目的 探讨小光斑飞点扫描式准分子激光LASIK对近视眼患者屈光度与裸眼视力的影响.方法 选取2017年1月至2019年1月保定市第一医院收治的近视眼患者500例(1 000眼),按其屈光度(等效球镜度),分为轻中度近视组(＜-6.0 D),高度近视组(-6.2～10.0D),每组各250例(500眼).所有患者均接受小光斑飞点扫描式准分子激光LASIK治疗.于术后1d及1个月、6个月检查患者屈光度水平;统计屈光度在±1.0D以内的患者占比;检测并比较裸眼视力水平;统计患者术后6个月内并发症发生情况.结果 术后1d至6个月,两组屈光度在±1.0 D以内的患者占比逐渐升高,但轻中度近视组与高度近视组各时间点间比较,差异无统计学意义(P＞0.05);与高度近视组比,术后1个月轻中度近视组患者裸眼视力≥0.5、≥0.8、≥1.0的患者占比均升高(P＜0.05);术后6个月轻中度近视组患者并发症总发生率为3.20％,低于高度近视组患者的21.20％ (P＜0.05).结论 对屈光度＜-6.00 D的轻中度近视患者,小光斑飞点扫描式准分子激光LASIK对其屈光度和裸眼视力的恢复效果较好,且随患者屈光度程度的增加,此手术治疗方式的治疗效果会受一定影响.

AIM: To determine the factors associated with primary angle-closure(PAC)progression to glaucoma(PACG)after laser peripheral iridotomy(LPI)at baseline.METHODS: This was a prospective cohort study. Subjects were consecutively enrolled among the patients with PAC at the ophthalmology clinic of our Hospital between January 2017 and December 2017. Among these 86 eyes of 86 PAC patients who fulfilled the inclusion criteria, 65 eyes of 65 patients who fulfilled the inclusion criteria of 5 or more VFs and 2 years or more of follow-up were selected. The mean follow-up period was 2.65±0.27 years. According to the occurrence of visual field defects and corresponding glaucomatous optic nerve damage, the patients were divided into the progressive group and the non-progressive group, and the correlative factors of PAC progression after LPI were analyzed in PAC patients.RESULTS: PAC progression after LPI was observed in 9 of 65 eyes(14%). There were significant differences in age and inter-visit IOP fluctuations between the progressive group(68.67±7.03 years, 10.11±4.17mmHg)and the non-progressive group(61.95±8.03 years, 5.54±2.73mmHg)(P<0.05). The frequency of PAC progressing into PACG with VCDR≥0.6, PAS≥1 quadrants, all angle-closure>2 quadrants was significantly higher in the progressing eyes than in the non- progressing eyes(P<0.05). PAC progression was significantly positively correlated with age, inter-visit IOP fluctuations, VCDR≥0.6, PAS≥1 quadrants, and all angle-closure >2 quadrants(rs=0.304, 0.396, 0.495, 0.268, 0.309).CONCLUSION:PAC patients after LPI with PAS≥1 quadrants and all angle-closure >2 quadrants, VCDR≥0.6, older age,higher inter-visit IOP fluctuations were more likely to progress to glaucoma.

AIM: To survey and analyze clinical prevalence of glaucoma in Baoding. METHODS: Totally 4 960 residents in Baoding were selected through cluster sampling between May 2017 and December of 2017 for glaucoma screening. The incidence of different types of glaucoma and the age and sex distribution were analyzed. The eye lesions of patients with diagnosed and newly diagnosed glaucoma were compared. RESULTS: The prevalence of glaucoma was 2.72%(135/4960), among which the prevalence of primary angle-closure glaucoma(PACG), primary open angle glaucoma(POAG), congenital glaucoma(CG)and secondary glaucoma(SG)was respectively 51.85%, 20.00%, 17.04%, and 11.11%, and the ratio of male to female for which was 1:1.92, 3.50:1, 2.83:1, and 1:1.14 respectively. There was no significant difference in the ratio of males and females in glaucoma patients(P>0.05). The composing proportions of patients with PACG, POAG, SG and CG over 40 were 95.71%, 51.85%, 52.17% and 0 respectively, and the composing ratios of patients with PACG, POAG, SG, and CG in age brackets of ≤49 years, 50-69, and ≥70 years were 1:5.63:2.13, 4.5:1.25:1, 4.67:2:1 and 15:0:0 respectively, with statistically significant difference(P<0.05). There was no significant difference in the changes of visual field and intraocular pressure >21mmHg in diagnosed and newly diagnosed glaucoma patients(P>0.05). The incidence of monocular low vision and monocular blindness in patients newly diagnosed with glaucoma was lower than that in patients diagnosed with glaucoma, and the incidence of optic nerve changes in the former was higher than that in the latter, with statistically significant difference(P<0.05). CONCLUSION: The prevalence of glaucoma in Baoding is 2.72%, of which PACG has the highest prevalence rate, followed by POAG, SG, and CG, and its incidence is not correlated with gender. Except for CG, which occurs in certain populations, PACG has the highest incidence among those of 50-69 years old. The prevalence of POAG and SG reduces with age, and the incidence of blindness is relatively low in new diagnosis patients with glaucoma, but the progression of the disease is more serious.

Objective To investigate the difference of the accommodative amplitude and the accommodative facility between the myopic anisometropic eyes and emmetropic eyes.Methods Twenty-one low myopic anisometropic children were involved,which were assigned with the 1.0D≤ spherical equivalent difference ＜2.5D.There were 20 emmetropic children as the control group.The monocular accommodative amplitude was measured with push-up test,and the monocular and binocular accommodative facility was measured with turning over convex and concave lens test.Results The mean value of the monocular accommodative amplitude and the monocular accommodative facility of the myopic anisometropic eyes was (16.54±1.33)D and (6.95±2.19) cycles/min,which was no significant difference from the emmetropic eyes (P ＞0.05).The mean value of binocular accommodative facility of the myopic anisometropic eyes was (4.45±2.09) cycles/min,which was statistically different from the emmetropic eyes (P ＜0.05).Conclusions The mean value of binocular accommodative facility of the myopic anisometropic eyes is lower than that of the emmetropic eyes.