准分子激光原位角膜磨镶术后角膜后表面变化及其影响因素  

Changes and their affecting factors of posterior corneal surface after laser in situ keratomileusis

作　　者：赵春娟[1] 林咸平[2] 

机构地区：[1]台州学院医学院眼科,浙江省台州318000 [2]浙江省台州医院眼科中心

出　　处：《临床眼科杂志》2009年第2期106-109,共4页Journal of Clinical Ophthalmology

基　　金：台州市科技局科研基金资助(072KY15);台州学院医学院科研基金资助(07ND03)

摘　　要：目的探讨近视眼准分子激光原位角膜磨镶术(LASIK)术后角膜后表面变化规律及影响因素。方法对72例(141只眼)行LASIK治疗的近视眼患者分别于术前、术后1周、1、3、6个月和12个月进行检查,分别记录视力、屈光度、眼压、角膜厚度、角膜后表面数据,将所得结果进行统计分析。结果LASIK术前、术后各时期角膜后表面屈光度分别为(-6.60±0.23)、(-7.01±0.30)、(-6.97±0.29)、(-7.08±0.35)、(-7.03±0.29)D及(-7.01±0.31)D;术前与术后各时期比较差异均有统计学意义(F=48.675,P=0.000);术后3个月与术后1周、术后1个月比较差异有统计学意义(均P<0.05);术后角膜后表面屈光力(Y)与术前角膜后表面屈光力(X1)、术后角膜厚度(X2)、术后角膜后表面Diff值(X3)、术前角膜厚度(X4)、术前近视屈光度(X5)建立多元回归方程为Y=-0.915+0.911X1+0.004X2-5.541X3-0.003X4+0.021X5(F=88.041,P=0.000)。LASIK术前、术后各时期角膜后表面Diff值分别为(0.032±0.007)、(0.057±0.014)、(0.056±0.015)、(0.060±0.016)、(0.056±0.017)及(0.059±0.048)mm,术前与术后各时期比较差异均有统计学意义(F=28.502,均P=0.000);但术后各时期之间比较差异均无统计学意义(均P>0.05);相关分析显示术后Diff值与术前眼压、近视屈光度和术后角膜后表面屈光力、角膜厚度等因素呈相关性(P均为0.000)。结论LASIK以直接改变角膜前表面屈光力来达到矫正近视目的,但也引起了角膜后表面变化,表现为术后角膜后表面前凸负性屈光力降低,这些变化以术后1周最明显,3个月后逐渐趋向稳定;其改变与角膜厚度、角膜切削深度和眼内压等因素相关。Objective To evaluate the regularity of changes and affecting factors of the posterior corneal surface alter laser in situ keratomileusis （LASIK）. Methods 141 eyes of 72 patients were examined before and 1 week, 1 month, 3 months, 6 months and 12 months after LASIK. Respective records were kept of eyesight, diopter, intraocular pressure, corneal thickness, data concerning posterior corneal surface obtained from corneal topography, and their Results were statistically analyzed. Results Diopters of posterior corneal surface were （ -6.60 ±0.23）, （ -7.01 ±0.30）, （ - 6.97 ±0.29）, （ -7.08 ±0.35）, （ -7.03 ±0.29） and （ -7.01 ±0.31 ） D before and each period after LASIK. There were statistical differences between before LASIK and all the periods after LASIK（ F =48.675, P =0.000）. There were also significant differences between 1 week and 3 months, 1 month and 3 months （ P 〈 0. 05 ） . Multiple regression equation established from refractive power of posterior corneal surface after LASIK （Y） and that before LASIK （ X1 ）, the thinnest corneal thickness after LASIK （ X2 ）, the highest Diff value of posterior corneal surface after LASIK（ X3 ）, the thinnest corneal thickness before LASIK （ X4 ）, and the spherical equivalent refraction before LASIK was Y = - 0. 915 ＋ 0. 911X1 ＋ 0.004X2 -5.541X3 -0.003X4 ＋0.021X5 （ F =88.041,PP0.000）. The highest Diff values of posterior corneal surface were （0.032 ±0.007）, （0.057 ±0.014）, （0.056 ±0.015）, （0.060 ±0.016）, （0.056 ±0.017） and （0.059 ±0. 048） nun before and each period after LASIK. There were statistical differences between before LASIK and each period after LASIK （ F =28.502s P =0.000）, hut no significant differences between the periods after LASIK（ P 〉0.05）. Correlation analysis showed that the Diff value after LASIK had correlation with the intraocular pressure, spherical equivalent refraction and before LASIK, the refractive power of posterior corneal surface and th

关 键 词：角膜磨镶术 激光原位 角膜地形图 角膜 近视眼 

分 类 号：R779.63[医药卫生—眼科] R776.4[医药卫生—临床医学]