全激光T-PRK手术对近视眼角膜后表面形态影响的临床观察  

Clinical observation of changes in posterior corneal surface after transepithelial photorefractive keratectomy

作　　者：苏燕[1] 侯杰[1] 郑秀云[1] 雷玉琳[1] 

机构地区：[1]济南市明水眼科医院,山东250200

出　　处：《眼科》2014年第3期161-164,共4页Ophthalmology in China

摘　　要：目的探讨全激光经角膜上皮的激光角膜切削术(T-PRK)矫治近视眼后角膜后表面形态的变化,并与准分子激光角膜上皮瓣下磨镶术(Epi-LASIK)进行比较。设计前瞻性比较性病例系列。研究对象济南明水眼科医院2013年7月至2014年1月行表层准分子激光手术的近视及近视散光患者68例(134眼),其中T-PRK组46例(81眼),Epi-LASIK 22例(53眼)。方法使用Pentacam眼前节分析系统分别于术前及术后1周、1、3和6个月测量角膜后表面高度及非球面参数Q值。主要指标角膜后表面高度及非球面参数Q值。结果两组术后角膜后表面高度均较术前发生轻度的位置后移,T-PRK组在术后1、3及6个月时,Epi-LASIK组在术后6个月时,较术前差异有统计学意义(P均<0.05)。两组角膜后表面Q值较术前差异均无明显变化(P均>0.05)。两组之间比较,无论是角膜后表面高度还是Q值的差异均无统计学意义(P均>0.05)。结论全激光T-PRK矫正近视术后角膜后表面高度有轻度位置后移的现象,但并未影响后表面整体的非球面形态。Objective To observe the changes of posterior corneal surface after transepithelial photorefractive keratectomy （T-PRK） and epipolis laser in situ keratomileusis （Epi-LASIK） for myopia. Design Prospective comparetive case series. Participants 134 eyes of 68 miopia patients were divided into T-PRK group （81 eyes） and Epi-LASIK group （53 eyes）. Methods Posterior corneal elevation and Q-value were analyzed using pentacam before and 1 week, 1, 3 and 6 months after operation,respectively. Main Outcome Measures Posterior coneal elevation and Q-value. Results In the T-PRK group, at 1st and 6th month after surgery and in the Epi-LASIK group at 6th month after surgery, the posterior corneal elevation have a statistically significant backward displacement（all P〈0.05）. No statistically significant difference was found in the postoperative corneal Q-value in both groups before and after surgery （all P〉0.05）. There was also no statistically significant difference of postoperative corneal surface elevation and Q-value between the two groups （all P〉0.05）. Conclusion The posterior corneal elevation showing a backward displacement after T-PRK for myopia,while posterior corneal asphericity has no changed.

关 键 词：近视 角膜屈光手术 角膜后表面 Q值 

分 类 号：R779.63[医药卫生—眼科]