LASIK术后角膜非球面性的变化及其对视功能影响  

The changes of corneal asphericity and its effect on visual performance after laser in situ keratomileusis for myopia

作　　者：刘俐利[1] 陈辉[1] 

机构地区：[1]南通大学附属医院眼科,南通226001

出　　处：《中国实用眼科杂志》2009年第5期485-488,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的探讨近视性LASIK术后角膜前表面不同范围非球面性参数Q值的变化及其对视功能的影响。方法将行常规LASIK的102例（204只眼），年龄18～36岁，等值球镜（SE）为-2．00～10．50D的青壮年近视患者按SE分为低度（-3．00D以下）、中度（-3．00～6．00D）、高度（-6．00D以上）三组。除常规检查外分别于术前、术后1、3、6个月对上述近视患者使用Pentacam眼前节测量分析系统进行角膜非球面性参数Q值测量分析，使用CSV-1000E对比敏感度测试仪检测对比敏感度。结果角膜前表面Q30、Q30术前分别为-0．14±0．15、-0．24±0．10，术后6个月时分别为0．66±0．74、0．59±0．53。术后不同时间点角膜前表面不同范围Q值与术前相比差异均有统计学意义（P〈0．05），术后3个月时前表面Q值较1个月时减小，两个时间点的前表面Q值之间差异有统计学意义（P〈0．05），3个月与6个月之间差异没有统计学意义（P〉0．05）。矫正度数越高，术后Q值变化越大。术后1、3、6个月前表面Q30值的变化（△Q30）与对比敏感度log值的变化之间无相关性（P〉0．05）。术后6个月时前表面Q30小于0．55组与大于0．55组之间的BSCVA、SI、EI和对比敏感度log值差异无统计学意义。术后6个月时前表面Q30的变化小于0．68组与大于0．68组之间的BSCVA、SI、EI和对比敏感度log值差异亦无统计学意义。结论LASIK术后角膜前表面的Q值由术前的负值变为正值且随矫正度数的增加而增加，术后3个月时角膜前表面Q值趋于稳定；LASIK术后角膜前表面Q值的绝对值或相对值的变化均不明显影响视功能。Objective To evaluate the changes ofasphericity of the anterior corneal surface and its effect on visual performance after laser in situ keratomileusis （LASIK）for myopia.Methods 102 patients （204 eyes）with spherical equivalence （SE）from -2.00D to -10.50D and age from 18 to 36 years old were divided into three groups： low myopia （below - 3.00D）, moderate myopia （range - 3.00D to - 6.00D）and high myopia （above -6.00D ）.The corneal asphericity （Q-value）was measured with Pentacam the measurement and evaluation system for the anterior segment of the eye before surgery and 1 month, 3 months, 6 months after surgery, respectively.Contrast sensitivity and other visual fimctions were also observed.Results The Q20 value and Q30 value of the anterior corneal surface were -0.14± 0.15,-0.24± 0.10 before surgery,and 0.66± 0.74,0.59± 0.53 at 6 months after surgery.There was significant difference in the Q-value of the anterior corneal surface before and after surgery （P 〈0.05 ）.The Q-value of anterior corneal surface was decreased slowly in the first 3 months after surgery, and tend to stable at 6 months.No relationship could be found between the changes of Q30 value of anterior corneal surface and the log value of CSF.At 6 months after surgery, BSCVA, SI, El and CSF log value did not significantly change either between the group of the Q30 value of anterior corneal surface lower than 0.55 and the group of higher than 0.55 or between the group of the changes of Q30 value of anterior corneal surface lower than 0.68 and the group of higher than 0.68.Conclusion After LASlK,the Q-value of anterior corneal surface changed from negative value into positive value and became stable after 3 months.The absolute or relative changes of the anterior corneal surface Q-value after operation had no significant effect on visual performance.

关 键 词：Q值 准分子激光原位角膜磨镶术(LASIK) 视觉质量 

分 类 号：R779.6[医药卫生—眼科] R779.65[医药卫生—临床医学]