角膜厚度不均匀性与薄点瞳心距关系及其对LASEK矫正散光影响  

Relationship between the distance from thinnest point to pupil center and unevenness of corneal thickness and the influence of the unevenness on correction of astigmatism by LASEK

作　　者：王树林[1] 史伟云[2] 刘明娜[2] 王海莹[2] 李静[2] 

机构地区：[1]郑州人民医院眼科,河南省郑州市450003 [2]山东省医学科学院山东省眼科研究所山东省眼科医院,山东省济南市250021

出　　处：《中国实用眼科杂志》2013年第8期1021-1024,共4页Chinese Journal of Practical Ophthalmology

基　　金：国家自然科学基金（11204277）

摘　　要：目的采用Pentacam观察角膜最薄点和瞳孔中心之间的距离（DTP）与角膜厚度分布不均匀性的关系，并探讨其对准分子激光上皮下角膜磨镶术（LASEK）矫正散光效果的影响。方法选取行LASEK矫正近视合并散光且术后6个月随访资料完整的106只眼，分为中低度散光组（-0．25～2．00D）54只眼和高度散光组（-2．25—4．00D）52只眼。根据Pentacam的检测结果计算DTP，以角膜最薄点为圆心，计算直径为3．0mm（D3．0mm）和6．5mm（D6．5mm）的同心圆与角膜厚度变化最大和最小子午线交点处厚度的差值。利用标准矢量分析法评估LASEK术后6个月时散光的矫正效果。结果106只眼的DTP为（0．64±0．23）mm，D6．5mm为（55．61±18．57）μm，D3．0mm为（16．71±4．45）μm，中低度散光组的D6．5mm小于高度散光组，差异有统计学意义（P〈0．05）。106只眼的DTP分别和D6．5mm，D3．0mm呈正相关（r=0．43，0．49，P〈O．01），D6．5mm和D3．0mm呈正相关（，=0．42，P〈0．01）。术后6个月中低度散光组的lEVI（矢量误差的绝对值）小于高度散光组，差异有统计学意义（P〈0．05）。高度散光组的IEVI与D6．5mm呈正相关（r=0．47，P〈0．05）。结论角膜最薄点和瞳孔中心的距离可能与角膜厚度分布的不均匀性有关，角膜厚度分布的不均匀性可能会影响LASEK对高度散光的矫正效果。Objective To observe relationship between the distance from thinnest point to pupil center （DTP） and unevenness of distribution of corneal thickness using Pentacam, and to investigate influence of unevenness of distribution on the correction of astigmatism by LASEK. Methods One hundred and six myopic astigmatism eyes treated with LASEK were divided into two groups, low-midrange astigmatism （-0.25D--2.00D） group and high astigmatism （-2.25D--4.00D） group. The following-up period was for 6 months. The DTP, and the unevenness of distribution of corneal thickness of 3.0mm （D3.0mm） and 6.5mm （D6.5mm） area were calculated. The correction of myopic astigmatism by LASEK based on standard vector analysis was evaluated. Results The DTP was （0.64±0.23） mm, D6.5mm was （55.61±18.57） μm and D3.0mm was （16.71±4.45） μm in 106 eyes. The D6.5mm of low-midrange astigmatism group was significant lower than that of high astigmatism group （P 〈0.05）. In 106 eyes, the DTP was positively correlated with D6.5mm and D3.0mm respec- tively （r =0.43, 0.49, P 〈0.01）. The D6.5mm was positively correlated with D3.0mm （r =0.42, P 〈0.01）. The [ EV] （absolute error vector） of low-midrange astigmatism group was significant lower than that of high astigmatism group （P 〈0.05）. The [ EV ] of high astigmatism group was positively correlated with D6.5mm （r =0.47, P 〈0.05）. Conclusions The distance from thinnest point to pupil center is correlated with the unevenness of distribution of corneal thickness. The unevenness of distri bution of corneal thickness may influence the outcome of correction of myopia with high astigma-tism by LASEK.

关 键 词：角膜厚度 瞳孔 矢量分析 散光 准分子激光 

分 类 号：R777[医药卫生—眼科]