薄瓣LASIK术后中央角膜厚度的变化分析  

Changes of central corneal thickness after thin-flap laser in situ keratomileusis

作　　者：赵明慧[1] 邹俊[1] 胡萍[1] 吴强[1] 

机构地区：[1]上海交通大学附属第六人民医院眼科,中国上海市200233

出　　处：《国际眼科杂志》2012年第2期312-315,共4页International Eye Science

摘　　要：目的:探讨薄瓣LASIK术后6mo内中央角膜厚度(central corneal thickness,CCT)及屈光度的变化规律。方法:使用非接触式角膜内皮细胞计追踪观察158例302眼近视眼行LASIK手术患者术前及术后1d;1wk;1,3,6mo时CCT的变化,同时记录患者的年龄,预计激光角膜切削值、术中手术光区的大小,术后预计屈光度以及实际屈光度的改变等。结果:术前平均CCT为531.6±24.3μm。术后第1d平均CCT迅速下降,术后1wk平均CCT继续下降,1mo后角膜厚度开始增厚。术前和术后第1dCCT差值与预计激光角膜切削值呈强相关性(r=0.916,P<0.01)。术后6mo和术后1d时CCT的差值,即6mo内CCT的增厚值与患者年龄、术眼屈光度和术中手术光区均呈显著负相关性(r=-0.180,P=0.026;r=-0.187,P<0.01;r=-0.171,P=0.137)。术后6mo时,实测平均等效球镜与术前预期值接近(术前等效球镜预期值平均为0.34±0.30D)。所有病例随访6mo,无1例发生屈光回退,6mo时裸眼视力均≥0.8,平均视力为1.3±0.2。结论:薄瓣LASIK术后CCT和屈光状态的稳定大约需要6mo时间。术后6mo内CCT增厚值与术前患者年龄、屈光度及术中手术光区大小均呈显著负相关性。术后6mo时实测平均等效球镜值与术前预期值接近。薄瓣LASIK手术治疗近视眼具有良好的预测性和稳定性。AIM：To analyze the changes of central corneal thickness（CCT） and refractive error in post thin-flap laser in situ keratomileusis（LASIK） eyes.METHODS：Totally 158 myopic patients（302 eyes） having thin-flap LASIK were prospectively evaluated.CCT and refractive error were measured before and 1 day,1 week,1 month,3,6 months after surgery.Age,predicted photoablation depth,optic zone,postoperative predicted diopter and actual diopter changes were also recorded.RESULTS：Preoperatively,the mean CCT was 531.6±24.3μm.On the first day postoperatively,CCT rapidly decreased.At 1 month,it was 427.2±38.0μm.At 3 months,it was 434.4±38.2μm,and at 6 months,it was 435.6±38.0μm.The CCT difference before and 1 day after LASIK was highly correlated with predicted photoablation depth（r=0.916,P0.01）.The increase of corneal thickness in post LASIK eyes in 6 months was negatively correlated with age,preoperative refractive error,and optical zone,respectively（r=-0.180,P=0.026;r=-0.187,P0.01;r=-0.171,P=0.137,respectively）.The spherical equivalent refraction at 6 months was close to the preoperative predicted values.All patients were followed up for six months,no case of refractive regression occurred.At 6 months,all the uncorrected visual acuity was≥0.8,the average visual acuity was 1.3±0.2.CONCLUSION：At 6 months after surgery,CCT and spherical equivalent refraction were relatively stable.The increase of CCT in post thin-flap LASIK eyes in 6 months was negatively correlated with age,preoperative refractive error,and optical zone,respectively.The spherical equivalent refraction at 6 months was close to the preoperational predicted values.The treatment of myopia in thin-flap LASIK has a good accuracy,and a long-term prediction.

关 键 词：角膜厚度 近视 非接触角膜内皮细胞计 薄瓣准分子激光原位角膜磨镶术 

分 类 号：R779.63[医药卫生—眼科]