LASIK治疗近视术后角膜非球面性变化多因素分析  

Changes of corneal asphericity and its related factors after laser in situ keratomileusis

作　　者：季鹏[1] 毕宏生[1] 王兴荣[1] 范华[1] 王桂敏[1] 王静波[2] 

机构地区：[1]山东中医药大学附属眼科医院山东中医药大学眼科研究所,山东250002 [2]山东省中医院

出　　处：《中国实用眼科杂志》2014年第3期311-314,共4页Chinese Journal of Practical Ophthalmology

基　　金：山东省医药卫生科技发展计划项目（2011BJYB15）;山东省医药卫生科技发展计划项目（2013WS0254）

摘　　要：目的探讨LASIK矫正近视术后角膜非球面性与角膜曲率、四阶球差变化及其相关性分析。方法对2011年6～10月在山东中医药大学第二附属医院选取采用飞秒激光制瓣虹膜识别定位LASIK治疗近视患者87例（173只眼），采用Orbscan—IIz角膜地形图检测患者术前和术后6个月时角膜中央6．0mm区平均屈光力（K值）和角膜非球面指数（Q值），采用Zywave像差仪检测术前和术后6个月的四阶球差值（4th—SA），分析手术前后Q值与K值、4th—sA的相关性。结果术前和术后6个月Q值分别为-0．13±0．09，1．05±0．54；K值（43．42±1．53）D，（38．04±1．81）D；四阶球差值（-0．12±0．15）μm，（-0．56±0．21）μm，手术前后比较差异均有统计学意义（P〈0．01）。术前Q值与K值和四阶球差差异有统计学意义（r=-0．29、r=-0．54，P〈0．01），K值和四阶球差差异无统计学意义（r=-0．001，P=0．99，P〉0．05）；术后Q值与K值和四阶球差差异有统计学意义（r=-0．76、r=-0．77，P〈0．01），K值和四阶球差差异有统计学意义（r=0．50，P〈0．01）。结论LASIK治疗近视术后角膜非球面指数有正性增大趋势，角膜曲率变平坦，四阶球差增大。Objective To investigate the corneal asphericity and corneal curvature, fourth-order spherical aberration changes and correlation analysis after laser in situ keratomileusis （LASIK） for myopia. Methods This prospective randomly study comprised 173 eyes of 87 patients treated with flap creation with the femtosecond laser combine iris recognize guided LASIK who were available for evaluation at 6 months. The fourth-order spherical aberration （4th-SA） was measured with a Zy- wave aberrometer before and 6 months postoperatively. The mean power （K value） and Corneal aspherical index （Q value） of central corneal 6.0 mm were measured with Orbscan IIz-corneal topog- raphy preoperative and 6 months postoperative, that analysis of the correlation between Q and K val- ue and the 4th-SA. Results There was a negative linear relationship between Q value and K value and 4th-spherical aberration （r =-0.29, r =-0.54, P 〈0.01）, no correlation relationship between K val- ue and 4th-spherical aberration （r =-0.001, P =0.99） preoperatively. There was a negative linear rela- tionship between Q value and K value and 4th-spherical aberration （r =-0.76, r =-0.77, P 〈0.01）, a positive linear relationship between K value and 4th-spherical aberration （r =0. 50, P 〈0.01） postoper- atively. Conclusions The corneal asphericity index changes from prolate to oblate shape after LASIK for myopia, the corneal curvature flattens,

关 键 词：角膜磨镶术 激光原位 非球面指数 球面像差 角膜屈光力 

分 类 号：R779.65[医药卫生—眼科]