LASIK术中瞬时高眼压对兔视网膜功能影响的研究  

Influence of transient high IOP during LASIK on retinal function

作　　者：赵海霞[1] 陆蓓[2] 李晓芳[1] 李晓玲[1] 秦丽茹[1] 

机构地区：[1]内蒙古医学院附属医院眼科,内蒙古自治区呼和浩特市010050 [2]汕头大学香港中文大学联合国际眼科中心,广东省汕头市515041

出　　处：《眼科新进展》2008年第5期323-326,共4页Recent Advances in Ophthalmology

基　　金：国家自然科学基金资助(编号:30660194);内蒙古医学院附属医院重大科研基金资助(编号:NYFY2007001)~~

摘　　要：目的探讨LASIK术中负压吸引致瞬时高眼压对兔视网膜功能的影响。方法32只健康新西兰大耳白兔随机分为正常对照组、实验对照组、负压吸引20s组和3min组。实验对照组只进行激光治疗,负压吸引20s组和负压吸引3min组先分别用负压发生器吸引兔眼角巩膜缘20s及3min。分别于术后不同修复期通过闪光-视觉诱发电位和闪光-视网膜电图观察视网膜视神经功能的变化,并与正常对照组进行比较。结果正常对照组和实验对照组左右眼的视网膜电图(electroretinogram,ERG)a波波幅和b波波幅比较差异无统计学意义(P>0.05)。与正常对照组相比,负压吸引20s组和3min组术后30min～7d各时间点ERG的b波振幅相比,差异有统计学意义(F=5.18,P<0.05),负压吸引20s组修复10min ERGb波波幅为(112.01±11.08)μV较正常对照组(84.96±13.48)μV升高(P<0.05),修复20min逐渐降低,为(94.51±14.43)μV;负压吸引3min组修复10min ERGb波波幅为(55.89±9.46)μV较正常对照组明显降低(P<0.05),修复20minERGb波波幅逐渐降低为(67.73±16.42)μV,修复30min时兔眼ERGb波波幅仍低,与正常相比差异有统计学意义(P<0.05)。随着负压吸引时间的延长,各时间点ERG的b波振幅降低,随着修复时间的延长,ERG的b波振幅逐渐恢复正常。而ERG的a波波幅和潜伏期、视觉诱发电位各波波幅和潜伏期均无差异。结论LASIK术中负压吸引引起的眼压急剧升高,不会影响视网膜的功能。Objective To study the influence of transient high intraocular pressure（IOP） during LASIK on retinal function. Methods Thirty-two New Zealand white rabbits were randomly divided into normal control, experimental control,negative suction 20 seconds and negative suction 3 minutes groups. Experimental control group were treated only using eximer laser. Rabbit eyes were suction for different periods of time （ 20 seconds, 3 minutes） by negative pressure generator in different groups. Retinal neurofunctinal changes were observed with flash-visual evoked potential（F-VEP） and flash-electroreinogram （ F-ERG） at different recovery stages, and compared with control groups. Results There was no obvious change in ERG a-wave and b-wave in normal control and experimental control（P 〉 0.05 ）. There was obvious increasing in ERG b （ 112.01 ± 11.08 ） μV after suction 20 seconds and recovery l0 minutes compared with control （84.96 ± 13.48） μV（P〈 0.05）. There was obvious decreasing in ERG b（55.89 ± 9.46） μV after suction 3 minutes and recovery l0 minutes compared with control （ 84.96 ± 13.48 ）μV（P 〈 0. 05 ）. There was gradually decreasing in ERG b （ 67.73 ± 16.42）μV after sucrion 3 minutes and recovery 20 minutes. Untill recovery 30 minutes,ERG b was still decreasing compared with normal control group（ P 〈 0. 05 ）. Amplitude of ERG b-wave of different observed time will decrease with suction periods prolonging （P 〈 0.05 ）. It can recovery to normal level with the recovery periods prolonging. Amplitude and incubation period of ERG a-wave and VEP P-wave did not significantly change after different duration of suction （P 〉 0.05 ）. Conclusion Acute IOP elevation caused by negative pressure suction during LASIK do not change the retinal function.

关 键 词：准分子激光原位角膜磨镶术 眼压 视网膜 负压吸引 

分 类 号：R779.6[医药卫生—眼科]