CAJ | 학술논문

目的探讨准分子激光原位角膜磨镶术( LASIK)对青壮年近视患者玻璃体后脱离(PVD)的影响.方法前瞻性系列病例研究.利用光学相干断层扫描(OCT)结合眼部B超对305例(607眼)青壮年近视患者于LASIK术前,术后1 d、1个月、3个月、6个月进行PVD检测,观察术后不同时间点PVD发生率的变化.并对术前OCT证实的PVD阳性眼进行术后黄斑周围四方位PVD高度、范围的检测与量化分析.数据采用x2检验、单因素方差分析、Friedman秩和检验进行处理.结果 LASIK术前及术后1 d、1个月、3个月、6个月,PVD发生率分别为26.5％、31.8％、32.0％、33.2％、34.7％,差异有统计学意义(x2=10.462,P＜O.05),而术后不同时间点PVD发生率差异无统计学意义.相比术前,上方PVD高度在术后1个月开始增高,差异有统计学意义(F=4.056,P＜0.05),其他各方位PVD高度术后差异无统计学意义.术后不同时间点之间黄斑区上方、下方、鼻侧、颞侧PVD高度变化差异无统计学意义.术后黄斑区上方、下方、鼻侧、颞侧方位PVD近点距(ND)均有减小(M=321.0、102.8、113.8、228.5,P均＜0.05),远点距(FD)均有增大(M=276.1、139.8、157.6、204.7,P均＜0.05).上方、颞侧FD在术后6个月时仍有增大趋势,其他各方位ND、FD变化趋势在术后6个月内趋于稳定.结论青壮年近视患者LASIK术后短时期内可诱发PVD产生,并能使PVD脱离的高度增高、范围扩大.
목적 탐토준분자격광원위각막마양술( LASIK)대청장년근시환자파리체후탈리(PVD)적영향.방법 전첨성계렬병례연구.이용광학상간단층소묘(OCT)결합안부B초대305례(607안)청장년근시환자우LASIK술전,술후1 d、1개월、3개월、6개월진행PVD검측,관찰술후불동시간점PVD발생솔적변화.병대술전OCT증실적PVD양성안진행술후황반주위사방위PVD고도、범위적검측여양화분석.수거채용x2검험、단인소방차분석、Friedman질화검험진행처리.결과 LASIK술전급술후1 d、1개월、3개월、6개월,PVD발생솔분별위26.5％、31.8％、32.0％、33.2％、34.7％,차이유통계학의의(x2=10.462,P＜O.05),이술후불동시간점PVD발생솔차이무통계학의의.상비술전,상방PVD고도재술후1개월개시증고,차이유통계학의의(F=4.056,P＜0.05),기타각방위PVD고도술후차이무통계학의의.술후불동시간점지간황반구상방、하방、비측、섭측PVD고도변화차이무통계학의의.술후황반구상방、하방、비측、섭측방위PVD근점거(ND)균유감소(M=321.0、102.8、113.8、228.5,P균＜0.05),원점거(FD)균유증대(M=276.1、139.8、157.6、204.7,P균＜0.05).상방、섭측FD재술후6개월시잉유증대추세,기타각방위ND、FD변화추세재술후6개월내추우은정.결론 청장년근시환자LASIK술후단시기내가유발PVD산생,병능사PVD탈리적고도증고、범위확대.
Objective To investigate the incidence,height and extent of posterior vitreous detachment (PVD) after laser in situ keratomileusis (LASIK) in young adult myopes.Methods This was a prospective case-series study.Optical coherence tomography (OCT) combined with B-scan was performed to examine the PVD on 305 myopia patients (607 eyes) before LASIK and 1 day,1 month,3 months, and 6 months after surgery.The incidence of PVD was observed before and after the surgery.The eyes with preoperative PVD, which had been confirmed by OCT,were measured after surgery to examine the height and the extent of PVD (the near distance and the far distance to the fovea centralis of the macula) among various quadrants of the perimacular after surgery.Data were analyzed with a x2 test,a one-way ANOVA, and a Friedman rank test.Results The incidence of PVD at 1 day, 1 month, 3 months, and 6 months after surgery was 31.8％, 32.0％, 33.2％,34.7％, respectively.The incidence of various indicators after surgery was significantly higher than that before surgery (26.5％) (x2=10.462,P＜0.05).The heights of PVD in the superior quadrant began to increase 1 month after surgery (F=4.056,P＜0.05).Though the heights of PVD in the other three quadrants were also heightened increased after surgery, there were no statistically significant differences, compared to preoperative level.The near distances of PVD in the superior, inferior,nasal, and temporal quadrants of the perimacular area were decreased after surgery (M=321.0,102.8,113.8,228.5,P＜0.05),while the furthest distances of PVD in the above four quadrants were increased after surgery (M=276.1, 139.8, 157.6,204.7,P＜0.05).The far distance of PVD in the superior and temporal quadrants had a tendency of continuous increases,while the far distance of PVD in the inferior and nasal quadrants and the near distance tended to stabilization during the 6months after surgery.Conclusion In the short term,LASIK may increase the occurrence of PVD,raise the height of PVD and enlarge the extent of PVD in young adult myopes.