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国际学术动态

发布时间:2021-11-25人气:
本文摘要:国际学术动态 | 提高您塑形镜验配乐成率的六个角膜地形图运用技巧 本文颁发于:美国网络学术期刊 Contact Lens Spectrum 2020年8月刊 作者: Nicholas Gidosh, OD, FAAO 虽然角膜地形图的丈量对于确定最初的角膜塑形镜的设计并不是须要的,但它们对于改善临床成果却至关重要。下面一系列技巧可以帮忙您充实发挥地形图仪的诊断效应。

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国际学术动态 | 提高您塑形镜验配乐成率的六个角膜地形图运用技巧 本文颁发于:美国网络学术期刊 Contact Lens Spectrum 2020年8月刊 作者: Nicholas Gidosh, OD, FAAO 虽然角膜地形图的丈量对于确定最初的角膜塑形镜的设计并不是须要的,但它们对于改善临床成果却至关重要。下面一系列技巧可以帮忙您充实发挥地形图仪的诊断效应。

Although topography measurements are not necessary for the determination of the initial ortho-k design, they are critical for improving clinical outcomes. Here is a series of tips to unleash the great diagnostic tools your topographer provides. 技巧1:确保高质量的地形图拍摄 Tip #1: Ensuring a quality capture 您或您的技能人员拍摄精彩的地形图很是重要。眼睑应该拉开,以确保整个角膜外貌有完整的数据收罗。

泪膜必需不变,以提供精确的地形图数据。基线扫描是最重要的,因为这些图片之后将用于与塑形后的图举行比力。

It is incredibly important that you or your technician is acquiring good topography scans. The lids should be out of the way to ensure there is full data acquisition across the corneal surface and the tear film is stable to render accurate topographic data. The baseline scans are the most important as these will be used for your comparisons to treatment maps going forward. 技巧2:操纵地形图数据确定角膜直径 Tip #2: Use topography data to determine the corneal diameter 角膜直径或程度可见虹膜直径(HVID)在验配任何定制镜片时都起着重要感化,角膜塑形镜也不破例。这种丈量可以通过瞳距尺丈量得到;然而,很多乐成的验配师使用他们的地形图仪来丈量HVID。这凡是为确定合适的镜片直径提供了一种更准确和可复制的方法。

假如角膜直径超出了地形图仪的捕捉框,那么可以使用对角线可见虹膜直径来取代。Corneal diameter or horizontal visible iris diameter (HVID) plays an important role when fitting any custom lens and orthokeratology is no exception. This measurement can be obtained through a hand ruler or gauge; however, many successful fitters use their topographer to measure HVID. This often gives a more accurate and repeatable method for determining appropriate lens diameters. If the corneal diameter is beyond the capture frame of the topographer, then a diagonal visible iris diameter can be used instead. 展开全文 技巧3:选择适当的标尺,以便更好地检察地形图 Tip #3: Choose the proper scale for a better view of map images 绝对或尺度的地形图标尺用来比力一个角膜和另一个角膜,看它是法则的还是不法则的。

尺度化的标尺在验配打仗镜时更有用,因为它们会从头指定相对于患者自身角膜的标尺值,这样就更容易看到角膜塑形术患者的治疗区域。Absolute, or standard, topography scales are used to compare one cornea to another to see if it is regular or irregular. Normalized scales are more helpful when fitting contact lenses because they reassign the scale values relative to the patient’s own cornea. This makes it easier to see the treatment zone of orthokeratology patients. 技巧4:轴向图用于检察屈光度,切线图用于检察镜片的定位 Tip #4: Axial maps are for power, tangential maps are for lens position 轴位图或屈光图,提供了关于角膜散光类型和角膜曲率的数据。这些图都是在设计定制镜片时最为有用的。

在角膜塑形术中,切向图可以使我们看到角膜在一个位置相对于相邻切向点的曲率。这是评估角膜塑形镜中心定位时最有助于阐发的地形图。Axial, or power, maps give us data about the type of corneal astigmatism and power of the corneal curvature. These are the most helpful maps when designing custom lenses. With orthokeratology, tangential maps allow us to see curvature of the cornea in one place, relative to neighboring tangential points. This is most helpful when analyzing topography to evaluate for orthokeratology lens centration. 技巧5:关于差异图 Tip #5: It’s all about the Difference maps 差异图用于比力塑形前后的角膜并可以更清楚地显示镜片的位置。

当将治疗后的切向图与基线图举行比力时, 在闭眼环境下更容易看到镜片的位置。当我们检察差异图时, 凡是有助于重置与我们想要矫正的近视度数相关标尺的最大值和最小值。

比方,假如我们试图矫正5.00 D近视,我们会手动将差异图的屈光标尺调解为-5.00到+5.00 D,以得到清晰的镜片位置和配适图像。Difference maps are used to compare a treatment map to the baseline scan and can be used to show position of the lens more clearly. When comparing the post treatment tangential map to the baseline, it is easier to see position of the lens in the closed eye environment. When viewing difference maps, it is often helpful to reset the scale with maximums and minimums relative to the amount of myopia we seek to correct. As an example, if we are trying to correct 5.00 D of myopia, we would manually change the dioptric scale of the difference map to go from -5.00 to +5.00 D to get a clear image of lens position and fit. (A) 箭头显示由于上眼睑而丢失的数据;这是由于基线捕获欠好造成的。Arrows show missing data as a result of upper lid; this was a result of poor baseline capture. (B) 箭头显示近视-5.00的切线差异图的比例重置。程度偏位此刻很明明。

Arrow shows the scale reset for this -5.00 myope’s tangential difference map. Lateral decentration is now evident. (C) 箭头所示为斜向可见虹膜直径丈量值,表白角膜足够大,可以使用更大的11.0毫米设计的镜片来解决偏位。Arrow shows the diagonal visible iris diameter measurement indicating the cornea was large enough for a larger 11.0 mm lens design to troubleshoot the decentration. 技巧6:高度图有助于确定环曲面设计的角膜塑形镜 Tip #6: Elevation maps aid in determining toric Ortho-K designs 高度图提供了角膜差别位置的高度数据。标尺或地形软件可用于确定平坦子午线(凡是是高点)和陡峭子午线(凡是是低点)之间的微米差。

30微米或更大的高度差发起使用环曲面镜片,这样可以得到更好的中心定位和匀称的配适。Elevation maps give us data about the height at different positions on the cornea. The scale or the topography software can be used to determine the micron difference between the flat meridian (usually the high elevation points) and the steep meridian (usually the low elevation points). An elevation difference of 30 microns or more is suggestive that a toric lens will work better when trying to achieve an evenly aligned, well centered lens. 本文作者简介 Nicholas Gidosh, OD, FAAO Nicholas Gidosh博士是费城眼科研究所角膜和打仗镜镜诊所的主任。他得到了萨卢斯大学宾夕法尼亚视光学院的眼视光学博士学位,在哪里他进修了特殊打仗镜验配的高阶学习课程,此刻是一名助理传授。

Gidosh博士还完成了费里斯州立密歇根眼视光学院的角膜和打仗镜住院医师培训,是美国眼视光学学会的资深会员。他曾担任临床研究员,从事软硬联合镜、巩膜镜、多焦镜和角膜塑形镜片的研究。Dr. Nicholas Gidosh is the Chief of the Cornea and Contact Lens Clinic at The Eye Institute in Philadelphia. He received his Doctor of Optometry degree from the Pennsylvania College of Optometry at Salus University where he pursed the advanced studies curriculum in specialty contact lens fitting and is now an assistant professor. Dr. Gidosh also completed a Cornea and Contact Lens residency at the Michigan College of Optometry at Ferris State and is a fellow of the American Academy of Optometry. He has served as a clinical investigator for studies involving hybrid, scleral, multifocal, and orthokeratology lenses. 返回,检察更多。


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