LASIK术后角膜后表面高度变化及影响因素  

Changes in posterior corneal elevation and effected factors after LASIK

作　　者：熊世红[1] 王薇[1] 陆平[1] 张帆[1] 苏红英[1] 刘萍[1] 王艳玲[1] 

机构地区：[1]首都医科大学附属北京友谊医院,北京100050

出　　处：《中华眼视光学与视觉科学杂志》2013年第2期112-115,共4页Chinese Journal Of Optometry Ophthalmology And Visual Science

摘　　要：目的研究准分子激光原位角膜磨镶术（LASIK）后角膜后表面高度的变化及影响因素。方法回顾性系列病例研究。对51（102眼）例近视眼患者施行LASIK手术，于术前、术后1个月和3个月进行Pentacam眼前节分析系统检查。在角膜中央4mm区域将角膜分为4个象限（颞上、颞下、鼻上和鼻下），每个象限取7个点，分别分析4个象限和角膜顶点后表面高度的变化。数据采用配对t检验和相关分析。结果角膜中央4mm区域，术后1个月角膜顶点、颞上、颞下、鼻上、鼻下象限角膜后表面高度变化平均为（-0．12±1．50）μm、（0．18±1．70）μm、（-0．16±1．50）μm、（0．15±1．62）μm、（0．01±1．45）μm；3个月时分别为（0．58±1．49）μm、（0．42±1．85）μm、（-0．50±1．99）μm、（0．59±1．67）μm、（-0．36±1．70）μm；术后1个月和3个月比较角膜顶点后表面高度变化有统计学意义（t=2．05，P〈0．05），其余各象限变化均没有统计学意义。角膜后表面高度变化术后1个月各部位与平均角膜中央厚度（CCT）、平均剩余角膜基质床厚度（RBT）、平均手术切削深度（AD）、等效球镜（SE）均没有相关性；3个月时角膜顶点后表面高度变化与SE成正相关（r=0．26，P〈0．01），其余各象限与CCT、RBT、AD、SE均没有相关性。结论角膜中央直径4mm范围内，LASIK术后各部位角膜后表面高度变化量（前凸和后移）均微小。同时随着预矫屈光度的增加角膜顶点后表面前移量逐渐增加。Objective To study changes in posterior corneal elevation after laser in situ keratomileusis （LASIK） and related factors. Methods It was a retrospective case series study. One hundred and two eyes of 51 myopic patients undergoing LASIK were examined with a Pentacam preoperatively, and 1 month and 3 months postoperatively. Analysis included posterior corneal elevation of the corneal apex, temporal superior, temporal inferior, nasal superior and nasal inferior quadrants （7 predetermined points in each quadrant） in a 4mm area of the central cornea. Results The changes in posterior corneal elevation in the corneal apex, temporal superior, temporal inferior, nasal superior and nasal inferior quadrants were -0.12±1.50μm、0.18±1.70μm、-0.16±1.50μm、0.15±1.62μm、0.01±1.45μm, respectively, at 1 month, and were 0.58±1.49μm、0.42±1.85μm、（-0.50±1.99）μm、0.59±1.67μm and -0.36±1.70μm , respectively, at 3 months. Between postoperative 1 month and 3 months, there was a significant difference in changes in the posterior elevation of the corneal apex, but there were no statistically significant differences in the 4 quadrants. At 1 month postoperatively, changes in the posterior corneal elevation in every area did not correlate with central corneal thickness （CCT）, residual bed thickness （RBT）, ablation depth （AD） or spherical equivalent （SE）. At 3 months postoperatively, there was a significant positive correlation between changes in posterior elevation in the corneal apex and SE, but there was no significant correlation between changes in posterior corneal elevation in 4 quadrants and CCT, RBT, AD, SE. Conclusion LASIK surgery induces tiny changes in posterior corneal elevation in the central 4 mm area. Higher refractive errors may increase the trend of a forward shift of the posterior surface of the corneal anex.

关 键 词：角膜磨镶术 激光原位 角膜切削术 角膜后表面 高度 近视 

分 类 号：R77[医药卫生—眼科]