CAJ | 학술논문

目的探究近视患者坐位、仰卧位时kappa角的大小,坐位与仰卧位时kappa角变化关系.方法临床病例对照研究.对201 1年7～12月在解放军总医院激光近视治疗中心符合行激光近视手术的患者215(395只眼),按近视程度分为低度、中度、高度三组.术前行Oculus Pentacam眼前节分析系统检查,获得坐位时kappa角在角膜的水平和垂直偏移量,术中患者仰卧位在角膜瓣制作完成掀瓣前开启鹰视酷眼激光仪x和y轴跟踪调节程序,获得患者卧位时kappa角水平和垂直方向的偏移量,进行低度、中度、高度分组统计.结果 (1)坐位正kappa角223只眼(56.4％),仰卧位正kappa角343只眼(86.8％).(2) kappa角与屈光度的关系采用单因素方差分析,低度、中度、高度三组患者的kappa角水平偏移量差异无统计学意义(P＞0.05),垂直偏移量差异有统计学意义(P＜0.05).(3)坐位与仰卧位kappa角关系采用配对t检验,水平、垂直偏移量差异有显著性且均有统计学意义(P＜0.05).(4) kappa角坐位与仰卧位垂直偏移量与近视度数差异有统计学意义(R坐位=-0.109,R仰卧位=-0.172 P＜0.05).结论坐位与仰卧位kappa角水平、垂直偏移量具有相关性.近视度数越大kappa角垂直偏移量越大.在行屈光手术时应考虑到体位变化对kappa角的影响.
목적 탐구근시환자좌위、앙와위시kappa각적대소,좌위여앙와위시kappa각변화관계.방법 림상병례대조연구.대201 1년7～12월재해방군총의원격광근시치료중심부합행격광근시수술적환자215(395지안),안근시정도분위저도、중도、고도삼조.술전행Oculus Pentacam안전절분석계통검사,획득좌위시kappa각재각막적수평화수직편이량,술중환자앙와위재각막판제작완성흔판전개계응시혹안격광의x화y축근종조절정서,획득환자와위시kappa각수평화수직방향적편이량,진행저도、중도、고도분조통계.결과 (1)좌위정kappa각223지안(56.4％),앙와위정kappa각343지안(86.8％).(2) kappa각여굴광도적관계채용단인소방차분석,저도、중도、고도삼조환자적kappa각수평편이량차이무통계학의의(P＞0.05),수직편이량차이유통계학의의(P＜0.05).(3)좌위여앙와위kappa각관계채용배대t검험,수평、수직편이량차이유현저성차균유통계학의의(P＜0.05).(4) kappa각좌위여앙와위수직편이량여근시도수차이유통계학의의(R좌위=-0.109,R앙와위=-0.172 P＜0.05).결론 좌위여앙와위kappa각수평、수직편이량구유상관성.근시도수월대kappa각수직편이량월대.재행굴광수술시응고필도체위변화대kappa각적영향.
Objective To investigate the change of Kappa angle in patient with myopia of sitting and supine position during laser assisted in-situ keratomi leusis (LASIK).Method A total of 215 patients with myopic included 395 eyes who underwent LASIK were divided into low,middle and high myopia groups according to different diopters.The horizontal and vertical offsets of kappa angle in sitting position of preoperative analytical system examination were measured by Oculus Pentacam.During the operation the X and Y axis tracking modulation of ALLEGRETTO Wavelight Excimer Laster System were opened for getting horizontal and vertical offsets of kappa angle in supine position.All data were analyzed respectively.Results Kappa angle of 223 eyes (56.4％) were positive values in sitting position,and 343 eyes (86.8％) were positive values in supine position.The relationship between kappa angle and diopter was analyzed with one-factor analysis of variance.The differences of horizontal offsets of kappa angle in different position of three groups were no statistically significant (P ＞0.05),but the differences of vertical offsets of kappa angle of the three groups were statistically significant (P ＜0.05).There were significant differences in horizontal and vertical kappa angle between sitting and supine position by paired T test (P ＜0.05),and there were positive correlations.The offsets of kappa angle in sitting and supine positions had a significantly negative relation with the degree of myopia (sitting position R=-0.109,supine position R=-0.172; P ＜0.05).Conclusions There is correlation in horizontal and vertical offsets of kappa angle in sitting and supine positions.With the increase of the myopic degree vertical offset of kappa angle is increased.Clinicians should take into account different postures when refractive surgery need be performed.