first kind and hence we can exactly quantify this distortion in the radial averages of signal and power spectra of astigmatic images. The argument to this Bessel function is similar to an aberration function (without the spherical aberration term) except that the defocus parameter is replaced by the differences of the defoci in the major and minor axes of astigmatism. The ill effects due this Bessel function are twofold. Since the zeroth order Bessel function is a decaying oscillatory function, it introduces additional zeros to the radial average and it also attenuates the CTF signal in the radial averages. Using our analysis, it is possible to simulate the effects of astigmatism in radial averages by imposing Bessel functions on idealized radial averages of images which are not astigmatic. We validate our theory using astigmatic TEM images.     

Determination of astigmatism in TEM images

We have developed a new two-step algorithm to determine the astigmatism of images from transmission electron microscopes (TEMs). Instead of computing the radial average of the power spectrum, we divide the power spectrum of a TEM image 1 to m (typically 32) sectors. We use a technique based on perturbation analysis of the contrast transfer function (CTF) to assimilate sector averages of the power spectrum of an image, which are incoherent in the presence of astigmatism, to a coherent radial average corresponding to a nominal defocus value. This is based on the fact that small defocus change from a nominal value can be considered to be equivalent to a perturbation on the spatial frequency spectra. Thus, instead of measuring the angular defocus variations, we optimise the frequency change required to obtain a coherent radial average. Numerically, this is achieved by minimizing sigma(2)/sigma(1) of a matrix formed from the sector averages, where sigma(i) denotes the ith singular value of the matrix. After the minimisation procedure, the second singular value should be very small compared with the first singular value, indicating that the matrix is nearly rank unity. In the second step, the nominal defocus can be obtained from the coherent radial average using any good defocus estimation program, which assumes zero astigmatism. The defocus value at a sector can be obtained from this nominal defocus value and one of the parameters from the unconstrained optima. Our algorithm is tested on astigmatic images of carbon film, 2D crystals of bacteriorhodopsin and cryo-images of HIV cores.     

Laser light: its nature and its action on the eye.

Lasers produce a coherent, focused, monochromatic, high-energy form of light. Because laser surgery is more versatile and precise and is freer of complications than conventional surgery it has become widely accepted in ophthalmology over the past 10 years. Applications range from routine procedures in the fundus to recent, more delicate interventions in the cornea. The argon laser is the most widely used to treat extrafoveal chorioretinal diseases such as age-related macular degeneration and diabetic retinopathy; it has also been used successfully to treat glaucoma by iridectomy or trabeculoplasty. The krypton red laser is the argon laser''s counterpart in the treatment of subfoveal and pigment-epithelium-related diseases. Posterior capsulotomy is the most widespread and successful intervention with the neodymium:yttrium-aluminum-garnet crystal laser; this laser is also used to cut vitreous traction bands and is increasingly used in iridectomy. Although the use of the excimer laser in corneal surgery is still largely investigational it has been shown to produce precise cuts in corneal layers for the correction of myopia or astigmatism. The variable-wavelength dye laser, capable of reaching a specific level in the retina or choroid, has offered exciting new developments, and it promises to soon be part of the ophthalmologist''s armamentarium in the treatment of eye disease.     

Q 值调整个体化准分子激光原位角膜磨镶术术后角膜

目的:观察Q值调整非球面切削与标准化LASIK术后不同角膜直径下的角膜的非球面变化来分析Q值引导个性化切削技术的临床效果。方法:前瞻性研究。随机选取2010年至2011年来我院就诊的准分子手术患者35例68眼,分别进行标准化LASIK(S组:17例34眼)和Q值调整个体化LASIK(Q组:18例34眼)矫治。术前2组各项指标均相似,差异无统计学意义。术前屈光度数分别为标准组球镜平均值为-4.76±2.02D(-1.5D～-9.75D),柱镜平均值为-0.71±0.7D(0～-2.5D)和Q值个体化组球镜平均值为-4.78±2.21D(-1.5～-9.5D),柱镜平均值为-0.84±0.55D(0～-2.5D)两组,对比两组非球面切削与标准化LASIK术后1个月不同角膜直径下的Q值及△Q。结果:两组术前Q10、Q15、Q20、Q25、Q30平均值分别为标准组:-0.12、-0.17、-0.20、-0.25、-0.30,Q值个体化组:-0.14、-0.19、-0.22、-0.27、-0.32.。术后一个月两组的△Q(△Q=Qpost-Qpre)△Q10、△Q15、△Q20、△Q25、△Q30分别为标准组:0.58、0.88、1.08、1.10、0.85,Q值个体化组,0.39、0.75、1.03、1.10、0.84。△Q10和△Q15术前术后变化在角膜直径为3.5mm之内时的差异有统计学意义。结论:Q值调整的个体化准分子激光原位角膜磨镶术术后角膜非球面变化与标准组相比皆由术前的长椭圆型Q值向扁椭圆型变化,但Q值调整的个体化组在角膜中央区的扁椭圆变化小于标准组,尤其在角膜中央3.5mm。说明Q值调整的个体化LASIK组在角膜中央区比标准组具有优势。     

Determination of optical parameters of the porcine eye and development of a simulated model

The eye is a very sophisticated system of optical elements for the preeminent sense of vision. In recent years, the number of laser surgery to correct the optical aberration such as myopia or astigmatism has significantly increased. Consequently, improving the knowledge related to the interactions of light with the eye is very important in order to enhance the efficiency of the surgery. For this reason, a complete optical characterization of the porcine eye is presented in this study. Kubelka‐Munk and Inverse Adding‐Doubling methods were applied to spectroscopy measurement to determine the absorption and scattering coefficients. Furthermore, the refractive index has been measured by ellipsometry. The different parameters were obtained for the cornea, lens, vitreous humor, sclera, iris, choroids and eyelid in the visible and infrared region. Thereafter, the results are implemented in a COMSOL Multiphysics® software to create an eye model. This model gives a better understanding of the propagation of light in the eye by adding optical parts such as the iris, the sclera or the ciliary bodies. Two simulations show the propagation of light from the cornea to the retina but also from the sclera to the retina. This last possibility provides a better understanding of light propagation during eye laser surgery such as, for example, transscleral cyclophotocoagulation. Figure: Eye simulation models allow the development of new laser treatments in a simple and safe way for patients. To this purpose, the creation of an eye simulated model based on optical parameters obtained from experimental data is presented in this study. This model will facilitate the understanding of the light propagation inside the porcine eye.     

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.