中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
CHINESE JOURNAL OF PRACTICAL OPHTHALMOLOGY
2014年
8期
984-987
,共4页
周少博%李辉%洪海峰%谭娟
週少博%李輝%洪海峰%譚娟
주소박%리휘%홍해봉%담연
角膜磨镶术%激光原位%近视%调节
角膜磨鑲術%激光原位%近視%調節
각막마양술%격광원위%근시%조절
Myopia%Laser keratomileusis%Accommodation%Anterior segment
目的 探索近视眼LASIK手术前后调节致眼前段结构变化的差异.方法 临床病例系列研究.对2010年3～8月在广州医学院第一附属医院眼科就诊的60例年龄在18～39岁近视患者,按近视程度分为轻中度近视组和高度近视组,统一行标准的LASIK手术,分别于术前、术后1周、1、3个月用眼前段OCT对非主导眼进行不同调节状态下眼前段扫描分析,测量该眼在调节放松(0.0 D)和诱发3.0 D调节两种状态下的眼前段参数术后变化,包括角膜后表面曲率、前房深度、晶状体厚度和暗瞳直径的大小.结果 60例患者,轻中度近视组32例,高度近视组28例.两组患者在调节放松状态下(0.0 D),角膜后表面曲率、前房深度、晶状体厚度和瞳孔直径在手术前后各时期的差异比较均无统计学意义(P＞0.05).在诱发3.0 D调节时,轻中度近视组与高度近视组,角膜曲率、前房深度和瞳孔直径在术前和术后1周、1、3个月的变化差异比较无统计学意义(P＞0.05);但晶状体厚度在各时期的变化差异比较有统计学意义(F轻中度近视组=3.595,P =0.025;F高压近视组=3.310,P=0.046),轻中度近视组术后1周晶状体的变化量较术前减少,高度近视组晶状体的变化量术后3个月较术前增大.结论 近视眼LASIK手术前后调节所致的眼前段改变,不同程度近视和不同部位在不同时期有所差异,调节所致的角膜后表面曲率和瞳孔直径变化在手术前后无明显差异;术后早期(1周)调节所致的晶状体改变量均低于术前,术后1个月可以恢复至术前水平,术后远期(3个月),高度近视调节所致晶状体的变化量甚至高于术前水平.
目的 探索近視眼LASIK手術前後調節緻眼前段結構變化的差異.方法 臨床病例繫列研究.對2010年3～8月在廣州醫學院第一附屬醫院眼科就診的60例年齡在18～39歲近視患者,按近視程度分為輕中度近視組和高度近視組,統一行標準的LASIK手術,分彆于術前、術後1週、1、3箇月用眼前段OCT對非主導眼進行不同調節狀態下眼前段掃描分析,測量該眼在調節放鬆(0.0 D)和誘髮3.0 D調節兩種狀態下的眼前段參數術後變化,包括角膜後錶麵麯率、前房深度、晶狀體厚度和暗瞳直徑的大小.結果 60例患者,輕中度近視組32例,高度近視組28例.兩組患者在調節放鬆狀態下(0.0 D),角膜後錶麵麯率、前房深度、晶狀體厚度和瞳孔直徑在手術前後各時期的差異比較均無統計學意義(P＞0.05).在誘髮3.0 D調節時,輕中度近視組與高度近視組,角膜麯率、前房深度和瞳孔直徑在術前和術後1週、1、3箇月的變化差異比較無統計學意義(P＞0.05);但晶狀體厚度在各時期的變化差異比較有統計學意義(F輕中度近視組=3.595,P =0.025;F高壓近視組=3.310,P=0.046),輕中度近視組術後1週晶狀體的變化量較術前減少,高度近視組晶狀體的變化量術後3箇月較術前增大.結論 近視眼LASIK手術前後調節所緻的眼前段改變,不同程度近視和不同部位在不同時期有所差異,調節所緻的角膜後錶麵麯率和瞳孔直徑變化在手術前後無明顯差異;術後早期(1週)調節所緻的晶狀體改變量均低于術前,術後1箇月可以恢複至術前水平,術後遠期(3箇月),高度近視調節所緻晶狀體的變化量甚至高于術前水平.
목적 탐색근시안LASIK수술전후조절치안전단결구변화적차이.방법 림상병례계렬연구.대2010년3～8월재엄주의학원제일부속의원안과취진적60례년령재18～39세근시환자,안근시정도분위경중도근시조화고도근시조,통일행표준적LASIK수술,분별우술전、술후1주、1、3개월용안전단OCT대비주도안진행불동조절상태하안전단소묘분석,측량해안재조절방송(0.0 D)화유발3.0 D조절량충상태하적안전단삼수술후변화,포괄각막후표면곡솔、전방심도、정상체후도화암동직경적대소.결과 60례환자,경중도근시조32례,고도근시조28례.량조환자재조절방송상태하(0.0 D),각막후표면곡솔、전방심도、정상체후도화동공직경재수술전후각시기적차이비교균무통계학의의(P＞0.05).재유발3.0 D조절시,경중도근시조여고도근시조,각막곡솔、전방심도화동공직경재술전화술후1주、1、3개월적변화차이비교무통계학의의(P＞0.05);단정상체후도재각시기적변화차이비교유통계학의의(F경중도근시조=3.595,P =0.025;F고압근시조=3.310,P=0.046),경중도근시조술후1주정상체적변화량교술전감소,고도근시조정상체적변화량술후3개월교술전증대.결론 근시안LASIK수술전후조절소치적안전단개변,불동정도근시화불동부위재불동시기유소차이,조절소치적각막후표면곡솔화동공직경변화재수술전후무명현차이;술후조기(1주)조절소치적정상체개변량균저우술전,술후1개월가이회복지술전수평,술후원기(3개월),고도근시조절소치정상체적변화량심지고우술전수평.
Objective To evaluate the difference of anterior segment changes resulted from accommodation before and after LASIK in myopia.Methods Sixty myopic patients with the age from 18 to 39 years who were going to undergo standard LASIK were enrolled in this study and were divided into two groups:low to moderate myopic group (＞-6.0D),and high myopic group (≤-6.0D).Anterior segment measurements were performed by anterior segment optic coherence tomography (OCT) in undominant eye under three different accommodative state of relax (0.0 D) and 3.0 D before LASIK and one week,one month,and 3 months after LASIK.The changes in posterior corneal curvature (PCC),anterior chamber depth (ACD),lens thickness (LT),pupil diameter (PD) with accommodation at different time after LASIK were compared with those measured before LASIK.Results There were no significant differences between preoperative PCC,ACD,LT,PD and those of post-operation at the state of non-accommodated in both groups (all P ＞0.05).Compared with pre-operation,the mean changes of LT induced by 3.0D accommodation were significantly decreased in both groups at 1 week postoperatively (all P ＜0.05).There were no significant differences between preoperative alteration in anterior segment induced by accommodation and 1-month postoperative alteration in both groups (all P ＞0.05).Changes of LT were significantly increased in 3 months after surgery in high myopia.Conclusions The changes of LT induced by accommodation in myopia seem to be decreased in the early days after LASIK and may recover or even increase at one to three months,which may be the mechanism that accommodative function changes after LASIK.
