中华眼视光学与视觉科学杂志
中華眼視光學與視覺科學雜誌
중화안시광학여시각과학잡지
CHINESE JOURNAL OF OPTOMETRY OPHTHALMOLOGY AND VISUAL SCIENCE
2012年
12期
745-748
,共4页
张光明%张明昌%胡燕华%聂绍松
張光明%張明昌%鬍燕華%聶紹鬆
장광명%장명창%호연화%섭소송
眼内压%角膜磨镶术,激光原位%角膜地形图%角膜后表面前突%屈光回退
眼內壓%角膜磨鑲術,激光原位%角膜地形圖%角膜後錶麵前突%屈光迴退
안내압%각막마양술,격광원위%각막지형도%각막후표면전돌%굴광회퇴
Intraocular pressure%Keratomileusis,laser in situ%Corneal topography%Forward shift of posterior corneal surface%Refractive regression
目的 描述准分子激光原位角膜磨镶术(LASIK)后角膜后表面前突并探讨影响其前突程度的因素.方法 前瞻性系列病例研究.2006年12月至2007年2月在华中科技大学同济医学院附属协和医院眼科行LASIK手术患者82例(通过3年的观察,无一例出现圆锥角膜),其中男38例,女44例,年龄18～44岁,平均(24.2±5.5)岁,取右眼数据进行分析.采用OrbscanⅡz、Goldman眼压计、超声角膜测厚仪分别测量这82眼手术前后角膜地形图、眼压以及角膜厚度.采用t检验和Pearson相关分析与线性回归等统计学方法.结果 ①LASIK术后角膜后表面最佳拟合球面半径缩短(113.32±66.87) μm,平均前突(71.97±28.70)μm,术前术后角膜后表面曲率差为(0.93±0.54)D.②LASIK手术后角膜后表面都有不同程度轻微前突,其程度与术前眼压呈正相关(r=0.461,P＜0.01);与术后角膜瓣下残余基质厚度呈负相关(r=-0.453,P＜0.01).③在36个月观察中,无一例发生角膜扩张,但术后角膜后表面都不同程度向前突出.结论 角膜后表面前突是LASIK术后角膜变薄的必然反应,其程度与术前眼压呈正相关,与术后角膜瓣下残余基质厚度呈负相关.
目的 描述準分子激光原位角膜磨鑲術(LASIK)後角膜後錶麵前突併探討影響其前突程度的因素.方法 前瞻性繫列病例研究.2006年12月至2007年2月在華中科技大學同濟醫學院附屬協和醫院眼科行LASIK手術患者82例(通過3年的觀察,無一例齣現圓錐角膜),其中男38例,女44例,年齡18～44歲,平均(24.2±5.5)歲,取右眼數據進行分析.採用OrbscanⅡz、Goldman眼壓計、超聲角膜測厚儀分彆測量這82眼手術前後角膜地形圖、眼壓以及角膜厚度.採用t檢驗和Pearson相關分析與線性迴歸等統計學方法.結果 ①LASIK術後角膜後錶麵最佳擬閤毬麵半徑縮短(113.32±66.87) μm,平均前突(71.97±28.70)μm,術前術後角膜後錶麵麯率差為(0.93±0.54)D.②LASIK手術後角膜後錶麵都有不同程度輕微前突,其程度與術前眼壓呈正相關(r=0.461,P＜0.01);與術後角膜瓣下殘餘基質厚度呈負相關(r=-0.453,P＜0.01).③在36箇月觀察中,無一例髮生角膜擴張,但術後角膜後錶麵都不同程度嚮前突齣.結論 角膜後錶麵前突是LASIK術後角膜變薄的必然反應,其程度與術前眼壓呈正相關,與術後角膜瓣下殘餘基質厚度呈負相關.
목적 묘술준분자격광원위각막마양술(LASIK)후각막후표면전돌병탐토영향기전돌정도적인소.방법 전첨성계렬병례연구.2006년12월지2007년2월재화중과기대학동제의학원부속협화의원안과행LASIK수술환자82례(통과3년적관찰,무일례출현원추각막),기중남38례,녀44례,년령18～44세,평균(24.2±5.5)세,취우안수거진행분석.채용OrbscanⅡz、Goldman안압계、초성각막측후의분별측량저82안수술전후각막지형도、안압이급각막후도.채용t검험화Pearson상관분석여선성회귀등통계학방법.결과 ①LASIK술후각막후표면최가의합구면반경축단(113.32±66.87) μm,평균전돌(71.97±28.70)μm,술전술후각막후표면곡솔차위(0.93±0.54)D.②LASIK수술후각막후표면도유불동정도경미전돌,기정도여술전안압정정상관(r=0.461,P＜0.01);여술후각막판하잔여기질후도정부상관(r=-0.453,P＜0.01).③재36개월관찰중,무일례발생각막확장,단술후각막후표면도불동정도향전돌출.결론 각막후표면전돌시LASIK술후각막변박적필연반응,기정도여술전안압정정상관,여술후각막판하잔여기질후도정부상관.
Objective To investigate the forward shift of the posterior corneal surface and related influential factors after laser in situ keratomileusis (LASIK).Methods It was a prospective case series study.Eighty-two patients with myopia (38 males and 44 females) who had undergone LASIK at Union Hospital between December 2006 and February 2007 were retrospectively reviewed.The average age was 24.2±5.5 years,ranging from 18 to 44 years.No case of keratoconus was found during 3 years of follow-up.Intraocular pressure,corneal thickness and topography measurements were obtained with a Goldmann tonometer,ultrasonic corneal pachymeter and Orbscan Ⅱ z before and after surgery.All surgery was performed by the same surgeon using a 217Z100 Bausch & Lomb.Results After LASIK,the best fit sphere radius of the posterior corneal surface was shortened by 113.32±66.87 μm,with an average forward shift of 71.97±28.70 μm.The difference in the posterior corneal surface power between pre-and post-operation was 0.93±0.54 D.The forward shift of the posterior corneal surface showed a positive correlation with preoperative intraocular pressure (r=0.461,P＜0.01),and a negative correlation with residual stromal bed thickness (r=-0.453,P＜0.00).There was a forward shift of varying degrees in the posterior comeal surface in most cases,including several severe cases.But no corneal ectasia was observed during the follow-up period of 36 months.Conclusion The forward shift of the posterior corneal surface could be an inevitable response because of corneal thinning after LASIK,and a change in the posterior corneal surface showed a positive correlation with preoperative intraocular pressure and a negative correlation with residual stromal bed thickness.
