中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
CHINESE JOURNAL OF PRACTICAL OPHTHALMOLOGY
2009年
7期
759-762
,共4页
马元孝%谷保民%陈清花%李庆国%张国霞
馬元孝%穀保民%陳清花%李慶國%張國霞
마원효%곡보민%진청화%리경국%장국하
LASIK%角膜瓣%皱褶%角膜生物力学
LASIK%角膜瓣%皺褶%角膜生物力學
LASIK%각막판%추습%각막생물역학
LASIK%Flaps of cornea%Folds%Corneal biomechanics
目的 临床观察LASIK术后角膜瓣上皮下皱褶出现的时间、形态及其对视力的影响,初步探讨发生的原因.方法 对LASIK术后有角膜瓣上皮下皱褶患者129例258只眼分别于术后1d、3d、1周、1月、3月、6月、1年采用裂隙灯显微镜观察角膜瓣上皮下皱褶出现的时间,形态,并从术中角膜瓣蒂留滞的位置,术前屈光度的大小,角膜瓣的厚度对其的影响,以及术前最佳矫正视力和术后裸眼视力进行对比分析.结果 LASIK术后角膜瓣上皮下皱褶,最早于术后12h出现,多见于术后3～7d,其形态改变有水平形、垂直形、不规则形,其中水平形占75%以上.发生的原因与术中角膜瓣蒂留滞的位置比较,差异无统计学意义﹙P＞0.05﹚.术前屈光度大、小对术后角膜瓣上皮下皱褶影响的比较,差异有统计学意义﹙P＜0.05).角膜瓣薄者对角膜瓣厚者对其影响的比较,差异有统计学意义﹙P＜0.05).术前最佳矫正视力和术后裸眼视力比较,差异无统计学意义﹙P＞0.05).结论 LASIK术后角膜瓣上皮下皱褶最早于术后12h出现,多见于术后3～7d,其形态改变有水平形、垂直形、不规则形,以水平形为多见.该改变对患者术后视力无明显影响.在裂隙灯显微镜下其病理性表现为前弹力层皱褶.其发生原因初步认为与角膜生物力学平衡重建有密切关系;另外角膜瓣薄者较厚者更容易发生.
目的 臨床觀察LASIK術後角膜瓣上皮下皺褶齣現的時間、形態及其對視力的影響,初步探討髮生的原因.方法 對LASIK術後有角膜瓣上皮下皺褶患者129例258隻眼分彆于術後1d、3d、1週、1月、3月、6月、1年採用裂隙燈顯微鏡觀察角膜瓣上皮下皺褶齣現的時間,形態,併從術中角膜瓣蒂留滯的位置,術前屈光度的大小,角膜瓣的厚度對其的影響,以及術前最佳矯正視力和術後裸眼視力進行對比分析.結果 LASIK術後角膜瓣上皮下皺褶,最早于術後12h齣現,多見于術後3～7d,其形態改變有水平形、垂直形、不規則形,其中水平形佔75%以上.髮生的原因與術中角膜瓣蒂留滯的位置比較,差異無統計學意義﹙P＞0.05﹚.術前屈光度大、小對術後角膜瓣上皮下皺褶影響的比較,差異有統計學意義﹙P＜0.05).角膜瓣薄者對角膜瓣厚者對其影響的比較,差異有統計學意義﹙P＜0.05).術前最佳矯正視力和術後裸眼視力比較,差異無統計學意義﹙P＞0.05).結論 LASIK術後角膜瓣上皮下皺褶最早于術後12h齣現,多見于術後3～7d,其形態改變有水平形、垂直形、不規則形,以水平形為多見.該改變對患者術後視力無明顯影響.在裂隙燈顯微鏡下其病理性錶現為前彈力層皺褶.其髮生原因初步認為與角膜生物力學平衡重建有密切關繫;另外角膜瓣薄者較厚者更容易髮生.
목적 림상관찰LASIK술후각막판상피하추습출현적시간、형태급기대시력적영향,초보탐토발생적원인.방법 대LASIK술후유각막판상피하추습환자129례258지안분별우술후1d、3d、1주、1월、3월、6월、1년채용렬극등현미경관찰각막판상피하추습출현적시간,형태,병종술중각막판체류체적위치,술전굴광도적대소,각막판적후도대기적영향,이급술전최가교정시력화술후라안시력진행대비분석.결과 LASIK술후각막판상피하추습,최조우술후12h출현,다견우술후3～7d,기형태개변유수평형、수직형、불규칙형,기중수평형점75%이상.발생적원인여술중각막판체류체적위치비교,차이무통계학의의﹙P＞0.05﹚.술전굴광도대、소대술후각막판상피하추습영향적비교,차이유통계학의의﹙P＜0.05).각막판박자대각막판후자대기영향적비교,차이유통계학의의﹙P＜0.05).술전최가교정시력화술후라안시력비교,차이무통계학의의﹙P＞0.05).결론 LASIK술후각막판상피하추습최조우술후12h출현,다견우술후3～7d,기형태개변유수평형、수직형、불규칙형,이수평형위다견.해개변대환자술후시력무명현영향.재렬극등현미경하기병이성표현위전탄력층추습.기발생원인초보인위여각막생물역학평형중건유밀절관계;령외각막판박자교후자경용역발생.
Objective To evaluate the occurring time,morphology pattern of sub-epithelium folds changes of flaps and the visual impact after LASIK and to explore the cause of folds changes.Methods Two hundreds and fifty-eight eyes of 129 subjects who underwent laser in situ keratomileusis(LASIK)in our hospital were examined with slit-lamp microscope to evaluate the occurring time and morphology pattern of sub-epithelium folds changes of flaps after LASIK at the different time of post-op and UCVA were analyzed.Results The sub-epithelium changes of flap folds after LASIK occurred most at the time of 3-7 days post-op,with the earliest at 12 hours after LASIK.The morphology pattern changes included horizontal,vertical and irregular,among them the horizontals accounting for more than 75%.The prevalence of sub-epithelium folds changes was related to the location of flap(P＜0.05),the thin flaps of cornea and the thick flaps of cornea(P＜0.05),the pre-op BCVA and post-op UCVA(P＞0.05).Conclusions The sub-epithelium folds changes of flaps after LASIK occurred most often at the time of 3-7 days post-op,with the earliest at 12 hours after LASIK.The morphology pattern included horizontal,vertical and irregular.The folds changes had no effect on the visual acuity.The causes of folds changes were related to the corneal biomechanical changes.The folds occurred easier in the thin flaps of cornea than that of thick flaps of cornea.
