CORNEAL HYDRATION CONTROL IN NORMAL AND DISEASED CORNEAS

评估角膜疾病的临床技术在很大程度上是 仅限于生物显微镜检查和形态计量分析 眼角膜。从这两个方面得出的观测和测量结果 手术并不一定能反映患者的生理状态 角膜，因此它们可能不能提供足够的临床 用来预测疾病、手术或医学影响的信息 对角膜功能的干预。 我们最近报道了一项评估角膜的临床测试。 通过监测诱导间质的恢复来实现功能 水合作用。基于以下角膜厚度恢复曲线 增加的水合水平，已经推导出一个模型，可以通过 用于描述角膜水化控制的几个方面 包括每小时角膜厚度恢复百分比(PRPH)， 睁眼稳态(OESS)厚度和恢复时间 到Oess厚度。 这项拟议计划的目的是(1)调查 年龄与角膜水化控制的关系，(2) 监测正常人群水合控制的纵向变化 受试者和内皮疾病患者超过3年 周期，以及(3)确定角膜水化控制的变化 双眼白内障手术前后检查结果分析 血管内皮细胞正常和病变。从这些研究中，我们还将 探讨角膜水化控制与角膜屈光度的关系 裂隙灯检查得出的临床测量结果和 形态计量分析。我们还将进一步提炼水合作用 改进的控制测试程序和分析策略 临床适用性。 长期目标是为眼科医生提供 有效和可靠的程序，将(1)帮助确定 哪些患者可能需要联合手术(例如，穿透 角膜移植和白内障摘除)，而不仅仅是白内障 摘除，(2)确定高危患者的角膜 失代偿，以及(3)使监测 内皮功能可能伴随着创伤，角膜疾病， 炎症、手术或其他媒介干预。

Clinical techniques for assessing corneal disease have largely been limited to biomicroscopic examination and morphometric analysis of the cornea. Observations and measurements derived from these two procedures do not necessarily reflect the physiological status of the cornea, and therefore they may not provide sufficient clinical information to predict the effects of disease, surgery, or medical intervention on corneal function. We have recently reported on a clinical test which assesses corneal function by monitoring recovery following induced stromal hydration. Based on corneal thickness recovery profiles following increased hydration levels, a model has been derived that can by used to describe several aspects of corneal hydration control including the percent corneal thickness recovery per hour (PRPH), open-eye steady-state (OESS) thickness, and recovery time to return to OESS thickness. The aims of this proposed project are (1) to investigate the relationship between age and corneal hydration control, (2) to monitor the longitudinal changes in hydration control in normal subjects and in patients with endothelial disease over a 3-year period, and (3) to determine changes in corneal hydration control by making test before and after cataract surgery in eyes with both normal and diseased endothelia. From these studies, we will also investigate the relationship between corneal hydration control and clinical measurements derived from slit lamp examinations and morphometric analysis. We will also further refine the hydration control test procedure and analysis strategies for improved clinical applicability. The long-term goals are to provide the ophthalmologist with an valid and reliable procedure that will (1) assist in determining which patients might require a combined surgery (e.g., penetrating keratoplasty and cataract extraction) as opposed to only a cataract extraction, (2) identify patients at high risk for corneal decompensation, and (3) make it possible to monitor changes in endothelial function that may accompany trauma, corneal disease, inflammation, surgery, or other medial intervention.