3其他应用
3.1青光眼手术前后房角和滤过泡的评价 原发性闭角型青光眼是世界范围内重要的致盲眼病,对这类患者证实有效的方法是LPI。Memarzadeh等[20]分别用Visante OCT及前房角镜对10例(10眼)LPI术前术后的前房形态进行检查,结果表明LPI术后OCT的成像具有客观性、定量性,提出在进一步研究中应加大样本量,了解OCT的其他用途[21]。 Singgh等[22]曾用Visante OCT观察了激光缝线松解术前术后、小梁切开术后滤过泡的形态学变化。
3.2白内障手术角膜透明切口的评价 在当今的白内障超声乳化手术中,角膜透明切口手术仍然是最流行的手术切口,Calladine等[23]用Visante OCT对术后1h的白内障患者的角膜透明切口进行观察,观察指标包括切口的长度、平均切口角度以及切口构建特征(外切口哆开、内切口哆开、内皮错位、与后弹力层局部脱离和切口失对合),分析这些特征与眼压的关系,结果表明低眼压更常发生这些特征,这些特征是发生眼内炎重要的危险因素。 Fine等[24]应用Visante OCT观察白内障术后透明角膜切口的形态学和愈合情况。
3.3其他 Visante OCT配合特定的软件可用于测量前房的容积[25];在角膜水肿的情况下,OCT可用于观察前房内的青光眼阀的小管[26]; Bakoff等[27]在静态眼没有调节的情况下,用前节OCT测量前节参数与年龄的关系,显示在不同的调节状况下,前节参数随年龄和调节的不同而有所改变。 总之,Visante OCT在眼前节的临床和科研中的应用尚处于初始阶段,但较之现有的眼前节成像系统,Visante OCT具有非接触性、无损伤性的、重复性好、测量范围广、获取图像快等特点,巩膜突在OCT图像中表现为高反射信号区,容易辨认。Visante OCT日益成为眼前节的主要检测工具。费用较高成为限制其广泛应用的一个因素,另外,Visante OCT不能很好地观察睫状体,房角隐窝在部分受试者中不能很好地定义[10]。对于角膜周边区域[3],Visante OCT信号比较弱,厚度测量较不可靠。进一步提高分辨率和扫描光束的组织穿透力,开发自动化程度更高的处理软件,减少人为测量和操作的误差,建立眼前节OCT检查结果的正常参考值和参考图谱是今后需解决的问题。Visante OCT将成为前房角检查、角膜屈光手术、人工晶状体手术等方面主要的检查和评价工具。
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