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目的 :对于“激光老视治疗”的临床结果及基于弹性改变假说及晶状体前移及晶状体松弛模式的眼调节机制进行分析。方法 :根据光在模型眼中的传导原理 ,导出了总屈光力因晶状体与角膜屈光力、前房深度、眼轴长度及折射率而改变的函数。使用晶状体伸张及调节实验值导出与总屈光力变化相关的眼参数的实验方程。激光术后调节幅度使用林氏动态模型进行描述 ,此模型含晶状体的前移及松弛两个分量。同时提出林氏 卡达假说 ,认为术后调节改变及低回退率来自于巩膜 睫状肌弹性的增加。结果 :调节 (AA)幅度大约为晶状体屈光力改变的 73%～ 76 % ,并且与睫状体的收缩及晶状体厚度增加呈非线性变化。我们提出对于 2 .0D的调节可由晶状体松弛 (LR)或前移 (AS)或LR及AS两者组合而达到。对于硬化的老年晶状体 ,AS是主要因素。结论 :激光老视治疗 (LAPP)的临床结果可由光在眼球的传导方式计算及由弹性改变假说和包含晶状体前移和松弛的动态模型的调节机制来分析 ,其中动态模式包含晶状体前移及松弛两个因素。
OBJECTIVE: To analyze the clinical results of laser presbyopia treatment and the eye regulation mechanism based on the hypothesis of elasticity change and the mode of lens forward and lens relaxation. Methods: According to the principle of light transmission in the model eye, the total refractive power was derived as a function of lens and corneal refractive power, anterior chamber depth, axial length and refractive index. The experimental equations for the ocular parameters related to the change in total power were derived using the lens stretching and adjusting experimental values. The magnitude of post-laser adjustment is described using the Lin’s dynamic model, which includes both forward and relaxation of the lens. At the same time, Lin Kadashi hypothesis is proposed, that the postoperative changes in regulation and low regression rate from the scleral ciliary muscle elasticity increased. RESULTS: The amplitude of accommodation (AA) was approximately 73% to 76% of the change in refractive power of the lens and was non-linear with the ciliary body shrinkage and lens thickness increase. We propose that the adjustment for 2.0D can be achieved by combining lens relaxation (LR) or advancing (AS) or both LR and AS. AS is the main factor for sclerosis in the elderly lens. CONCLUSIONS: The clinical outcome of laser presbyopia therapy (LAPP) can be analyzed by the light transmission in the eyeball and by the regulation of the elastic change hypothesis and the dynamic model including lens anteversion and relaxation, with dynamic modes including lens advancing and relaxing Two factors.