CAJ | 학술논문

目的研究近视眼患者准分子激光原位角膜磨镶术(LASIK)术后中央角膜厚度(CCT)以及切削深度对全眼像差和角膜前表面像差的影响.方法回顾性研究.选择LASIK术后的近视患者184例(349眼),使用Hartmann-Shack原理设计的WASCA波前像差分析仪和Humphrey角膜地形图检测仪测量LASIK术后3个月时患者的全眼像差和角膜前表面像差,使用角膜测厚仪测量CCT.研究所得数据应用SPSS 15.0统计软件包分别对左右眼进行相关分析.结果 ①术后CCT分别与左右眼角膜前表面眼像差相关性存在统计学意义的Zemike项:右眼有Z4、Z5、Z7、Z8、Z12、Z24;左眼有Z4、Z12.切削深度分别与术后左右眼角膜前表面像差相关性存在统计学意义的Zernike项:右眼有Z3、Z4、Z5、Z7、Z8、Z11、Z12、Z16、Z18、Z19、Z24;左眼有Z4、Z7、Z9、Z10、Z11、Z12、Z14、Z23、Z24.②术后CCT分别与左右眼全眼像差相关性存在统计学意义的Zemike项:右眼有Z7、Z8、Z16;左眼有Z3、Z5、Z8、Z10、Z12.切削深度分别与术后左右眼全眼像差相关性均存在统计学意义的Zemike项:右眼有Z5、Z6、Z7、Z8、Z24;左眼有Z5、Z10、Z11、Z12、Z13、Z20、Z24.③术后角膜高阶像差、全眼高阶像差、角膜总像差、全眼总像差与CCT都呈负相关,与切削深度都呈正相关,且均有显著统计学意义(P＜0.05).结论 ①LASIK术后,与术后CCT及切削深度存在相关性的主要为全眼像差、角膜前表面像差中的离焦(Z4)、球差(Z12)等轴上像差项,它们受CCT、切削深度的影响最为明显.②术后CCT及切削深度是LASIK术后全眼像差、角膜前表面像差的重要影响因素,尤其是对角膜高阶像差.
목적 연구근시안환자준분자격광원위각막마양술(LASIK)술후중앙각막후도(CCT)이급절삭심도대전안상차화각막전표면상차적영향.방법 회고성연구.선택LASIK술후적근시환자184례(349안),사용Hartmann-Shack원리설계적WASCA파전상차분석의화Humphrey각막지형도검측의측량LASIK술후3개월시환자적전안상차화각막전표면상차,사용각막측후의측량CCT.연구소득수거응용SPSS 15.0통계연건포분별대좌우안진행상관분석.결과 ①술후CCT분별여좌우안각막전표면안상차상관성존재통계학의의적Zemike항:우안유Z4、Z5、Z7、Z8、Z12、Z24;좌안유Z4、Z12.절삭심도분별여술후좌우안각막전표면상차상관성존재통계학의의적Zernike항:우안유Z3、Z4、Z5、Z7、Z8、Z11、Z12、Z16、Z18、Z19、Z24;좌안유Z4、Z7、Z9、Z10、Z11、Z12、Z14、Z23、Z24.②술후CCT분별여좌우안전안상차상관성존재통계학의의적Zemike항:우안유Z7、Z8、Z16;좌안유Z3、Z5、Z8、Z10、Z12.절삭심도분별여술후좌우안전안상차상관성균존재통계학의의적Zemike항:우안유Z5、Z6、Z7、Z8、Z24;좌안유Z5、Z10、Z11、Z12、Z13、Z20、Z24.③술후각막고계상차、전안고계상차、각막총상차、전안총상차여CCT도정부상관,여절삭심도도정정상관,차균유현저통계학의의(P＜0.05).결론 ①LASIK술후,여술후CCT급절삭심도존재상관성적주요위전안상차、각막전표면상차중적리초(Z4)、구차(Z12)등축상상차항,타문수CCT、절삭심도적영향최위명현.②술후CCT급절삭심도시LASIK술후전안상차、각막전표면상차적중요영향인소,우기시대각막고계상차.
Objective To investigate the association between postoperative center corneal thickness (CCT), ablation depth and wavefront aberrations in the anterior corneal surface and the whole eye in myopic eyes after laser in situ keratomileusis (LASIK) surgery. Methods Retrospective study. One hundred and eight-four subjects (349 eyes) were enrolled in this study. The wavefront aberrations in the anterior corneal surface and the whole eye were measured using the Humphrey corneal topography and the WASCA wavefront analyzer at more than 3 months after LASIK surgery.The center corneal thickness was measured with a pachymeter. All statistical correlation analyses were performed using SPSS 15.0 software. Results The results about the association between CCT, ablation depth and wavefront aberrations after surgery would be: ①In the anterior corneal surface,Z4, Z5, Z7, Z8, Z12, Z24 in right eye and Z4, Z12 in left eye had statistically significant correlation with CCT. Z3, Z4, Z5, Z7, Z8, Z11, Z12, Z16, Z18, Z19, Z24 in right eye and Z4,Z7, Z9, Z10, Z11, Z12, Z14, Z23, Z24 in left eye had statistically significant correlations with ablation depth. ②In the whole eye, Z7, Z8, Z16 in right eye and Z3, Z5, Z8, Z10, Z12 in left eye had statistically significant correlations with CCT. Z5, Z6, Z7, Z8, Z24 in right eye and Z5,Z10, Z11, Z12, Z13, Z20, Z24 in left eye had statistically significant correlation with ablation depth. ③Corneal HOA RMS, whole eye HOA RMS, corneal total RMS, whole total RMS had statistically significant negative correlations with CCT, and had statistically positive correlations with ablation depth. Conclusion ①After LASIK surgery, the correlation of whole eye and anterior corneal surface aberrations are strongly manifested on defocus aberration, spherical aberration etc., they are all on-axis aberrations and significantly affected by CCT and ablation depth. ②Postoperative CCT and ablation depth are important factors for whole eye and anterior corneal surface aberrations after LASIK surgery, especially for corneal HOA RMS.