中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
CHINESE JOURNAL OF PRACTICAL OPHTHALMOLOGY
2010年
9期
978-981
,共4页
准分子激光角膜切削术%准分子激光原位角膜磨镶术%中央角膜知觉%生存分析%COX回归
準分子激光角膜切削術%準分子激光原位角膜磨鑲術%中央角膜知覺%生存分析%COX迴歸
준분자격광각막절삭술%준분자격광원위각막마양술%중앙각막지각%생존분석%COX회귀
Photorefractive keratectomy (PRK)%Laser in situ keratomileusis (LASIK)%Central corneal sensitivity%Survival analysis%COX regression
目的 研究准分子激光角膜切削术(PRK)、角膜瓣蒂止上方的准分子激光原位角膜磨镶术(LASIK)(Superior-hinged LASIK,S-H-LASIK)及角膜瓣蒂止鼻侧的LASIK(Nasal-hinged LASIK,N-H-LASIK)术后远期角膜知觉的改变并分析其相关危险因素.方法 对93例186只眼接受近视激光手术患者,其中PRK58只眼、N-H-LASIK102只眼、S-H-LASIK26只眼,随访3～10年,检测干跟症相关指标中央角膜知觉(CCS),对获得的数据差异的比较采用Kaplan-Meier法进行生存分析,角膜触觉影响因素的分析采用COX回归模型.结果 (1)PRK、N-H-LASIK、S-H-LASIK术后出现半数CCS改变的时间是3462、2721、1383d.(2)角膜触觉的主要影响因素有患者的年龄(OR=0.965,95%CI:0.938～0.992)、术前等量球镜(OR=1.385,95%CI:1.149～1.669)、术前平均角膜曲率(OR=1.392,95%CI:1.088～1.780)、术后平均角膜曲率(OR=0.881,95%CI:0.781～0.994)、角膜切削厚度(OR=1.028,95%CI:1.009～1.047).(3)N-H-LASIK手术引起角膜触觉改变的可能性是PRK手术方法的96.074倍(95%CI:12.090～763.451),S-H-LASIK手术引起角膜触觉改变的可能性是PRK手术方法的633.364倍(95%CI:61.807～6490.401).结论 近视激光手术可以导致患者术后远期角膜知觉的下降;相对于PRK手术,LASIK手术尤其是角膜瓣的蒂位于上方者,是术后角膜知觉下降的高危因素,其他的危险因素主要与手术中激光切削的角膜组织面积和深度有关
目的 研究準分子激光角膜切削術(PRK)、角膜瓣蒂止上方的準分子激光原位角膜磨鑲術(LASIK)(Superior-hinged LASIK,S-H-LASIK)及角膜瓣蒂止鼻側的LASIK(Nasal-hinged LASIK,N-H-LASIK)術後遠期角膜知覺的改變併分析其相關危險因素.方法 對93例186隻眼接受近視激光手術患者,其中PRK58隻眼、N-H-LASIK102隻眼、S-H-LASIK26隻眼,隨訪3～10年,檢測榦跟癥相關指標中央角膜知覺(CCS),對穫得的數據差異的比較採用Kaplan-Meier法進行生存分析,角膜觸覺影響因素的分析採用COX迴歸模型.結果 (1)PRK、N-H-LASIK、S-H-LASIK術後齣現半數CCS改變的時間是3462、2721、1383d.(2)角膜觸覺的主要影響因素有患者的年齡(OR=0.965,95%CI:0.938～0.992)、術前等量毬鏡(OR=1.385,95%CI:1.149～1.669)、術前平均角膜麯率(OR=1.392,95%CI:1.088～1.780)、術後平均角膜麯率(OR=0.881,95%CI:0.781～0.994)、角膜切削厚度(OR=1.028,95%CI:1.009～1.047).(3)N-H-LASIK手術引起角膜觸覺改變的可能性是PRK手術方法的96.074倍(95%CI:12.090～763.451),S-H-LASIK手術引起角膜觸覺改變的可能性是PRK手術方法的633.364倍(95%CI:61.807～6490.401).結論 近視激光手術可以導緻患者術後遠期角膜知覺的下降;相對于PRK手術,LASIK手術尤其是角膜瓣的蒂位于上方者,是術後角膜知覺下降的高危因素,其他的危險因素主要與手術中激光切削的角膜組織麵積和深度有關
목적 연구준분자격광각막절삭술(PRK)、각막판체지상방적준분자격광원위각막마양술(LASIK)(Superior-hinged LASIK,S-H-LASIK)급각막판체지비측적LASIK(Nasal-hinged LASIK,N-H-LASIK)술후원기각막지각적개변병분석기상관위험인소.방법 대93례186지안접수근시격광수술환자,기중PRK58지안、N-H-LASIK102지안、S-H-LASIK26지안,수방3～10년,검측간근증상관지표중앙각막지각(CCS),대획득적수거차이적비교채용Kaplan-Meier법진행생존분석,각막촉각영향인소적분석채용COX회귀모형.결과 (1)PRK、N-H-LASIK、S-H-LASIK술후출현반수CCS개변적시간시3462、2721、1383d.(2)각막촉각적주요영향인소유환자적년령(OR=0.965,95%CI:0.938～0.992)、술전등량구경(OR=1.385,95%CI:1.149～1.669)、술전평균각막곡솔(OR=1.392,95%CI:1.088～1.780)、술후평균각막곡솔(OR=0.881,95%CI:0.781～0.994)、각막절삭후도(OR=1.028,95%CI:1.009～1.047).(3)N-H-LASIK수술인기각막촉각개변적가능성시PRK수술방법적96.074배(95%CI:12.090～763.451),S-H-LASIK수술인기각막촉각개변적가능성시PRK수술방법적633.364배(95%CI:61.807～6490.401).결론 근시격광수술가이도치환자술후원기각막지각적하강;상대우PRK수술,LASIK수술우기시각막판적체위우상방자,시술후각막지각하강적고위인소,기타적위험인소주요여수술중격광절삭적각막조직면적화심도유관
Objective To investigate the long-term change of corneal sensation after the myopic correction by excimer laser eye surgery and analyze the related risk factors. Methods A total of 186 eyes of 93patients that had undergone eye surgery were evaluated, 58 eyes were treated with photorefractive keratectomy (PRK) and 102 eyes received the nasal-hinged flap (N-H-LASIK) procedure, while superior-hinged flap (S-H-LASIK) procedure was performed on the other 26 eyes. After the operation, all the patients were followedup from three to ten years. The central corneal sensitivity (CCS) was examined to determine the occurrence of dry eye symptoms. Kaplan-Meier survival analysis was evaluated. COX regression was used to observe the factors that might affect the central corneal sensitivity. Results First, The median survival time of CCS after the surgery in patients with PRK, N-H-LASIK and S-H-LASIK was 3462 days, 2721 days and 1383 days respectively. Second, the factors that mainly contributed to the change of central corneal sensation involved the patient's age (OR=0.965, 95% CI: 0.938～0.992), the preoperative spherical equivalent (OR=1.385, 95% CI:1.149～1.669), the average cormeal curvature at preoperative (OR=1.392, 95%CI: 1.088～1.780), postoperative
