Kulikova I L, Aleksandrova K A
MD, DSc, Deputy Director for Clinical Work; Cheboksary Branch of S. Fyodorov Eye Microsurgery Federal State Institution of the Ministry of Health of Russia, 10 Traktorostroiteley St., Cheboksary, 428000, Chuvash Republic, Russia; Professor of the Ophthalmology Course; Institute for Advanced Training of Doctors of the Ministry of Health of the Chuvash Republic, 27 Mikhail Sespel St., Cheboksary, 428018, Chuvash Republic, Russia.
Ophthalmologist, Diagnostic and Treatment Department; Cheboksary Branch of S. Fyodorov Eye Microsurgery Federal State Institution of the Ministry of Health of Russia, 10 Traktorostroiteley St., Cheboksary, 428000, Chuvash Republic, Russia.
Sovrem Tekhnologii Med. 2023;15(5):24-31. doi: 10.17691/stm2023.15.5.03. Epub 2023 Oct 30.
is to evaluate the ocular accommodation system in hyperopic anisometropia and amblyopia in children after femtosecond laser-assisted keratomileusis (FS-LASIK) and in children with spectacle correction using optical coherence tomography (OCT).
The present study included children with hyperopia and anisometropia of more than 3 D, high and medium degree of amblyopia. Patients were divided into two groups: group 1 consisted of 30 children after FS-LASIK, group 2 was comprised of 30 children with spectacle correction. The temporal part of the ciliary muscle was assessed using the CASIA2 optical coherence tomography system (Tomey, Japan). The study was carried out with a narrow pupil fixing the gaze on the target at a distance of 33 cm and under cycloplegic conditions. The ciliary muscle thickness (CMT) was analyzed at four different levels: the maximum thickness of the ciliary muscle (CMT), and at a distance of 1, 2, and 3 mm from the scleral spur (CMT, CMT, and CMT, respectively). The fluctuation amplitude in the thickness of the ciliary muscle (ΔCMT), i.e. the ratio of indicators with a narrow and wide pupil, was also evaluated.
The ciliary muscle thickness of the amblyopic eye in group 1 was 808±38 μm for CMT, 724±54 μm for CMT, 446±44 μm for CMT, and 223±37 μm for CMT, these indicators in group 2 were 812±33, 735±33, 432±35, and 229±29 μm, respectively.Children of group 1 have been found to have an increase in ΔCMT of the amblyopic eye. The value of ACMT increased from 21±6 to 30±4 μm, ACMT from 19±6 to 29±5 μm, ACMT from 12±4 to 16±4 μm, ACMT from 11±4 to 16±4 μm, which is associated with an increase in visual acuity and a decrease in the refractive component. All changes within the group were statistically significant (p<0.01).
OCT is a fairly informative method for studying the accommodative structures of the eye in children, providing the opportunity to objectively assess the amplitude of fluctuations in the thickness of the ciliary muscle during the treatment. It has been established that after refraction operation, the work of the ciliary muscle of the amblyopic eye was significantly improved, which is reflected in the increased values of ΔCMT, CMT, and CMT and brings these parameters closer to those of the better paired leading eye.
目的是使用光学相干断层扫描（OCT）评估儿童远视性屈光参差和弱视患者在飞秒激光原位角膜磨镶术（FS-LASIK）后以及佩戴眼镜矫正后的眼调节系统。
本研究纳入远视度数超过3D、屈光参差以及中高度弱视的儿童。患者分为两组：第1组为30例FS-LASIK术后儿童，第2组为30例佩戴眼镜矫正的儿童。使用CASIA2光学相干断层扫描系统（日本多美）评估睫状肌颞侧部分。研究在窄瞳孔下进行，将注视目标固定在33cm远处，并在睫状肌麻痹状态下。在四个不同水平分析睫状肌厚度（CMT）：睫状肌最大厚度（CMT），以及距巩膜突1mm、2mm和3mm处的厚度（分别为CMT、CMT和CMT）。还评估了睫状肌厚度的波动幅度（ΔCMT），即窄瞳孔和宽瞳孔指标的比值。
第1组弱视眼的睫状肌厚度，CMT为808±38μm，CMT为724±54μm，CMT为446±44μm，CMT为223±37μm；第2组相应指标分别为812±33、735±33、432±35和229±29μm。发现第1组弱视眼的ΔCMT增加。ACMT值从21±6μm增加到30±4μm，ACMT从19±6μm增加到29±5μm，ACMT从12±4μm增加到16±4μm，ACMT从11±4μm增加到16±4μm，这与视力提高和屈光成分降低有关。组内所有变化均具有统计学意义（p<0.01）。
OCT是研究儿童眼部调节结构的一种相当有信息量的方法，为客观评估治疗期间睫状肌厚度的波动幅度提供了机会。已证实屈光手术后，弱视眼睫状肌的功能显著改善，这体现在ΔCMT、CMT和CMT值增加，并使这些参数更接近较好的对侧主导眼。
