CAJ | 학술논문

目的探讨屈光性晶状体置换联合散光性角膜切开术术后角膜生物力学特性的改变及其对手术效果的影响.方法收集角膜散光≥1.50D的患者,在屈光性晶状体置换术时联合行散光性角膜切开术.术前,术后1周、1、3、6个月用眼反应分析仪(Ocular response analyzer,Reichert,Depew,NY)测量角膜阻力因子(corneal resistance factor,CRF)、角膜滞后性(corneal hysteresis,CH)、Goldmann眼压(Goldmann correlated intraocular pressure,IOP)；用角膜地形图仪(Pentacam ver.1.11；Oculus,Germany)观察角膜散光的变化.采用重复测量数据方差分析及Pearson相关分析进行统计分析.结果共23例(32只眼).CRF、CH术后1周、1个月均低于术前水平(P＜0.05),术后3个月、6个月与术前比较差异均无统计学意义(P＞0.05).IOP术后各时间点与术前比较差异均无统计学意义(P＞0.05).散光矢量分解后术后J0的变化与CRF、CH负相关(P＜0.05),与IOP无相关(P＞0.05).J45的变化与CRF、CH、IOP无相关(P＞0.05).结论屈光性晶状体置换术联合散光性角膜切开术不会引起角膜生物力学特性的长期改变,CRF、CH对散光性角膜切开术手术效果产生一定的影响.
목적 탐토굴광성정상체치환연합산광성각막절개술술후각막생물역학특성적개변급기대수술효과적영향.방법 수집각막산광≥1.50D적환자,재굴광성정상체치환술시연합행산광성각막절개술.술전,술후1주、1、3、6개월용안반응분석의(Ocular response analyzer,Reichert,Depew,NY)측량각막조력인자(corneal resistance factor,CRF)、각막체후성(corneal hysteresis,CH)、Goldmann안압(Goldmann correlated intraocular pressure,IOP)；용각막지형도의(Pentacam ver.1.11；Oculus,Germany)관찰각막산광적변화.채용중복측량수거방차분석급Pearson상관분석진행통계분석.결과 공23례(32지안).CRF、CH술후1주、1개월균저우술전수평(P＜0.05),술후3개월、6개월여술전비교차이균무통계학의의(P＞0.05).IOP술후각시간점여술전비교차이균무통계학의의(P＞0.05).산광시량분해후술후J0적변화여CRF、CH부상관(P＜0.05),여IOP무상관(P＞0.05).J45적변화여CRF、CH、IOP무상관(P＞0.05).결론 굴광성정상체치환술연합산광성각막절개술불회인기각막생물역학특성적장기개변,CRF、CH대산광성각막절개술수술효과산생일정적영향.
Objective To study the changes of corneal biomechanical parameters and the correlations between surgical induced corneal astigmatism and corneal biomechanical parameters in Astigmatic Keratotomy (AK).Methods Patients with corneal astigmatism ≥1.50D underwent AK during refractive intraocular lens exchange.Corneal resistance factor (CRF),Corneal hysteresis (CH) and Goldmann-correlated intraocular pressure (IOP) measurements were obtained with the Ocular Response Analyzer (ORA,Reichert.,Depew,NY) before and 1 week,1 month,3 months and 6 months after surgery.Corneal astigmatism was also measured with Scheimpflug imaging (Pentacam ver.1.11; Oculus,Germany).Results Thirty-two eyes were included in this study.Both CRF and CH decreased briefly at 1 week and 1 month after AK surgery (both P ＜0.05) and recovered to the preoperative levels at 3 months and 6 months (both P ＞0.05).There was no significant change in IOP (P ＞0.05).The change of J0 (astigmatism vector analyzer) was negatively correlated with CRF and CH (P ＜0.05),but was not correlated with IOP.The change of J45 was not correlated with CRF,CH and IOP (both P ＞0.05).Conclusions AK surgery does not induce a significant change in comeal biomechanics,except for 1 week and 1 month postoperatively.CRF and CH may play some role in the change of astigmatism after AK.