Pentacam测量LASIK术后角膜后表面和前房形态变化的研究  

Changes of corneal posterior surface and anterior chamber after LASIK measured by Pentacam

作　　者：柯红琴[1] 刘磊[2] 栗静[2] 李新宇[2] 徐曼[3] 

机构地区：[1]云南省第二人民医院眼科,云南省昆明市650000 [2]华中科技大学同济医学院附属同济医院眼屈光治疗中心,湖北省武汉市430030 [3]武汉市爱尔眼科医院,湖北省武汉市430030

出　　处：《眼科新进展》2013年第5期466-468,471,共4页Recent Advances in Ophthalmology

摘　　要：目的研究LASIK术后角膜后表面和前房形态的变化及其相关影响因素。方法将52例(102眼)施行LASIK的近视及近视散光患者按照承载因子(loadingfator,LF;LF=术前中央角膜厚度/术后剩余基质床厚度)分为3组,LF<1.6为A组(50眼),1.6≤LF<1.7为B组(25眼),LF≥1.7为C组(27眼),分别于术前、术后2d、7d、1个月和3个月用Pentacam测量角膜后表面最适参考球面(posterior best fitsurface,PBFS)、后表面最高点(posterior elevation,PE)、中央前房深度(anterior chamber depth,ACD)和最小前房角的变化。结果 PBFS:A、B、C3组术后PBFS均较术前明显降低,A组在术后3个月时与术前相比差异无统计学意义(P>0.05),B、C组术后3个月时仍较术前降低。术前PBFS和术后7d时PBFS的差值ΔPBFS与术前中央角膜厚度、屈光度数、术后剩余基质床厚度、LF和术后7d时的中央角膜厚度均无线性相关关系。PE:3组患者术后3个月内PE与术前相比均无明显差异。ACD:A组术后3个月内ACD与术前相比差异均无统计学意义(均为P>0.05)。B、C两组术后3个月内ACD与术前相比均明显降低。最小前房角:3组患者术后3个月内最小前房角与术前相比差异均无统计学意义(均为P>0.05)。结论 LASIK术后7d内角膜后表面有前移,之后在此基础上又出现后移,3个月时大多可恢复至术前水平,未恢复者与1个月时相比也无进行性发展。LF≥1.6的患者术后ACD变浅,可能与术后调节增加有关。Objeetive To investigate the changes of corneal posterior surface and anterior chamber after laser in situ keratomeileusis （LASIK）. Methods Fifty-two cases（ 102 eyes） with myopia or myopic astigmatism that had received LASIK were divided into 3 groups according to loading factor （ LF, LF = preoperative central corneal thickness/postoperative residual matrix bed thickness） ： group A （ 50 eyes, LF 〈 1.6 ）, group B （ 25 eyes, 1.5 ≤LF 〈 1.7 ） and group C （27 eyes, LF≥1.7 ）. Posterior best fit surface （ PBFS）, posterior elevation （ PE）, anterior chamber depth （ ACD ） and the minimum anterior chamber angle（MACA） change were measured using Pentacam preoperatively, 2 days,7 days, 1 month and 3 months postoperatively. Results Postoperative PBFS of the three groups were all significantly lower than that preoperatively; Difference between PBFS of group A 3 months after the operation and that preoperatively was of no statistical significance （P 〉 0.05 ） ; PBFS of group B and group C 3 months after the opera-tion were lower than those preoperatively. No linear correlation was found between CCT 7 days after the operation and APBFS （ D-value between Preoperative PBFS and that 3 days after the operation）, preoperative CCT, preoperative diopter, postoperative RBT and LF. No significant difference existed among PE of the 3 groups at all postopera-tive points-in-time and those preoperatively, respectively （ all P 〉 0.05 ）. No significant difference existed among ACD of group A at all postoperative points-in-time and that preoperatively（ all P 〉 0.05 ） ;ACD of group B and group C 3 months after the operation were lower than those preoperatively. No significant difference were observed among ACD of the 3 groups at all postoperative points-in-time and those preoperatively, respectively（ all P 〉 0.05 ）. Conelusion The corneal posterior surface moved forward 7 days after the operation,and moved backward later,mostly it could recover 3 months after the operatio

关 键 词：准分子激光原位角膜磨镶术 PENTACAM 角膜后表面 前房 

分 类 号：R779.6[医药卫生—眼科]