ORA在角膜生物力學(xué)特性研究中的應(yīng)用
發(fā)布時(shí)間：2018-08-31 16:32
【摘要】：目的：通過(guò)眼反應(yīng)分析儀對(duì)角膜生物力學(xué)特性參數(shù)的差異比較,探討角膜滯后量和角膜阻力因子的臨床意義。 方法：2009年11月～2010年3月,于北京協(xié)和醫(yī)院眼科門診隨機(jī)選取84例(168只眼)正常人,采用ORA眼反應(yīng)分析儀(Reichert Ocular Response Analyzer,ORA)測(cè)眼壓及角膜滯后量(corneal hysteresis, CH)、角膜阻力因子(corneal resistane factor,CRF),與非接觸眼壓計(jì)(NCT)測(cè)量對(duì)比,然后用A型超聲角膜測(cè)厚儀測(cè)量中央角膜厚度(central corneal thickness.CCT),并進(jìn)行相關(guān)分析；隨機(jī)選取31例(62只眼)青光眼及可疑青光眼患者,采用ORA測(cè)眼壓及CH、CRF,然后用A型超聲角膜測(cè)厚儀測(cè)量CCT,之后與Goldmann(?)壓計(jì)(GAT)測(cè)量對(duì)比,并進(jìn)行相關(guān)分析；選取角膜屈光手術(shù)后隨訪者51例(102只眼),采用ORA測(cè)眼壓及CH、CRF,與非接觸眼壓計(jì)NCT測(cè)量對(duì)比,然后用A型超聲角膜測(cè)厚儀測(cè)量CCT,并進(jìn)行相關(guān)分析。比較ORA所測(cè)正常人、青光眼及可疑青光眼患者及角膜屈光手術(shù)后患者角膜生物力學(xué)特性(corneal biomechamical properties)參數(shù)的差異,探討CH、CRF的臨床意義。 結(jié)果：正常人眼壓值,ORA測(cè)得模擬Goldmann(?)壓值(Goldmann-correlated IOP value,IOPg)為17.90±4.17mmHg,角膜補(bǔ)償后眼壓(Corneal-Compensated Intraocular Pressure,IOPcc)為18.34±4.00mmHg;NCT跟壓值為17.44±3.54mmHg。IOPcc、IOPg、NCT眼壓之間相關(guān)性良好,均值兩兩間有顯著差異。CCT為536.20±29.17μm。NCT眼壓測(cè)量值與CCT中等水平相關(guān),相關(guān)系數(shù)為0.429；而IOPcc與CCT問(wèn)僅有低水平弱相關(guān),相關(guān)系數(shù)為0.258。正常人男性IOPg顯著高于女性,IOPcc無(wú)明顯差異,IOPcc、IOPg與年齡無(wú)明顯相關(guān)性。正常人CH和CRF分別為10.13±2.11mmHg和10.90±2.31mmHg,與年齡、性別無(wú)明顯相關(guān)性。CH與CCT有低水平弱相關(guān),相關(guān)系數(shù)為0.277；CRF與CCT中等水平相關(guān),相關(guān)系數(shù)為0.466。 青光眼及可疑青光眼患者IOPg為19.16±4.10mmHg,IOPcc為19.91±4.44mmHg;GAT眼壓值為18.91±3.75mmHg。青光眼及可疑青光眼患者IOPg、IOPcc、GAT三者相關(guān)性良好,均值間IOPcc顯著高于IOPg、GAT(?)壓值,GAT跟壓值與IOPg無(wú)明顯差異。GAT跟壓測(cè)量值與CCT中等水平相關(guān),相關(guān)系數(shù)為0.344。青光眼及可疑青光眼患者CH和CRF分別為9.83±2.13mmHg和11.03±2.11mmHg。與正常組對(duì)比,青光眼及可疑青光眼患者IOPg、IOPcc顯著高于正常組,而CH、CRF、CCT間無(wú)明顯差異。 角膜屈光手術(shù)后,LASEK術(shù)后隨訪者IOPg為13.26±3.52mmHg, IOPcc為16.64±3.29mmHg, NCT眼壓值為14.13±3.61mmHg, CH為8.01±1.60mmHg, CRF為7.70±1.82mmHg, CCT為447.59±43.75μ m; LASIK術(shù)后隨訪者IOPg為13.10±5.29mmHg, IOPcc為16.70±5.25mmHg, NCT眼壓值為13.91±4.99mmHg,CH為7.83±1.52mmHg, CRF為7.50±1.75mmHg, CCT為447.96±46.22μm。與正常人對(duì)比,角膜屈光術(shù)后患者IOPg、IOPcc、NCT眼壓值、CCT、CH、CRF均明顯低于正常人,但I(xiàn)OPcc下降無(wú)NCT眼壓值明顯。LASEK術(shù)后組和LASIK術(shù)后組之間IOPg、IOPcc、NCT(?)壓值、CCT、CH、CRF無(wú)明顯差異。 結(jié)論：ORA測(cè)量眼壓具有較高的可重復(fù)性,與GAT、NCT之間的一致性較好,并且其測(cè)量值受中央角膜厚度的影響較少。ORA測(cè)量參數(shù)CH和CRF能反映角膜生物力學(xué)特性。正常人CH、CRF值男女間無(wú)顯著差異,與年齡也無(wú)明顯相關(guān)性,與CCT有較低水平的相關(guān)性。青光眼及可疑青光眼人CH、CRF值與正常人相比無(wú)顯著差異。角膜屈光術(shù)后CH值和CRF值明顯低于正常人,但LASEK術(shù)后組與LASIK術(shù)后組間無(wú)顯著差異。ORA測(cè)量的眼壓值可能較GAT、NCT更接近真實(shí)值,尤其角膜屈光手術(shù)后。
[Abstract]:Objective: To investigate the clinical significance of corneal hysteresis and corneal resistance factor by comparing the biomechanical parameters of cornea with eye reaction analyzer.
Methods: From November 2009 to March 2010, 84 normal subjects (168 eyes) were randomly selected from the ophthalmic clinic of Peking Union Medical College Hospital. The intraocular pressure (IOP), corneal hysteresis (CH), corneal resistance factor (CRF) and non-contact tonometer (NCT) were measured by ORA. Corneal central corneal thickness (CCT) was measured by A-mode ultrasonic keratometer, and the correlation analysis was made. 31 cases (62 eyes) of glaucoma and suspected glaucoma were randomly selected, intraocular pressure (IOP) and CH, CRF were measured by ORA, then CCT was measured by A-mode ultrasonic keratometer, and then measured by Goldmann (?) Mann manometer (GAT). 51 cases (102 eyes) were followed up after corneal refractive surgery. The intraocular pressure (IOP), CH, CRF and NCT were measured by ORA and non-contact tonometer respectively. The CCT was measured by A-ultrasonic corneal thickness meter, and the correlation analysis was made. To investigate the clinical significance of CH and CRF by comparing the corneal biomechanical properties.
Results: In normal subjects, the simulated Goldmann-correlated IOP value (IOPg) measured by ORA was 17.90 (+ 4.17 mmHg), Corneal-Compensated Intraocular Pressure (IOPcc) was 18.34 (+ 4.00 mmHg), NCT was 17.44 (+ 3.54 mmHg) IOPcc, NC, IOPg, and T were well correlated. The correlation coefficient was 0.429. The correlation coefficient between IOPcc and CT was 0.258. There was no significant difference between IOPcc and IOPcc. There was no significant correlation between IOPcc, IOPg and age. There was a weak correlation between CH and CT, the correlation coefficient was 0.277; CRF and CT were moderate correlation, the correlation coefficient was 0.466.
IOPg, IOPcc and GAT in glaucoma and suspected glaucoma were 19.16 (+ 4.10) mmHg, 19.91 (+ 4.44) mmHg and 18.91 (+ 3.75) mmHg respectively. There was a good correlation among IOPcc, IOPcc and GAT in glaucoma and suspected glaucoma. The correlation coefficients were 0.344. CH and CRF in glaucoma and suspected glaucoma were 9.83 (+ 2.13) mmHg and 11.03 (+ 2.11) mmHg, respectively. Compared with normal group, IOPg and IOPcc in glaucoma and suspected glaucoma were significantly higher than those in normal group, but there was no significant difference among CH, CRF and CCT.
After corneal refractive surgery, IOPg, IOPg, IOPg, IOPcc, IOPg, IOPcc, IOPcc, IOPg, IOPcc, IOP, NCT, IOIOP, NCT, NCT, NCT, NCT, NCT, IOIOIOP, NCT, CH, CH, CH, CH, CRF, CRF, 7.70 [.70 [(7.70 [(7.70 [1.70 [1.82 [1.82) mmHg, CCT, CCT, 44.47.59 [(44.47.59 [(44.45.45.45.45.75) micro, LASIK, IOPg, IOPg, IOPg, IOPcc 1 6.64.64 [16.64.64 CH 7.8 Compared with normal subjects, IOPg, IOPcc, NCT, CCT, CH and CRF in corneal refractive surgery were significantly lower than those in normal subjects, but IOPcc decreased without NCT. IOPg, IOPcc, NCT, CCT, CH, CRF were not significantly different between LASEK and LASIK groups.
CONCLUSION: ORA has high reproducibility, good consistency with GAT and NCT, and its measurement is less affected by central corneal thickness. The parameters of ORA, CH and CRF, can reflect corneal biomechanical characteristics. There is no significant difference between male and female, no significant correlation with age, and lower levels of CTC. The values of CH and CRF in glaucoma and suspected glaucoma were not significantly different from those in normal eyes. The values of CH and CRF in corneal refractive surgery were significantly lower than those in normal eyes, but there was no significant difference between LASEK group and LASIK group.
【學(xué)位授予單位】：北京協(xié)和醫(yī)學(xué)院
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2010
【分類號(hào)】：R770.4
本文編號(hào)：2215549
[Abstract]:Objective: To investigate the clinical significance of corneal hysteresis and corneal resistance factor by comparing the biomechanical parameters of cornea with eye reaction analyzer.
Methods: From November 2009 to March 2010, 84 normal subjects (168 eyes) were randomly selected from the ophthalmic clinic of Peking Union Medical College Hospital. The intraocular pressure (IOP), corneal hysteresis (CH), corneal resistance factor (CRF) and non-contact tonometer (NCT) were measured by ORA. Corneal central corneal thickness (CCT) was measured by A-mode ultrasonic keratometer, and the correlation analysis was made. 31 cases (62 eyes) of glaucoma and suspected glaucoma were randomly selected, intraocular pressure (IOP) and CH, CRF were measured by ORA, then CCT was measured by A-mode ultrasonic keratometer, and then measured by Goldmann (?) Mann manometer (GAT). 51 cases (102 eyes) were followed up after corneal refractive surgery. The intraocular pressure (IOP), CH, CRF and NCT were measured by ORA and non-contact tonometer respectively. The CCT was measured by A-ultrasonic corneal thickness meter, and the correlation analysis was made. To investigate the clinical significance of CH and CRF by comparing the corneal biomechanical properties.
Results: In normal subjects, the simulated Goldmann-correlated IOP value (IOPg) measured by ORA was 17.90 (+ 4.17 mmHg), Corneal-Compensated Intraocular Pressure (IOPcc) was 18.34 (+ 4.00 mmHg), NCT was 17.44 (+ 3.54 mmHg) IOPcc, NC, IOPg, and T were well correlated. The correlation coefficient was 0.429. The correlation coefficient between IOPcc and CT was 0.258. There was no significant difference between IOPcc and IOPcc. There was no significant correlation between IOPcc, IOPg and age. There was a weak correlation between CH and CT, the correlation coefficient was 0.277; CRF and CT were moderate correlation, the correlation coefficient was 0.466.
IOPg, IOPcc and GAT in glaucoma and suspected glaucoma were 19.16 (+ 4.10) mmHg, 19.91 (+ 4.44) mmHg and 18.91 (+ 3.75) mmHg respectively. There was a good correlation among IOPcc, IOPcc and GAT in glaucoma and suspected glaucoma. The correlation coefficients were 0.344. CH and CRF in glaucoma and suspected glaucoma were 9.83 (+ 2.13) mmHg and 11.03 (+ 2.11) mmHg, respectively. Compared with normal group, IOPg and IOPcc in glaucoma and suspected glaucoma were significantly higher than those in normal group, but there was no significant difference among CH, CRF and CCT.
After corneal refractive surgery, IOPg, IOPg, IOPg, IOPcc, IOPg, IOPcc, IOPcc, IOPg, IOPcc, IOP, NCT, IOIOP, NCT, NCT, NCT, NCT, NCT, IOIOIOP, NCT, CH, CH, CH, CH, CRF, CRF, 7.70 [.70 [(7.70 [(7.70 [1.70 [1.82 [1.82) mmHg, CCT, CCT, 44.47.59 [(44.47.59 [(44.45.45.45.45.75) micro, LASIK, IOPg, IOPg, IOPg, IOPcc 1 6.64.64 [16.64.64 CH 7.8 Compared with normal subjects, IOPg, IOPcc, NCT, CCT, CH and CRF in corneal refractive surgery were significantly lower than those in normal subjects, but IOPcc decreased without NCT. IOPg, IOPcc, NCT, CCT, CH, CRF were not significantly different between LASEK and LASIK groups.
CONCLUSION: ORA has high reproducibility, good consistency with GAT and NCT, and its measurement is less affected by central corneal thickness. The parameters of ORA, CH and CRF, can reflect corneal biomechanical characteristics. There is no significant difference between male and female, no significant correlation with age, and lower levels of CTC. The values of CH and CRF in glaucoma and suspected glaucoma were not significantly different from those in normal eyes. The values of CH and CRF in corneal refractive surgery were significantly lower than those in normal eyes, but there was no significant difference between LASEK group and LASIK group.
【學(xué)位授予單位】：北京協(xié)和醫(yī)學(xué)院
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2010
【分類號(hào)】：R770.4
【參考文獻(xiàn)】
相關(guān)期刊論文 前2條
1 楊堅(jiān),曾衍鈞,李志輝;人角膜的生物力學(xué)特性[J];生物物理學(xué)報(bào);1999年01期
2 段宣初,吳勤,蔣幼芹,卿國(guó)平,江冰,石晶明;中央角膜厚度對(duì)壓平眼壓計(jì)測(cè)量值的影響[J];中國(guó)實(shí)用眼科雜志;2004年10期
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