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
2014年
8期
487-492
,共6页
牛广增%范玉香%高瑞新%王连丰%苏蕊%白东升
牛廣增%範玉香%高瑞新%王連豐%囌蕊%白東升
우엄증%범옥향%고서신%왕련봉%소예%백동승
角膜上皮下神经丛密度%角膜知觉%角膜磨镶术,激光原位%角膜切削术,上皮下,激光
角膜上皮下神經叢密度%角膜知覺%角膜磨鑲術,激光原位%角膜切削術,上皮下,激光
각막상피하신경총밀도%각막지각%각막마양술,격광원위%각막절삭술,상피하,격광
Nerve plexus density under corneal epithelium basal cells%Corneal sensation%Keratomileusis,laser in situ%Keratectomy,subepithelial,laser-assisted
目的 通过测定LASIK和LASEK术后角膜上皮下神经丛密度、角膜知觉变化,评估2种手术方式对角膜神经损伤的情况.方法 前瞻性临床病例研究.选取河北省沧州市中心医院LASIK手术患者102例(204眼),LASEK手术患者34例(68眼).测定2组术前,术后1周、1个月、3个月、6个月、1年、2年时角膜上皮下神经丛密度和角膜知觉,对上述2个指标采用重复测量方差分析进行比较.结果 术前LASIK组角膜上皮下神经丛密度和角膜知觉分别为(1 582±175)μm、(58.82±0.53)mm.术后1周[(208±32)μm]、1个月[(254 ±32) μm]、3个月[(588±65)μm]、6个月[(648 ±65) μm]、1年[(938±119)μm]时角膜上皮下神经丛密度均较术前降低(F=7.13,P＜0.05);术后2年时恢复到术前水平(t=0.147,P＞0.05).术后1周[(0.59±0.40)mm]、1个月[(15.59±2.67)mm]、3个月[(41.18±3.44)mm]、6个月[(52.88±2.58)mm]时角膜知觉均较术前降低(F=78.13,P＜0.05);术后1年时恢复到术前水平(t=1.144,P＞0.05).术前LASEK组角膜上皮下神经丛密度和角膜知觉分别为(1 406±195)μm、(58.82±0.53)mm.术后1周[(182±33)μm]、1个月[(538±83)μm]、3个月[(784±74)μm]、6个月[(1024±74)μm]时角膜上皮下神经丛密度均较术前降低(F=34.51,P＜0.05);术后1年时恢复到术前水平(t=1.906,P＞0.05);术后1周[(1.18±0.53)mm]、1个月[(38.82±3.11)mm]、3个月[(55.29±1.00)mm]时角膜知觉均较术前降低(F=361.98,P＜0.05);术后6个月时恢复到术前水平(t=0.899,P＞0.05).LASEK组在术后1个月、3个月、6个月时角膜知觉恢复优于LASIK组,其余时间点差异无统计学意义.LASEK组在术后6个月和1年时角膜上皮下神经丛密度恢复优于LASIK组,其余时间点差异无统计学意义.结论 LASIK和LASEK术后角膜上皮下神经丛密度、角膜知觉均较术前降低;LASEK术后角膜上皮下神经丛密度、角膜知觉恢复均优于LASIK.
目的 通過測定LASIK和LASEK術後角膜上皮下神經叢密度、角膜知覺變化,評估2種手術方式對角膜神經損傷的情況.方法 前瞻性臨床病例研究.選取河北省滄州市中心醫院LASIK手術患者102例(204眼),LASEK手術患者34例(68眼).測定2組術前,術後1週、1箇月、3箇月、6箇月、1年、2年時角膜上皮下神經叢密度和角膜知覺,對上述2箇指標採用重複測量方差分析進行比較.結果 術前LASIK組角膜上皮下神經叢密度和角膜知覺分彆為(1 582±175)μm、(58.82±0.53)mm.術後1週[(208±32)μm]、1箇月[(254 ±32) μm]、3箇月[(588±65)μm]、6箇月[(648 ±65) μm]、1年[(938±119)μm]時角膜上皮下神經叢密度均較術前降低(F=7.13,P＜0.05);術後2年時恢複到術前水平(t=0.147,P＞0.05).術後1週[(0.59±0.40)mm]、1箇月[(15.59±2.67)mm]、3箇月[(41.18±3.44)mm]、6箇月[(52.88±2.58)mm]時角膜知覺均較術前降低(F=78.13,P＜0.05);術後1年時恢複到術前水平(t=1.144,P＞0.05).術前LASEK組角膜上皮下神經叢密度和角膜知覺分彆為(1 406±195)μm、(58.82±0.53)mm.術後1週[(182±33)μm]、1箇月[(538±83)μm]、3箇月[(784±74)μm]、6箇月[(1024±74)μm]時角膜上皮下神經叢密度均較術前降低(F=34.51,P＜0.05);術後1年時恢複到術前水平(t=1.906,P＞0.05);術後1週[(1.18±0.53)mm]、1箇月[(38.82±3.11)mm]、3箇月[(55.29±1.00)mm]時角膜知覺均較術前降低(F=361.98,P＜0.05);術後6箇月時恢複到術前水平(t=0.899,P＞0.05).LASEK組在術後1箇月、3箇月、6箇月時角膜知覺恢複優于LASIK組,其餘時間點差異無統計學意義.LASEK組在術後6箇月和1年時角膜上皮下神經叢密度恢複優于LASIK組,其餘時間點差異無統計學意義.結論 LASIK和LASEK術後角膜上皮下神經叢密度、角膜知覺均較術前降低;LASEK術後角膜上皮下神經叢密度、角膜知覺恢複均優于LASIK.
목적 통과측정LASIK화LASEK술후각막상피하신경총밀도、각막지각변화,평고2충수술방식대각막신경손상적정황.방법 전첨성림상병례연구.선취하북성창주시중심의원LASIK수술환자102례(204안),LASEK수술환자34례(68안).측정2조술전,술후1주、1개월、3개월、6개월、1년、2년시각막상피하신경총밀도화각막지각,대상술2개지표채용중복측량방차분석진행비교.결과 술전LASIK조각막상피하신경총밀도화각막지각분별위(1 582±175)μm、(58.82±0.53)mm.술후1주[(208±32)μm]、1개월[(254 ±32) μm]、3개월[(588±65)μm]、6개월[(648 ±65) μm]、1년[(938±119)μm]시각막상피하신경총밀도균교술전강저(F=7.13,P＜0.05);술후2년시회복도술전수평(t=0.147,P＞0.05).술후1주[(0.59±0.40)mm]、1개월[(15.59±2.67)mm]、3개월[(41.18±3.44)mm]、6개월[(52.88±2.58)mm]시각막지각균교술전강저(F=78.13,P＜0.05);술후1년시회복도술전수평(t=1.144,P＞0.05).술전LASEK조각막상피하신경총밀도화각막지각분별위(1 406±195)μm、(58.82±0.53)mm.술후1주[(182±33)μm]、1개월[(538±83)μm]、3개월[(784±74)μm]、6개월[(1024±74)μm]시각막상피하신경총밀도균교술전강저(F=34.51,P＜0.05);술후1년시회복도술전수평(t=1.906,P＞0.05);술후1주[(1.18±0.53)mm]、1개월[(38.82±3.11)mm]、3개월[(55.29±1.00)mm]시각막지각균교술전강저(F=361.98,P＜0.05);술후6개월시회복도술전수평(t=0.899,P＞0.05).LASEK조재술후1개월、3개월、6개월시각막지각회복우우LASIK조,기여시간점차이무통계학의의.LASEK조재술후6개월화1년시각막상피하신경총밀도회복우우LASIK조,기여시간점차이무통계학의의.결론 LASIK화LASEK술후각막상피하신경총밀도、각막지각균교술전강저;LASEK술후각막상피하신경총밀도、각막지각회복균우우LASIK.
Objective To study corneal nerve damage by observing the corneal subepithelial nerve plexus density and corneal sensitivity after LASIK and LASEK.Methods In this prospective clinical study,102 LASIK (204 eyes) and 34 LASEK (68 eyes) postoperative patients from the Central Hospital of Cangzhou City were enrolled.Nerve plexus density under corneal epithelium basal cells and corneal sensitivity were examined in both groups 1 day preoperatively and 1 week,1 month,3 months,6 months,1 year,and 2 years after the surgery.Repeat measured ANOVA was used to statistically analyze and compare the above two indicators.Results The LASIK group:corneal subepithelial nerve plexus density was 1 582±175 μm preoperatively and 208±32 μm at 1 week,254±32 μm at 1 month,588±65 μm at 3 months,648±65 μm at 6 months,and 938±119 μm at 1 year.All measurements had decreased significantly after surgery (F=7.13,P＜0.05).However,the measurements had almost returned to preoperative levels 2 years after surgery (t=0.147,P＞0.05).Corneal sensitivity was 58.82±0.53 mm preoperatively and 0.59±0.40 mm at 1 week,15.59±2.67 mm at 1 month,41.18±3.44 mm at 3 months and 52.88±2.58 mm at 6 months.All measurements had decreased significantly after the surgery (F=78.13,P＜0.05).However,the measurements had almostreturned to preoperative levels at 1 year after surgery (t=1.144,P＞0.05).The LASEK group:corneal subepithelial nerve plexus density was 1 406±195 μm preoperatively and was 182±33 μm at 1 week,538±83 μm at 1 month,784±74 μm at 3 months,and 1 024±74 μm at 6 months.All measurements had decreased significantly after surgery (F=34.51,P＜0.05).However,the measurements had almost returned to preoperative levels at 1 year after surgery (t=1.906,P＞0.05).Corneal sensitivity was 58.82±0.53 mm preoperatively and 1.18±0.53 mm at 1 week,38.82±3.11 mm at 1 month,and 55.29±1.00 mm at 3 months.All measurements had decreased significantly after the surgery (F=361.98,P＜0.05).However,measurements had almost returned to preoperative levels 6 months after surgery (t=0.899,P＞0.05).When the two types of surgeries were compared,recovery of corneal sensation in the LASEK group was better at 1 month,3 months,and 6 months postoperatively than recovery in the LASIK group.Recovery of corneal density in the subepithelial nerve plexus was better in the LASEK group at 6 months and 1 year than recovery in the LASIK group.However,the differences at the time points were not statistically significant.Conclusion The density of the corneal subepithelial nerve plexus and corneal sensitivity are lower in both the LASEK and LASIK groups compared to preoperative levels.After surgery,recovery of both the subepithelial nerve plexus density and corneal sensitivity are better in the LASEK group than in the LASIK group.
