Evaluation of the Changes in Anterior Segment Morphology with Ultrasound Biomicroscopy after Vitrectomy without Use of Tamponade in Pseudophakic Eyes

Aim: In this study we investigated the changes in anterior segment morphology in pseudophakia patients that underwent ultrasound biomicroscopy (UBM) after pars plana vitrectomy (PPV) operation without use of tamponade. Method: Pseudophakic patients who undergo PPV were enrolled in this prospective study between October 2012 and April 2015. Study included patients in whom intraocular tamponade was not used during PPV operation. UBM measurements were performed both before and 10 days after the operation. Anterior chamber depth (ACD) was measured using axial images of anterior segment. Trabecular meshwork-iris angle (TIA), ciliary body thickness (CBT), sclera thickness (ST), trabecular meshwork-ciliary process distance (T-CPD), iris-ciliary processes distance (I-CPD), and iris thickness (IT) were measured at temporal quadrant based on radial section images of the angle. Values measured before and after the operation were statistically compared with each other. Results: This study included 30 patients (18 females, 12 males) that underwent an operation ultrasound biomicroscopy (UBM) after pars plana vitrectomy (PPV) operation without use of tamponade. Mean age was 69.6 ± 9.1 (55 - 85) years. Eighteen operations occurred on the left eye whereas twelve operations occurred on the right eye. CBT1, CBT2, CBT Max, T-CPD, and I-CPD were significantly decreased after operation when compared with the values of baseline (before) (p = 0.018, p = 0.012, p = 0.001, p = 0.033, p = 0.015, respectively). Other evaluated parameters did not show statistically significant changes after the operation (p > 0.05). Discussion: PPV results in significant changes in ciliary body morphology together with changes in anterior segment parameters in pseudophakic cases.

Comparison of Anterior Segment Optical Coherence Tomography and Ultrasound Biomicroscopy for Iris Parameter Measurements in Patients with Primary Angle Closure Glaucoma

Purpose: To compare the repeatability and consistency of anterior segment optical coherence tomography (AS-OCT) and ultrasound biomicroscopy (UBM) in measuring iris parameters in patients with primary angle closure glaucoma. Methods: Twenty-two patients (38 eyes) with primary angle closure glaucoma,including 5 eyes with acute angle closure glaucoma,10 fellow eyes of acute angle closure glaucoma, and 23 eyes with chronic angle closure glaucoma, were recruited consecutively in our hospital. All subjects underwent anterior scanning by AS-OCT and UBM. Peripheral iris thickness (PIT) and iris curvature (IC) in the anterior segment image obtained by AS-OCT and UBM were measured twice. The reproducibility of these two scans was evaluated by the intraclass correlation coefficient (ICC). A paired t-test was used to compare the difference between the two scans and the 95% limits of agreement (LoA) were calculated. Results:The ICCs of PIT and IC measured by UBM were 0.892 and 0.936 respectively, while for AS-OCT these values were 0.629 and 0.859, respectively. UBM had a higher reproducibility in both PIT and IC measurements as compared with AS-OCT.Differences in PIT measurement between AS-OCT and UBM(P=0.331).were not statistically significant, the 95% LoA (-0.178～0.156) mm was 36.1～41.2% of the mean. The IC was 0.053 mm smaller when measured by UBM than by AS-OCT (P=0.017), with the 95% LoA (-0.100～0.206) mm, or 36.2～74.6% of the mean.Conclusion:UBM had a higher reproducibility in measuring iris parameters than AS-OCT. The consistency between AS- OCT and UBM in measuring iris parameters was low in primary angle closure glaucoma patients. (Eye Science 2013; 28:1-6)

Utility of transporter/receptor(s) in drug delivery to the eye

The eye is a highly protected organ, and designing an effective therapy is often considered a challenging task. The anatomical and physiological barriers result in low ocular bioavailability of drugs. Due to these constraints, less than 5% of the administered dose is absorbed from the conventional ophthalmic dosage forms. Further, physicochemical properties such as lipophilicity, molecular weight and charge modulate the permeability of drug molecules. Vision-threatening diseases such as glaucoma, diabetic macular edema, cataract, wet and dry age-related macular degeneration, proliferative vitreoretinopathy, uveitis, and cytomegalovirus retinitis alter the pathophysiological and molecular mechanisms. Understanding these mechanisms may result in the development of novel treatment modalities. Recently, transporter/receptor targeted prodrug approach has generated significant interest in ocular drug delivery. These transporters and receptors are involved in the transport of essential nutrients, vitamins, and xenobiotics across biological membranes. Several influx transporters(peptides, amino acids, glucose, lac-tate and nucleosides/nucleobases) and receptors(folate and biotin) have been identified on conjunctiva, cornea, and retina. Structural and functional delineation of these transporters will enable more drugs targeting the posterior segment to be successfully delivered topically. Prodrug derivatization targeting transporters and receptors expressed on ocular tissues has been the subject of intense research. Several prodrugs have been designed to target these transporters and enhance the absorption of poorly permeating parent drug. Moreover, this approach might be used in gene delivery to modify cellular function and membrane receptors. This review provides comprehensive information on ocular drug delivery, with special emphasis on the use of transporters and receptors to improve drug bioavailability.

Assessment of anterior chamber angle changes after phacoemulsification with swept-source OCT

AIM:To assess the changes of anterior chamber angle in patients with shallow anterior chamber after phacoemulsification combined with intraocular lens(IOL)implantation,based on anterior segment swept-source optical coherence tomography(AS-SS-OCT)measurements.METHODS:This was a prospective case control study;sixty eyes of sixty case were scheduled for cataract surgery with normal intraocular pressure(IOP).Based on anterior chamber depth(ACD)and gonioscopy findings,the eyes were divided into two groups:group of shallow anterior chamber and narrow angle(SAC group,30 eyes);and group of normal anterior chamber group with wide angle(NAC group,30 eyes).Measurements of ACD,anterior chamber volume(ACV),iris volume(IV),lens vault(LV),angle opening distance(AOD),angle recess area(ARA),trabecular iris space area(TISA),and trabecular iris angle(TIA)were conducted in each group before and 3mo after surgery.RESULTS:There was no significant difference in age,axial length(AL),corneal curvature,corneal diameter,intraocular pressure,and IV between two groups before surgery,except for the LV(P=0.000).ACD and ACV were prominently larger in the NAC group than the SAC group 3mo after operation(3.69±0.38 vs 3.85±0.39 mm,P=0.025;161.37±19.47 vs 178.26±20.30 mm3,P=0.002).AOD750,ARA750 in nasal and inferior quadrants,TISA750 in all quadrants except temporal,and TIA750 in all quadrants in SAC group were significantly smaller than those in NAC group after operation(all P<0.05).CONCLUSION:Cataract surgery can deepen anterior chamber and increase the width of anterior chamber angle in Chinese subjects,but the angle related parameters including AOD750,ARA750,TISA750,TIA,TISA750,and ACV in patients with shallow anterior chamber and narrow angle do not reach the normal level.

Comparison of two Nd:YAG laser posterior capsulotomy: cruciate pattern vs circular pattern with vitreous strand cutting

AIM： To investigate the effects and safety of neodymium： yttrium-aluminium-garnet（Nd：YAG） laser posterior capsulotomy with vitreous strand cuttingMETHODS： A total of 40 eyes of 37 patients with symptomatic posterior capsular opacity（PCO） were included in this prospective randomized study and were randomly subjected to either cruciate pattern or round pattern Nd：YAG posterior capsulotomy with vitreous strand cutting（modified round pattern）. The best corrected visual acuity（BCVA）, intraocular pressure（IOP）, refractive error, endothelial cell count（ECC）, anterior segment parameters, including anterior chamber depth（ACD） and anterior chamber angle（ACA） were measured before and 1 mo after the laser posterior capsulotomy. RESULTS： In both groups, the BCVA improved significantly（P〈0.001 for the modified round pattern group, P=0.001 for the cruciate pattern group）; the IOP and ECC did not significantly change. The ACD significantly decreased（P〈0.001 for both） and the ACA significantly increased（P=0.001 for the modified round pattern group and P=0.034 for the cruciate group）. The extent of changes in these parameters was not significantly different between the groups.CONCLUSION： Modified round pattern Nd：YAG laser posterior capsulotomy is an effective and safe method for the treatment of PCO. This method significantly changes the ACD and ACA, but the change in refraction is not significant. Modified round pattern Nd：YAG laser posterior capsulotomy can be considered a good alternative procedure in patients with symptomatic PCO.

Objective evaluation of the changes in the crystalline lens during accommodation in young and presbyopic populations using Pentacam HR system

AIM: To quantify the changes in the lens profile with accommodation in different age groups. METHODS: The Pentacam HR system was used to obtain the images of the anterior eye segment from 23 young and 15 presbyopic emmetropic subjects in unaccommodated (with an accommodation stimulus of 0.0D) and accommodated (with an accommodation stimulus of 5.0D for the young group and 1.0D for the presbyopic group) states. The phakic crystalline lens shape, including curvature of crystalline lens and central lens thickness (CLT), and the measurements of anterior segment length (ASL), central anterior chamber depth (CACD) were investigated. The anterior chamber volume (ACV) was also measured. RESULTS: The reduction of CACD and ACV were significant in both groups after accommodation stimulus. From the profile of anterior eye segment, a significant decrease in anterior crystalline lens radii of curvature (-2.52mm) and a mean increase in CLT (0.222mm) and ASL (0.1138mm) were found in the. young group with an accommodation stimulus of 5.0D. However, no statistically significant changes of CLT, ASL, or crystalline lens radii of curvature were found in the presbyopic group. CONCLUSION: Our data showed that the shallowing of anterior chamber during accommodation was caused by the forward bulging of the anterior lens surface, rather than by anterior shifting of lens position in either young or presbyopic subjects.

Management and treatment of bizarre open globe trauma in three steps:a case report

This is a case presentation of a very bizarre open globe trauma with anterior segment foreign body-fishing hook stuck in the cornea and iris. Complications due to this kind of eye trauma might be very hazardous and with serious impact on visual function. We are representing our approach and experience of three step management of this kind of eye injury: first-extract the foreign body, close and reconstruct the eyeball, second-fight inflammation, and third-restore the visual function by cataract surgery.

Evaluation of dry eye disease in newly diagnosed anxiety and depression patients using anterior segment optical coherence tomography

Background:We aimed to evaluate dry eye diseases(DED)in patients with newly diagnosed depression and anxiety patients.Methods:Forty newly diagnosed depression,35 anxiety patients,and 37 controls without any history of taking psychiatric drugs(or before the beginning of psychiatric medication)and topical ophthalmic drop use,were included in the study.All depression and anxiety diagnoses were performed by an experienced psychiatrist.Beck depression and anxiety tests were used to measure disease severity.Tear film break up time(TBUT),Schirmer’s test,Oxford scores and ocular surface disease index(OSDI)were admiinistered to participants.Anterior segment optical coherence tomography was used to measure tear meniscus heights(TMH),tear meniscus depths(TMD)and tear meniscus areas(TMA).Results:In anxiety and depression groups,Schirmer’s test(mm)(7.24±6.02,6.58±4.9 and 18.79±4.9 respectively,p<0.05)and TBUT(s)(5.62±3.1,5.6±3.5 and 13.37±1.7 respectively,p<0.05)were significantly lower than control group.In addition,OSDI and Oxford scores were significantly higher than controls.OSDI scores were 28.01±19,30.43±18.49,14.38±8.14 respectively(p=0.002)and Oxford scores were 1.9±0.7,2.1±0.6 and 0.7±0.4 respectively(p=0.001).TMD,TMH and TMA values were significantly lower in anxiety and depression groups compared with control groups.Correlations between disease inventory scores and dry eye tests were detected.Conclusions:This study showed a relation between DED and newly diagnosed anxiety and depression patients with no history of psychiatric drug use.The presence of correlation between dry eye tests and disease inventory scores strengthens this association.This is an important knowledge that need to be evaluated in these patients before starting psychiatric medication.

原发性闭角型青光眼患者一级亲属眼前节结构特点

目的:研究原发性闭角型青光眼(PACG)患者一级亲属的眼前节结构特点。方法:选择2020-09/2022-10于南昌大学附属眼科医院就诊的40-60岁PACG一级亲属48例48眼作为观察组,同时纳入同年龄段、无青光眼及青光眼家族史的健康体检者40例40眼为对照组,按年龄分为低龄组(40-49岁)和高龄组(50-60岁)。所有研究对象均行超声生物显微镜(UBM)检查,使用camera measure测量软件进行测量,主要测量指标包括前房深度(ACD)、前房面积(ACA)、前房宽度(ACW)、眼前节深度(ASD)、房角开放距离(AOD 500)、小梁虹膜夹角(TIA)、小梁虹膜间面积(TISA_(500))、晶状体拱高(LV)、虹膜曲率(IC)、虹膜厚度(IT 500)、巩膜睫状突夹角(SCPA)及虹膜睫状突距离(ICPD)。比较两组各指标。结果:观察组ACD、ACA、AOD 500、TISA_(500)、TIA均比对照组小,LV、IC均比对照组大(均P<0.05)。高龄观察组ACD、ACA、AOD 500、TISA_(500)、TIA明显小于同龄对照组,LV、IC大于同龄对照组(均P<0.05);低龄观察组ACD、AOD 500、TISA_(500)、TIA明显小于同龄对照组,LV、IC显著大于同龄对照组(均P<0.05)。高龄观察组的ACD、ACA、AOD 500、TISA_(500)、TIA均显著小于低龄观察组,LV、IC显著大于低龄观察组(均P<0.05)。观察组与对照组ACD分布有差异(P<0.05),其中中重度浅前房的占比约为对照组的10倍。相关性分析表明,TISA_(500)与ACD、ACA呈正相关,与LV、IC呈负相关,TISA_(500)主要受LV影响。IC与LV呈正相关,与ACD、ACA呈负相关。结论:正常眼轴的PACG一级亲属存在房角关闭的高风险性。PACG一级亲属的眼前节结构较正常人拥挤,晶状体前移可能是导致房角狭窄的始动影响因素。

基于改进YOLOv8的生物显微镜图像眼前节参数测量方法研究

目的:针对眼科超声图像数量有限、标注成本高和模型泛化能力不强的问题,提出一种基于改进YOLOv8的超声生物显微镜(ultrasonic biological microscopy,UBM)图像眼前节参数测量方法。方法:首先,使用StyleGAN3进行数据增强,降低YOLOv8模型对UBM图像的敏感度,提高模型的泛化性能;其次,借鉴半监督学习中的伪标签自训练的方法,使用以原始UBM图像为数据集的YOLOv8模型生成虚拟UBM图像的伪标签;最后,使用扩充后的数据集训练YOLOv8模型,同时使用全局上下文网络(global context network,GCNet)模块改进YOLOv8模型,使用关键点排序算法对YOLOv8的预测结果进行排序,结合先验知识筛选出合格图像后,计算眼前节生理参数的测量值。结果:与眼科专家的手工标注结果相比,经StyleGAN3数据增强和自训练的YOLOv8模型的定位误差为(61.94±40.66)μm,测量前房角间距、瞳孔直径、睫状沟间距、中央角膜厚度、前房深度、晶状体厚度的平均相对误差分别为0.62%、1.35%、0.68%、4.87%、0.93%、0.75%。结论:提出的方法能够提高UBM图像眼前节参数测量的精度,且能满足实时性的需求。

有晶状体眼后房型人工晶状体植入术后拱高与眼前节参数的相关性研究

目的研究分析有晶状体眼后房型人工晶状体(ICL)植入术后早期的拱高与术前眼前节参数的相关性。方法回顾性病例研究。收集2021年7月至2022年10月行ICL植入手术患者388例(696只眼)的病历资料,所有患者术后随访1周,使用三维眼前节分析仪(Pentacam)测量患者术后拱高,分析ICL术后早期拱高与术前角膜水平直径即白到白(WTW)、平均睫状沟直径(STS)、房角距离(ATA)、前房深度(ACD)、术前等效球镜(SE)、眼轴长度(AL)、晶状体厚度(LT)、晶状体矢高(CLR)以及晶状体前表面顶点到水平睫状沟直径所在平面的距离(STSL)之间的相关性,并通过逐步多元线性回归分析建立预测拱高的线性回归方程。结果患者行ICL植入术后1周裸眼视力为-0.08(-0.08,<0.00)logMAR,较术前1.00(1.00,1.22)logMAR显著提升,差异有统计学意义(Z=-22.892,P<0.001),术后1周的拱高与WTW(r=0.229,P<0.001)、ACD(r=0.296,P<0.001)、STS(r=0.163,P<0.001)、AL(r=0.079,P<0.05)、ICL尺寸(r=0.210,P<0.001)呈正相关,与STSL(r=-0.163,P<0.001)、CLR(r=-0.203,P<0.001)、LT(r=-0.292,P<0.001)呈负相关,与SE和ATA无显著相关性(P>0.05)。线性回归结果显示:影响和预测ICL术后早期拱高的因素有ACD、STSL、LT、ICL尺寸。线性回归方程:拱高=-209.742+116.764×(ACD)-114.234×(STSL)-106.168×(LT)+58.156×ICL尺寸(R^(2)=0.130)。结论术后1周的拱高与WTW、ACD、STS、AL、ICL尺寸呈正相关,与STSL、CLR、LT呈负相关,与SE和ATA不相关,ACD、STSL、LT和ICL尺寸是影响和预测术后拱高的重要因素。

屈光参差儿童双眼前节生物参数差异性分析

目的:分析屈光参差儿童双眼前节生物参数间的差异。方法:纳入235例6~15岁双眼屈光度相差≥1.00 D且双眼轴相差≥0.3 mm的儿童,分为双眼均近视(A组)、双眼均未近视(B组)和一眼近视一眼未近视(C组)。测量双眼前节生物学参数(角膜曲率、前房深度、晶体厚度)、屈光度、眼轴长度及体格发育指标(身高、体重、体重指数),分析屈光参差儿童双眼间眼前节生物学参数的差异,以及生物学参数与性别、体格发育指标的相关性。结果:每组儿童双眼间角膜曲率比较无统计学差异(均P>0.05),双眼间长眼轴眼前房深度大于短眼轴眼(均P<0.01)。A组和B组双眼间晶体厚度比较无统计学差异(P>0.05),而C组近视眼的晶体厚度薄于未近视眼(P<0.01)。双眼前节参数差异与性别及体格发育指标无相关性(均P>0.05)。结论:屈光参差儿童双眼角膜曲率无差异。长眼轴眼前房深于短眼轴者,已近视和未近视者晶体厚度双眼间比较无统计学差异,而一眼近视一眼未近视者近视眼晶体厚度薄于未近视眼,提示屈光参差患者在眼部发育过程中眼前节生物参数的变化可能存在不同的调控机制,且与性别及体格发育指标无相关性。

Corneal biomechanical data and biometric parameters measured with Scheimpflug-based devices on normal corneas

AIM： To analyze the correlations between ocular biomechanical and biometric data of the eye,measured by Scheimpflug-based devices on healthy subjects.METHODS： Three consecutive measurements were carried out using the corneal visualization Scheimpflug technology（Cor Vis ST） device on healthy eyes and the 10 device-specific parameters were recorded.Pentacam HR-derived parameters（corneal curvature radii on the anterior and posterior surfaces;apical pachymetry;corneal volume;corneal aberration data;depth,volume and angle of the anterior chamber） and axial length（AL） from IOLMaster were correlated with the 10 specific CorV is ST parameters.RESULTS： Measurements were conducted in 43 eyes of 43 volunteers（age 61.24±15.72y）.The 10 specific Cor Vis ST data showed significant relationships with corneal curvature radii both on the anterior and posterior surface,pachymetric data,root mean square（RMS） data of lower-order aberrations,and posterior RMS of higher-order aberrations and spherical aberration of the posterior cornea.Anterior chamber depth showed a significant relationship,but there were no significant correlations between corneal volume,anterior chamber volume,mean chamber angle or AL and the 10 specific CorV is ST parameters.CONCLUSION： Cor Vis ST-generated parameters are influenced by corneal curvature radii,some corneal RMS data,but corneal volume,anterior chamber volume,chamber angle and AL have no correlation with the biomechan-ical parameters.The parameters measured by CorV is ST seem to refer mostly to corneal properties of the eye.

基于SS-OCT分析眼轴长度与眼前节参数的相关性

目的:利用扫频源光相干断层扫描成像(SS-OCT)观察与探讨眼轴长度(AL)与眼前节相关参数的相关性。方法:横断面临床研究,纳入2022-01-01/03-31在郑州大学第一附属医院眼科门诊招募的不同程度近视的成人志愿者109例,依据AL将受检者分为4组:A组(AL≤24.0mm)、B组(24.0mm26.0mm)。SS-OCT(视微影像)进行眼前节检查,对中央角膜厚度(CCT)、晶状体厚度(LT),前房参数:中央前房深度(ACD)、前房宽度(ACW)、房角开放距离(AOD500)、房角隐窝面积(ARA500)、小梁网-虹膜间面积(TISA500)、小梁虹膜夹角(TIA500),晶状体矢高(CLR)进行记录,并分析其与AL、等效球镜度数(SE)的关系。结果:四组CCT比较无差异(P>0.05)。四组SE、LT、ACD、ACW、AOD500、ARA500、TISA500、TIA500、CLR比较有差异(均P<0.01)。SE、LT与AL呈负相关(r=-0.75、-0.41,均P<0.01);ACD、ACW、CLR与AL呈正相关(r=0.58、0.45、0.54,均P<0.01);AOD500、ARA500、TISA500、TIA500(颞侧及鼻侧)与AL呈正相关(均P<0.01)。ACD、CLR与SE呈负相关(r=-0.21、-0.25,均P<0.01),LT与SE呈正相关(r=0.21,P<0.05)。结论:随着AL的增加CCT无明显改变,ACD、ACW及房角开放程度则增加,晶状体位置后移,LT变薄。

眼前节生物学参数与有晶状体眼后房型人工晶状体植入术后拱高的相关性分析

目的分析眼前节生物学参数与有晶状体眼后房型人工晶状体(ICL)植入术后拱高的相关性。方法回顾分析2018年1月~2019年12月于我院行ICL植入术患者的临床资料。记录术前中央前房深度(ACD)、角膜水平白到白(WTW)直径、晶状体厚度(LT)、晶状体矢高(CLR)及术后3个月拱高,分析各项眼前节参数与拱高的相关性。结果本研究共纳入33例(58眼),术前平均等效球镜为(-10.54±2.84)D,WTW为(11.45±0.27)mm,ACD为(3.12±0.17)mm,LT为(3.72±0.26)mm,CLR为(206.72±157.58)μm,术后3个月平均拱高为(410.31±146.11)μm。年龄与拱高无明显相关性(P=0.058)。术前ACD、WTW、LT、CLR与拱高具有显著相关性,其中ACD、WTW与拱高呈正相关(P=0.001,P=0.039),LT、CLR与拱高呈负相关(P=0.041,P<0.001)。结论ICL植入术后拱高与术前ACD、WTW呈正相关,与LT、CLR呈负相关。

基于YOLOv5的眼前节参数实时测量算法研究

目的:针对已有算法无法在超声生物显微镜(ultrasonic biological microscopy,UBM)图像中同时测量多个眼前节生理参数的问题,提出一种基于YOLOv5的眼前节参数实时测量算法。方法:先使用YOLOv5算法在UBM图像中定位出中央角膜上皮层、中央角膜内皮、两侧前房角、两侧睫状沟、瞳孔两端、瞳孔中央及晶状体后囊,再结合先验知识将其排序并筛选出合格图像后,计算中央角膜厚度、前房深度、晶状体厚度、睫状沟间距、前房角间距及瞳孔直径等眼前节生理参数。使用欧氏距离之差的绝对值评估该算法对眼前节生理参数的测量误差。结果:该算法对眼前节关键点的定位误差为(66.27±66.25)μm,预测中央角膜厚度的相对误差为9.61%,预测其他眼前节参数的相对误差均在3%以下。在配备Ryzen 5 4600U处理器的便携式计算机上检测一张UBM图片仅需要140 ms。结论:该算法准确性高、实时性强、对硬件要求低,能够精确且快速地测量多个眼前节生理参数。

超声睫状体成形术对青光眼患者眼前节结构的影响及眼前节各参数变化与眼压的关系

目的探讨超声睫状体成形术(UCP)对青光眼患者眼前节结构的影响及眼前节各参数变化与眼压的关系。方法选取2020年3月至2022年5月就诊于新乡医学院第一附属医院眼科行UCP治疗的青光眼患者23例(23眼)作为研究对象。记录患者术前及术后1周、1个月、3个月及6个月的眼压,术前及术后1个月、3个月及6个月行超声生物显微镜检查,记录保存四个方位的图像,记录患者前房深度、瞳孔直径、前房角开放距离(AOD 500)、小梁虹膜夹角(TIA)、巩膜睫状突夹角(SCPA)、睫状体面积(CBA)等眼前节参数,分析各参数的变化量及其与眼压变化的相关性。结果手术前后患者眼压总体比较差异有统计学意义(F=32.039,P<0.01);术后1周[(23.21±5.38)mmHg,1 kPa=7.5 mmHg]、1个月[(24.59±5.64)mmHg]、3个月[(24.63±6.68)mmHg]、6个月[(26.21±6.32)mmHg]患者眼压均较术前[(48.70±6.77)mmHg]明显降低,差异均有统计学意义(均为P<0.05)。术前与术后不同时间患者房角参数(上侧、下侧、颞侧、鼻侧各个方向的AOD 500、TIA)比较差异均无统计学意义(均为P>0.05)。术前与术后不同时间患者上侧和下侧SCPA、CBA比较差异均有统计学意义(均为P<0.01);无论上侧和下侧,术后1个月、3个月、6个月患者SCPA均较术前增大(均为P<0.05),CBA均较术前减小(均为P<0.05)。Pearson相关分析结果显示,术后6个月患者眼压变化量与上侧、下侧的睫状体参数SCPA变化量均存在负相关性(均为P<0.05),与上侧、下侧的睫状体参数CBA变化量均无相关性(均为P>0.05)。结论UCP手术可有效控制青光眼患者眼压,使治疗区域的SCPA增大,CBA减少,且术后6个月患者眼压变化量与上侧、下侧的睫状体参数SCPA变化量呈负相关。

优化ICL V4c植入术的临床研究进展

随着有晶状体眼后房型人工晶状体植入术的发展及可植入式接触镜(ICL)的不断改进,ICL V4c植入术目前已经成为矫正中高度近视的主流术式之一。术后拱高是评价手术安全性的重要指标,在常规ICL V4c植入手术的基础上,如何优化手术以获得更理想的拱高是近年来学者们研究的热点。本文以术前检查、术中手术设计以及术后随访为中心,总结分析优化ICL V4c植入手术的方案,为提高手术安全性提供帮助。

两种基于Scheimpflug成像原理的生物测量仪对眼前节参数测量的一致性研究

目的:评估两种基于Scheimpflug成像技术原理的国产Scansys和进口Sirius三维眼前节分析系统,对近视患者眼前节生物参数测量的差异性与一致性。方法:系列病例研究,选取2022-05/10沈阳爱尔卓越眼科医院诊断为轻中度近视拟行屈光手术(包括全飞秒、半飞秒、TransPRK、ICL植入术)患者103例103眼(所有患者均右眼入组)。收集患者术前角膜曲率(Km)、中央角膜厚度(CCT)、前房深度(ACD Endo.)、前房角(ACA)、前房容积(ACV)、白到白(WTW)。结果:Scansys和Sirius测量术前Km为42.88(41.54,44.60)、42.98(41.56,44.52)D,CCT为541.52±29.08、549.55±29.62μm,ACA为42.70°±2.67°、46.63°±5.13°,WTW为12.10±0.60、11.98±0.47mm,差异均有统计学意义(均P<0.01)。Scansys和Sirius测量ACV为194.26±31.06、191.47±25.65mm 3,ACD Endo.为3.40(3.17,3.57)、3.43(3.19,3.56)mm,差异均无统计学意义(均P>0.05)。两种仪器测量Km、CCT、ACA、ACD Endo.、ACV、WTW值区间范围小,平均差异接近0,95%LoA线外点比例均<5%,一致性较好。结论:Scansys和Sirius对眼前节参数测量结果差异较小,一致性较好,临床上可以相互参考替代。Scansys理论上可以用来推算ICL型号,或可成为眼前节参数测量的一种新选择。

EyeHealer:A large-scale anterior eye segment dataset with eye structure and lesion annotations

Anterior segment eye diseases account for a significant proportion of presentations to eye clinics worldwide,including diseases associated with corneal pathologies,anterior chamber abnormalities(e.g.blood or inflammation),and lens diseases.The construction of an automatic tool for segmentation of anterior segment eye lesions would greatly improve the efficiency of clinical care.With research on artificial intelligence progressing in recent years,deep learning models have shown their superiority in image classification and segmentation.The training and evaluation of deep learning models should be based on a large amount of data annotated with expertise;however,such data are relatively scarce in the domain of medicine.Herein,the authors developed a new medical image annotation system,called EyeHealer.It is a large-scale anterior eye segment dataset with both eye structures and lesions annotated at the pixel level.Comprehensive experiments were conducted to verify its performance in disease classification and eye lesion segmentation.The results showed that semantic segmentation models outperformed medical segmentation models.This paper describes the establishment of the system for automated classification and segmentation tasks.The dataset will be made publicly available to encourage future research in this area.