CAJ | 학술논문

目的：探讨准分子激光原位角膜磨镶术（ LASIK ）使用Femto LDV飞秒激光制瓣近视患者的角膜生物力学各指标的变化。 　　方法：选取93例186眼近视患者均行飞秒激光辅助LASIK术。分别于术前；术后3，6 mo应用眼反应分析仪（ ocular response analyzer ， ORA ）检测角膜补偿眼压（ corneal compensated intraocular pressure ， Iopcc ）、模拟Goldmann眼压（ Goldmann correlated IOP value ， Iopg ）、角膜阻力因子（ corneal resistance factor ， CRF ）、角膜滞后量（ corneal hysteresis ，CH）。超声角膜厚度测量。比较术后3 mo与术前，术后6 mo与术后3 mo测量值的差异。 　　结果：术后3 mo中央角膜平均厚度为447．61±39．57μm与术前539．88±29．72μm比较，差异有显著统计学意义（ t＝-47．223， P＝0．000）；术后6 mo 448．78±39．19μm较术后3mo厚度差异有统计学意义（t＝2．15，P＝0．033）。术后3 mo Iopcc ， Iopg 分别为13．75±2．13，9．54±2.35 mmHg较术前16．29±2．88，15．09±3．29 mmHg显著降低（t＝-13．604，-23．594；P＝0．000，0．000）。 Iopcc， Iopg分别较术前降低2．55±2．25，5．55±3．21mmHg。术后6 mo 13．61±1．96，9．32±2．07 mmHg与术后3 mo比较差异无统计学意义（ t＝-0．977，1．447，P＝0．33，0．15）。CRF，CH术后3mo测量值6．36±1．45，7．71±1．30mmHg较术前9．84±1．99，9．77±1．56mmHg显著降低（t＝-24．116，-19．171；P＝0．000，0．000）。 CRF，CH分别较术前降低3．49±1．97，2．06±1．47mmHg。术后6mo 6．24±1．38，&nbsp；7.67±1．25 mmHg与术后3 mo比较差异无统计学意义（ t＝1．456，0．636，P＝0．147，0．525）。 　　结论：飞秒激光辅助LASIK术对角膜生物力学有显著影响，术后角膜生物力学各指标较术前显著降低。术后3 mo内生物力学各指标基本稳定。
목적：탐토준분자격광원위각막마양술（ LASIK ）사용Femto LDV비초격광제판근시환자적각막생물역학각지표적변화。 　　방법：선취93례186안근시환자균행비초격광보조LASIK술。분별우술전；술후3，6 mo응용안반응분석의（ ocular response analyzer ， ORA ）검측각막보상안압（ corneal compensated intraocular pressure ， Iopcc ）、모의Goldmann안압（ Goldmann correlated IOP value ， Iopg ）、각막조력인자（ corneal resistance factor ， CRF ）、각막체후량（ corneal hysteresis ，CH）。초성각막후도측량。비교술후3 mo여술전，술후6 mo여술후3 mo측량치적차이。 　　결과：술후3 mo중앙각막평균후도위447．61±39．57μm여술전539．88±29．72μm비교，차이유현저통계학의의（ t＝-47．223， P＝0．000）；술후6 mo 448．78±39．19μm교술후3mo후도차이유통계학의의（t＝2．15，P＝0．033）。술후3 mo Iopcc ， Iopg 분별위13．75±2．13，9．54±2.35 mmHg교술전16．29±2．88，15．09±3．29 mmHg현저강저（t＝-13．604，-23．594；P＝0．000，0．000）。 Iopcc， Iopg분별교술전강저2．55±2．25，5．55±3．21mmHg。술후6 mo 13．61±1．96，9．32±2．07 mmHg여술후3 mo비교차이무통계학의의（ t＝-0．977，1．447，P＝0．33，0．15）。CRF，CH술후3mo측량치6．36±1．45，7．71±1．30mmHg교술전9．84±1．99，9．77±1．56mmHg현저강저（t＝-24．116，-19．171；P＝0．000，0．000）。 CRF，CH분별교술전강저3．49±1．97，2．06±1．47mmHg。술후6mo 6．24±1．38，&nbsp；7.67±1．25 mmHg여술후3 mo비교차이무통계학의의（ t＝1．456，0．636，P＝0．147，0．525）。 　　결론：비초격광보조LASIK술대각막생물역학유현저영향，술후각막생물역학각지표교술전현저강저。술후3 mo내생물역학각지표기본은정。
AIM: To investigate the changes of corneal biomechanics after Femto LDV laser flapping in laser in situ keratomileusis ( LASIK) . METHODS: Preoperatively, 3 months, 6 months after LASIK, 93 myopia patients ( 186 eyes ) in flapping procedure by Femto LDV laser were examined by Ocular response analyzer (ORA).The central corneal thickness ( CCT ) was also measured by ultrasonic pachymetry. Parameters were compared between postoperative ( 3 months) and preoperative, postoperative (6 months). Comparisons included the corneal thickness and corneal compensated intraocular pressure ( Iopcc ) , Goldmann correlated IOP value ( Iopg ) , corneal resistance factor ( CRF) , corneal hysteresis ( CH) . RESULTS: The CCT ( 447.61 ±39.57μm ) were significantly changed comparing with preoperative (539.88±29.72μm) (t=-47.223;P=0.000).The CCT of 6 months postoperative ( 448.78 ±39.19μm ) was slightly thicker than that of 3 months'(t=2.15,P=0.033).Iopcc, Iopg of 3 months after LASIK (13.75±2.13, 9.54±2.35) mmHg were significantly changed comparing with preoperative (16.29±2.88, 15.09±3.29 )mmHg (t=-13.604,-23.594;P=0.000, 0.000).The difference was (2.55 ±2.25, 5.55 ± 3.21) mmHg.There were no significant changes between Iopcc, Iopg of 6 months (13.61±1.96,9.32±2.07)mmHg and that of 3 months after LASIK. CRF and CH of 3 months after LASIK (6.36±1.45,7.71±1.30)mmHg were significantly changed comparing with preoperative's (9.84±1.99,9.77±1.56)mmHg (t=-24.116, -19.171; P=0.000, 0.000).The difference was (3.49 ±1.97, 2.06 ± 1.47 ) mmHg. There were no statistical differences between 6 months (6.24 ±1.38, 7.67 ±1.25) mmHg and 3 months(t=1.456, 0.636;P=0.147, 0.525). CONCLUSION: The corneal biomechanical properties after FS-LASIK are lower than that of preoperative. Corneal biomechanics sustains steadily about 3 months after LASIK.