ORA在角膜生物力学特性研究中的应用
发布时间：2018-08-31 16:32
【摘要】：目的：通过眼反应分析仪对角膜生物力学特性参数的差异比较,探讨角膜滞后量和角膜阻力因子的临床意义。 方法：2009年11月～2010年3月,于北京协和医院眼科门诊随机选取84例(168只眼)正常人,采用ORA眼反应分析仪(Reichert Ocular Response Analyzer,ORA)测眼压及角膜滞后量(corneal hysteresis, CH)、角膜阻力因子(corneal resistane factor,CRF),与非接触眼压计(NCT)测量对比,然后用A型超声角膜测厚仪测量中央角膜厚度(central corneal thickness.CCT),并进行相关分析；随机选取31例(62只眼)青光眼及可疑青光眼患者,采用ORA测眼压及CH、CRF,然后用A型超声角膜测厚仪测量CCT,之后与Goldmann(?)压计(GAT)测量对比,并进行相关分析；选取角膜屈光手术后随访者51例(102只眼),采用ORA测眼压及CH、CRF,与非接触眼压计NCT测量对比,然后用A型超声角膜测厚仪测量CCT,并进行相关分析。比较ORA所测正常人、青光眼及可疑青光眼患者及角膜屈光手术后患者角膜生物力学特性(corneal biomechamical properties)参数的差异,探讨CH、CRF的临床意义。 结果：正常人眼压值,ORA测得模拟Goldmann(?)压值(Goldmann-correlated IOP value,IOPg)为17.90±4.17mmHg,角膜补偿后眼压(Corneal-Compensated Intraocular Pressure,IOPcc)为18.34±4.00mmHg;NCT跟压值为17.44±3.54mmHg。IOPcc、IOPg、NCT眼压之间相关性良好,均值两两间有显著差异。CCT为536.20±29.17μm。NCT眼压测量值与CCT中等水平相关,相关系数为0.429；而IOPcc与CCT问仅有低水平弱相关,相关系数为0.258。正常人男性IOPg显著高于女性,IOPcc无明显差异,IOPcc、IOPg与年龄无明显相关性。正常人CH和CRF分别为10.13±2.11mmHg和10.90±2.31mmHg,与年龄、性别无明显相关性。CH与CCT有低水平弱相关,相关系数为0.277；CRF与CCT中等水平相关,相关系数为0.466。 青光眼及可疑青光眼患者IOPg为19.16±4.10mmHg,IOPcc为19.91±4.44mmHg;GAT眼压值为18.91±3.75mmHg。青光眼及可疑青光眼患者IOPg、IOPcc、GAT三者相关性良好,均值间IOPcc显著高于IOPg、GAT(?)压值,GAT跟压值与IOPg无明显差异。GAT跟压测量值与CCT中等水平相关,相关系数为0.344。青光眼及可疑青光眼患者CH和CRF分别为9.83±2.13mmHg和11.03±2.11mmHg。与正常组对比,青光眼及可疑青光眼患者IOPg、IOPcc显著高于正常组,而CH、CRF、CCT间无明显差异。 角膜屈光手术后,LASEK术后随访者IOPg为13.26±3.52mmHg, IOPcc为16.64±3.29mmHg, NCT眼压值为14.13±3.61mmHg, CH为8.01±1.60mmHg, CRF为7.70±1.82mmHg, CCT为447.59±43.75μ m; LASIK术后随访者IOPg为13.10±5.29mmHg, IOPcc为16.70±5.25mmHg, NCT眼压值为13.91±4.99mmHg,CH为7.83±1.52mmHg, CRF为7.50±1.75mmHg, CCT为447.96±46.22μm。与正常人对比,角膜屈光术后患者IOPg、IOPcc、NCT眼压值、CCT、CH、CRF均明显低于正常人,但IOPcc下降无NCT眼压值明显。LASEK术后组和LASIK术后组之间IOPg、IOPcc、NCT(?)压值、CCT、CH、CRF无明显差异。 结论：ORA测量眼压具有较高的可重复性,与GAT、NCT之间的一致性较好,并且其测量值受中央角膜厚度的影响较少。ORA测量参数CH和CRF能反映角膜生物力学特性。正常人CH、CRF值男女间无显著差异,与年龄也无明显相关性,与CCT有较低水平的相关性。青光眼及可疑青光眼人CH、CRF值与正常人相比无显著差异。角膜屈光术后CH值和CRF值明显低于正常人,但LASEK术后组与LASIK术后组间无显著差异。ORA测量的眼压值可能较GAT、NCT更接近真实值,尤其角膜屈光手术后。
[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.
【学位授予单位】：北京协和医学院
【学位级别】：博士
【学位授予年份】：2010
【分类号】：R770.4
本文编号：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.
【学位授予单位】：北京协和医学院
【学位级别】：博士
【学位授予年份】：2010
【分类号】：R770.4
【参考文献】
相关期刊论文 前2条
1 杨坚,曾衍钧,李志辉;人角膜的生物力学特性[J];生物物理学报;1999年01期
2 段宣初,吴勤,蒋幼芹,卿国平,江冰,石晶明;中央角膜厚度对压平眼压计测量值的影响[J];中国实用眼科杂志;2004年10期
，本文编号：2215549
本文链接：https://www.wllwen.com/yixuelunwen/yank/2215549.html
最近更新
教材专著
