准分子激光皮下角膜磨镶术后雾状混浊形成的影响因素  

Analysis of Factors that Contribute to Corneal Haze After Laser-assisted Subepithelial Keratomileusis

作　　者：王晓雄[1] 张少维[1] 邢怡桥[1] 张宁[1] 万金方[1] 

机构地区：[1]武汉大学人民医院眼科,湖北武汉430060

出　　处：《武汉大学学报（医学版）》2007年第4期518-520,531,共4页Medical Journal of Wuhan University

摘　　要：目的:通过准分子激光上皮下角膜磨镶术(LASEK)术后角膜上皮下雾状混浊(haze)形成等级的分析,探讨haze形成的主要影响因素。方法:于2005年10月至2006年6月接受LASEK手术的92例(179只眼)连续病例中,选取随访超过3个月的病例83例(162眼,占总眼数的90.50%),其中男性23例(45只眼),女性60例(117只眼);年龄为18-48岁,平均(26.81±7.23)岁;术前屈光度(等效球镜度数)为-15.75--4.00D,平均(-9.24±2.48)D;术前角膜中央厚度为440-533μm,平均(489.83±18.00)μm。应用SPSS12.0软件中的Spearman等级相关分析方法和逻辑回归分析方法,分析术后角膜上皮下雾状混浊(haze)与手术前后各项检测指标,包括患者年龄、术前屈光度、术前角膜中央厚度、术中角膜切削深度、术中角膜切削率(术中角膜切削深度/术前角膜中央厚度)、术后角膜上皮愈合时间等因素的关系。结果:83例患者术中角膜切削深度为67.90-143.30μm,平均(117.60±14.55)μm;术中角膜切削率为0.135-0.295,平均(0.240±0.028);角膜上皮愈合时间,3 d为127眼(78.40%),4 d为27眼(16.67%),5 d为6眼(3.70%),6 d为2眼(1.23%);术后最后一次复查时的角膜haze,0级为130眼(80.25%),0.5级为13眼(8.02%),1级为11眼(6.79%),2级为5眼(3.09%),3级为3眼(1.85%)。等级相关分析显示,haze与年龄呈负相关(r=-0.173,P<0.05),与术中角膜切削深度呈正相关(r=0.155,P<0.05),逻辑回归分析显示,年龄与术中角膜切削深度不能预测haze的发生。结论:LASEK术后haze形成等级与术中角膜切削深度呈正相关,与患者年龄呈负相关,但相关性较小,主要的影响因素尚待进一步研究。Objective： To analyze the factors that contribute to corneal haze after LASEK and to investigate their clinical significance. Methods： 162 eyes of 83 patients who had LASEK were examined. The age of 83 patients was 18-48 （26.81±7.23） years, the spherical equivalent refraction ranged from-15.75 to -4.00（-9. 24±2.48）D, and the corneal thickness was 440-533（489.83±18.00）μm. The grades of corneal haze after surgery and the indices obtained were adopted to undergo a Spearman correlation analysis by SPSS 12.0 software. Results ： The depth of ablation was 67.90-143.30 （117.60±14.55） μm,the ablation ratio was 0. 135-0. 295 （0. 240±0. 028）, the corneal haze was 0-3 grade, with 130 eyes（80.25%）in grade 0, 13 eyes（8.02%） in grade 0.5, 11 eyes （6.79%） in grade 1, 5 eyes （3.09%） in grade 2 and 3 eyes （1.85%） in grade 3. The factors that contribute to corneal haze were age （r=-0. 173,P〈0.05） and the depth of ablation （r=0. 155, P〈0. 05）. Conclusion： There was a positive correlation between corneal haze and the depth of ablation and a negative correlation between corneal haze and the patients＇ age.

关 键 词：准分子激光上皮下角膜磨镶术 角膜上皮下雾状混浊 切削深度 

分 类 号：R77[医药卫生—眼科]