Pentacam系统对LASIK手术前后眼压测量值的修正  

The correction of Goldmann applanation tonometer with Pentacam System in measurement of IOP before and after LASIK

作　　者：何燕玲[1] 元力[1] 黎晓新[1] 胡亦文[1] 

机构地区：[1]北京大学人民医院眼科,100044

出　　处：《眼科研究》2009年第1期67-70,共4页Chinese Ophthalmic Research

摘　　要：目的评价Pentacam三维眼前节分析诊断系统对准分子激光原位角膜磨镶术(LASIK)前后眼压测量值校正的准确性。方法将105例(208眼)拟行LASIK的患者于术前和术后12个月分别行Pentacam三维眼前节分析系统检查和Goldmann压平眼压测量,并用Pentacam系统所提供的5种校正方法对眼压测量值进行校正。结果208眼LASIK术前眼压(15.75±2.59)mmHg,术后(10.78±2.27)mmHg,术后眼压明显低于术前(P<0.01);在Pentacam系统校正眼压的方法中除Kohlhaas法外,均只依据角膜顶点厚度对眼压进行校正。在5种修正方法中,Ehlers、Shah和Dresden法的眼压修正值与角膜厚度成负相关;Orssengo/Pye法的校正值随角膜厚度的增减依指数曲线关系变化;Kohlhaas法依据不同的角膜厚度和角膜曲率对眼压测量值进行校正。经Pentacam系统校正后,只有Ehlers法校正的眼压术前、术后差异无统计学意义(P>0.05)。结论Pentacam三维眼前节分析诊断系统根据角膜厚度和/或角膜曲率校正眼压测量值,LASIK术后建议使用Ehlers法对眼压测量值进行修正,有助于对可疑青光眼和眼压异常者进行判断。Objective Intraocular pressure （IOP） measurement is very important in the patient received LASIK. The Pentacam system offer a good way of correcting IOP measured with tonometer. The purpose of present paper attempted to assess the accuracy of corrected value of IOP measured by Goldmann applanation tonometer （GAT） using Pentacam system before and after laser in situ keratomileusis （ LASIK）. Methods GAT was used to measure the 208 eyes of 105 cases with the mean preoperative spherical equivalent refraction （- 5.81±2.02 ） D before operation and 12 months after operation, and Pentacam system （Pentacam, OCULUS） was used in the same cases for the correct of GAT measurement value. The corrected IOP value was calculated using the correction tables proposed by Ehlers, Shah, Dresden, Orssengo/Pye and Kohlhaas respectively. Results The mean IOP value by GAT was （ 15.75± 2.59 ） mmHg before LASIK and （10. 78± 2.27） mmHg after LASIK, indicating a significant reduce following an operative procedure（ P 〈 0. 01 ）. The corrected IOP value by Pentaeam was upon central corneal thickness （CCT） and keratometry values as measured （P 〈 0. 01 ）. There was a negative linear relationship between CCT and corrected IOP for the propose of Ehlers, Shah and Dresden and an exponential correction for the propose of Orssengo/Pye （ r = 0. 73 - 1.00, P 〈 0.01 ） , but no significant correlation between IOP and corneal radiual curvature was found among the four methods（r = 0. 036 -0. 065,P 〉 0.05 ）. The corrected IOP value proposed by Kohlhaas was influenced by CCT and corneal curvature （P 〈 0.01 ）. No statistically significant difference in corrected IOP value proposed by Ehlers was found between before and after LASIK （t = 1. 779, P 〉 0.05 ）. Conclusion A correction of GAT data according to Pentaeam correction tables is helpful for determining the IOP value. The method of Ehlers is recommended to be used after LASIK.

关 键 词：Goldmann压平眼压 PENTACAM系统 眼压校正 准分子激光原位角膜磨镶术 

分 类 号：R779.63[医药卫生—眼科]