CAJ | 학술논문

目的研究准分子激光原位角膜磨镶术(LASIK)后角膜后表面高度的变化及影响因素.方法回顾性系列病例研究.对51(102眼)例近视眼患者施行LASIK手术,于术前、术后1个月和3个月进行Pentacam眼前节分析系统检查.在角膜中央4 mm区域将角膜分为4个象限(颞上、颞下、鼻上和鼻下),每个象限取7个点,分别分析4个象限和角膜顶点后表面高度的变化.数据采用配对t检验和相关分析.结果角膜中央4 mm区域,术后1个月角膜顶点、颞上、颞下、鼻上、鼻下象限角膜后表面高度变化平均为(-0.12±1.50)μm、(0.18±1.70)μm、(-0.16±1.50)μm、(0.15±1.62)μm、(0.01±1.45)μm;3个月时分别为(0.58±1.49)μm、(0.42±1.85) μm、(-0.50±1.99)μm、(0.59±1.67)μm、(-0.36±1.70)μm；术后1个月和3个月比较角膜顶点后表面高度变化有统计学意义(t=2.05,P＜0.05),其余各象限变化均没有统计学意义.角膜后表面高度变化术后1个月各部位与平均角膜中央厚度(CCT)、平均剩余角膜基质床厚度(RBT)、平均手术切削深度(AD)、等效球镜(SE)均没有相关性;3个月时角膜顶点后表面高度变化与SE成正相关(r=0.26,P＜0.01),其余各象限与CCT、RBT、AD、SE均没有相关性.结论角膜中央直径4 mm范围内,LASIK术后各部位角膜后表面高度变化量(前凸和后移)均微小.同时随着预矫屈光度的增加角膜顶点后表面前移量逐渐增加.
목적 연구준분자격광원위각막마양술(LASIK)후각막후표면고도적변화급영향인소.방법 회고성계렬병례연구.대51(102안)례근시안환자시행LASIK수술,우술전、술후1개월화3개월진행Pentacam안전절분석계통검사.재각막중앙4 mm구역장각막분위4개상한(섭상、섭하、비상화비하),매개상한취7개점,분별분석4개상한화각막정점후표면고도적변화.수거채용배대t검험화상관분석.결과 각막중앙4 mm구역,술후1개월각막정점、섭상、섭하、비상、비하상한각막후표면고도변화평균위(-0.12±1.50)μm、(0.18±1.70)μm、(-0.16±1.50)μm、(0.15±1.62)μm、(0.01±1.45)μm;3개월시분별위(0.58±1.49)μm、(0.42±1.85) μm、(-0.50±1.99)μm、(0.59±1.67)μm、(-0.36±1.70)μm；술후1개월화3개월비교각막정점후표면고도변화유통계학의의(t=2.05,P＜0.05),기여각상한변화균몰유통계학의의.각막후표면고도변화술후1개월각부위여평균각막중앙후도(CCT)、평균잉여각막기질상후도(RBT)、평균수술절삭심도(AD)、등효구경(SE)균몰유상관성;3개월시각막정점후표면고도변화여SE성정상관(r=0.26,P＜0.01),기여각상한여CCT、RBT、AD、SE균몰유상관성.결론 각막중앙직경4 mm범위내,LASIK술후각부위각막후표면고도변화량(전철화후이)균미소.동시수착예교굴광도적증가각막정점후표면전이량축점증가.
Objective To study changes in posterior corneal elevation after laser in situ keratomileusis (LASIK) and related factors.Methods It was a retrospective case series study.One hundred and two eyes of 51 myopic patients undergoing LASIK were examined with a Pentacam preoperatively,and 1 month and 3 months postoperatively.Analysis included posterior corneal elevation of the corneal apex,temporal superior,temporal inferior,nasal superior and nasal inferior quadrants (7 predetermined points in each quadrant) in a 4mm area of the central cornea.Results The changes in posterior corneal elevation in the corneal apex,temporal superior,temporal inferior,nasal superior and nasal inferior quadrants were-0.12±1.50 μm,0.18±1.70 μm,-0.16±1.50 μm,0.15±1.62 μm and 0.01±1.45μm,respectively,at 1 month,and were 0.58±1.49 μm,0.42±1.85 μm,-0.50±1.99 μm,0.59±1.67 μm and-0.36±1.70 μm,respectively,at 3 months.Between postoperative 1 month and 3 months,there was a significant difference in changes in the posterior elevation of the corneal apex,but there were no statistically significant differences in the 4 quadrants.At 1 month postoperatively,changes in the posterior corneal elevation in every area did not correlate with central corneal thickness (CCT),residual bed thickness (RBT),ablation depth (AD) or spherical equivalent (SE).At 3 months postoperatively,there was a significant positive correlation between changes in posterior elevation in the corneal apex and SE,but there was no significant correlation between changes in posterior corneal elevation in 4 quadrants and CCT,RBT,AD,SE.Conclusion LASIK surgery induces tiny changes in posterior corneal elevation in the central 4 mm area.Higher refractive errors may increase the trend of a forward shift of the posterior surface of the corneal apex.