近视眼LASIK术后屈光回退的相关因素分析  

Multivariate analysis of regression after excimer laser in situ keratomileusis on myopia

作　　者：赵春娟[1] 方燕[2] 费安裕[2] 林成平[2] 

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

出　　处：《中国实用眼科杂志》2009年第10期1184-1187,共4页Chinese Journal of Practical Ophthalmology

基　　金：台州市科技局资助项目（072KY15）;台州学院医学院资助项目（07ND03）

摘　　要：目的 探讨影响准分子激光原位角膜磨镶术（LASIK）治疗近视术后疗效的相关因素.方法 采用LASIK对72例（141只眼）近视眼患者进行治疗.分别记录术前、术后第1周、第1个月、第3个月、第6个月和第12个月视力、屈光度、眼压、角膜厚度、角膜地形图检查所得的角膜后表面数据.根据术后第12个月裸眼视力和等效球镜屈光度分2组,Ⅰ组屈光回退组视力＜5.0且术后近视等效球镜屈光度＞1.00I）,计35只眼;Ⅱ组视力正常组视力≥5.0,计106只眼.分析术后裸眼视力与i者多因素关系.结果 术后第12个月裸眼视力4.4～5.1,平均4.97±0.13,以术后第12个月裸眼视力为因变量（Y）与术前近视屈光度（X1）、角膜切削比（X2）,术后第12个月角膜后表面最高点Diff值（X3）,术后第12个月和术后第1周角膜厚度差（X4）,术后第12个月和术后第1周角膜后表面屈光度差（X5）等进行逐步回归分析建立多元同归方程Y=5.09-0.034X1＋1.785X2-2.216X3-0.002X4＋0.081X5（F=21.474,19＜0.01）.术后随访角膜厚度有不同程度增加,角膜后表面屈光度降低,角膜后表面Diff值增高,屈光回退组各指标不同阶段比较差异有统计学意义（分别F=8.56、4.68、2.49;均P＜0.05）,变化尤以术后3个月内明显;正常眼组各指标不同阶段比较除角膜最薄处厚度有差异外,余均无统计学意义（角膜最薄厚度F=7.27,P＜0.01;其余均P＞0.05）.结论 LASIK治疗近视是一种安全、有效的方法,但欲取得较好疗效,应考虑不同因素如术前近视屈光度、角膜切削比、术后角膜增殖、术后角膜后表面改变等因素的影响.Objective To analyze the relative factors that affect postoperative results of laser in situ keratomileusis （LASIK） for treating myopia.Methods A total of 72 patients （141 eyes） underwent LASIK, which were divided into two groups according to uncorrected visual acuity 12 months after operation and spherical equivalent diopter after operation.Group 1 was refractive regression one consisting of 36 eyes with visual acuity〈5.0 and diopter 〉1.00 D.Group 2 was normal one with 105 eyes.Their visual acuity, diopter, intraocular pressure, corneal thickness and the data by corneal topography before operation wererespeetively recorded one week, one month, three months, six month and twelve months after operation.The relationship between uncorrected visual acuity and relative factors was analyzed.Results Uncorrected visual acuity of three months after operation was 4.4-5.1, with an average of 4.97＋ 0.13.A multiple regression equation was set up.It was Y= 5.09-0.034X1 ＋ 1.785X2-2.216X3- 0.002X4 ＋ 0.081X5 （F=21.474, P〈0.01 ）.（Y stands for uncorrected visual acuity three months after operation; X1 stands for preoperative myopia diopter; X2 stands for the ratio of corneal cutting; X3 stands for Diff three months after operation; X4 stands for remainder of corneal thickness one week after operation; X5 stands for remainder of corneal posterior surface diopter）.As postoperative, the thickness in corneal thinnest place, negative diopter and Diff of corneal posterior surface were found to increase to a different degree.There was statistical significance between the different stages in refractive regression group （F=8.56,4.68,2.49; P〈0.05 ）, but there was no statistical significance in the normal eye group except corneal thickness difference in the thinnest place.Conclusions LASIK is a safe and effective way to treat myopia, but for better postoperative results, many factors such as preoperative myopia diopter, the ratio of corneal cutting, postoperative corneal proliferation and changes in postoprea

关 键 词：近视眼 准分子激光原位角膜磨镶术 屈光回退 多因素分析 

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