CAJ | 학술논문

目的探讨影响准分子激光原位角膜磨镶术(LASIK)治疗近视术后疗效的相关因素.方法采用LASIK对72例(141只眼)近视眼患者进行治疗.分别记录术前、术后第1周、第1个月、第3个月、第6个月和第12个月视力、屈光度、眼压、角膜厚度、角膜地形图检查所得的角膜后表面数据.根据术后第12个月裸眼视力和等效球镜屈光度分2组,Ⅰ组屈光回退组视力＜5.0且术后近视等效球镜屈光度＞1.00I),计35只眼;Ⅱ组视力正常组视力≥5.0,计106只眼.分析术后裸眼视力与i者多因素关系.结果术后第12个月裸眼视力4.4～5.1,平均4.97±0.13,以术后第12个月裸眼视力为因变量(Y)与术前近视屈光度(X1)、角膜切削比(X2),术后第12个月角膜后表面最高点Diff值(X3),术后第12个月和术后第1周角膜厚度差(X4),术后第12个月和术后第1周角膜后表面屈光度差(X5)等进行逐步回归分析建立多元同归方程Y=5.09-0.034X1+1.785X2-2.216X3-0.002X4+0.081X5(F=21.474,19＜0.01).术后随访角膜厚度有不同程度增加,角膜后表面屈光度降低,角膜后表面Diff值增高,屈光回退组各指标不同阶段比较差异有统计学意义(分别F=8.56、4.68、2.49;均P＜0.05),变化尤以术后3个月内明显;正常眼组各指标不同阶段比较除角膜最薄处厚度有差异外,余均无统计学意义(角膜最薄厚度F=7.27,P＜0.01;其余均P＞0.05).结论 LASIK治疗近视是一种安全、有效的方法,但欲取得较好疗效,应考虑不同因素如术前近视屈光度、角膜切削比、术后角膜增殖、术后角膜后表面改变等因素的影响.
목적 탐토영향준분자격광원위각막마양술(LASIK)치료근시술후료효적상관인소.방법 채용LASIK대72례(141지안)근시안환자진행치료.분별기록술전、술후제1주、제1개월、제3개월、제6개월화제12개월시력、굴광도、안압、각막후도、각막지형도검사소득적각막후표면수거.근거술후제12개월라안시력화등효구경굴광도분2조,Ⅰ조굴광회퇴조시력＜5.0차술후근시등효구경굴광도＞1.00I),계35지안;Ⅱ조시력정상조시력≥5.0,계106지안.분석술후라안시력여i자다인소관계.결과 술후제12개월라안시력4.4～5.1,평균4.97±0.13,이술후제12개월라안시력위인변량(Y)여술전근시굴광도(X1)、각막절삭비(X2),술후제12개월각막후표면최고점Diff치(X3),술후제12개월화술후제1주각막후도차(X4),술후제12개월화술후제1주각막후표면굴광도차(X5)등진행축보회귀분석건립다원동귀방정Y=5.09-0.034X1+1.785X2-2.216X3-0.002X4+0.081X5(F=21.474,19＜0.01).술후수방각막후도유불동정도증가,각막후표면굴광도강저,각막후표면Diff치증고,굴광회퇴조각지표불동계단비교차이유통계학의의(분별F=8.56、4.68、2.49;균P＜0.05),변화우이술후3개월내명현;정상안조각지표불동계단비교제각막최박처후도유차이외,여균무통계학의의(각막최박후도F=7.27,P＜0.01;기여균P＞0.05).결론 LASIK치료근시시일충안전、유효적방법,단욕취득교호료효,응고필불동인소여술전근시굴광도、각막절삭비、술후각막증식、술후각막후표면개변등인소적영향.
Objective To analyze the relative factors that affect postoperative results of laser in situ keratomilensis(LASIK)for treating myopia.Methods A total of 72 patients(141 eyes)underwent LASIK,which were divided into two groups according to uncorrected visual acuity 12 months after operation and spherical equivalent diopter after operation.Group 1 was refractive regression one consisting of 36 eyes with visual acuity＜5.0 and diopter ＞1.00 D.Group 2 was normal one with 105 eyes.Their visual acuity,diopter,intraocular pressure,corneal thickness and the data by corneal topography before operation wererespectively recorded one week,one month,three months,six month and twelve months after operation.The relationship between uncorrected visual acuity and relative factors was analyzed.Results Uncorrected visual acuity of three months after operation was 4.4～5.1,with an average of 4.97±0.13.A multiple regression equation was set up.It was Y=5.09-0.034X1+1.785X2-2.216X3-0.002X4+0.081X5(F=-21.474,P＜0.01).(Y stands for uncorrected visual acuity three months after operation;X1 stands for preoperative myopia diopter;X2 stands for the ratio of corneal cutting;X3 stands for Diff three months after operation;X4 stands for remainder of corneal thickness one week after operation;X5 stands for remainder of corneal posterior surface diopter).As postopera five,the thickness in corneal thinnest place,negative diopter and Diff of corneal posterior surface were found to increase to a different degree.There was statistical significance between the different stages in refractive regression group(F=-8.56,4.68,2.49;P＜0.05),but there was no statistical significance in the normal eye group except corneal thickness difference in the thinnest place.Conclusions LASIK is a safe and effective way to treat myopia,but for better postoperative results,many factors such as preoperative myopia diopter,the ratio of corneal cutting,postoperative corneal proliferation and changes in postopreative corneal posterior surface should be taken into account.