近视眼LASIK手术前后调节所致眼前段结构变化的比较  

Comparison of anterior segment changes resulted from accommodation before and after LASIK in myopia

作　　者：周少博[1] 李辉[1] 洪海峰[1] 谭娟[1] 

机构地区：[1]广州医学院第一附属医院,广东510120

出　　处：《中国实用眼科杂志》2014年第8期984-987,共4页Chinese Journal of Practical Ophthalmology

基　　金：广东省医学科学技术研究基金（A2012244）;广州医学院科学研究项目（2012C81）

摘　　要：目的 探索近视眼LASIK手术前后调节致眼前段结构变化的差异.方法 临床病例系列研究.对2010年3～8月在广州医学院第一附属医院眼科就诊的60例年龄在18～39岁近视患者,按近视程度分为轻中度近视组和高度近视组,统一行标准的LASIK手术,分别于术前、术后1周、1、3个月用眼前段OCT对非主导眼进行不同调节状态下眼前段扫描分析,测量该眼在调节放松（0.0 D）和诱发3.0 D调节两种状态下的眼前段参数术后变化,包括角膜后表面曲率、前房深度、晶状体厚度和暗瞳直径的大小.结果 60例患者,轻中度近视组32例,高度近视组28例.两组患者在调节放松状态下（0.0 D）,角膜后表面曲率、前房深度、晶状体厚度和瞳孔直径在手术前后各时期的差异比较均无统计学意义（P＞0.05）.在诱发3.0 D调节时,轻中度近视组与高度近视组,角膜曲率、前房深度和瞳孔直径在术前和术后1周、1、3个月的变化差异比较无统计学意义（P＞0.05）;但晶状体厚度在各时期的变化差异比较有统计学意义（F轻中度近视组=3.595,P =0.025;F高压近视组=3.310,P=0.046）,轻中度近视组术后1周晶状体的变化量较术前减少,高度近视组晶状体的变化量术后3个月较术前增大.结论 近视眼LASIK手术前后调节所致的眼前段改变,不同程度近视和不同部位在不同时期有所差异,调节所致的角膜后表面曲率和瞳孔直径变化在手术前后无明显差异;术后早期（1周）调节所致的晶状体改变量均低于术前,术后1个月可以恢复至术前水平,术后远期（3个月）,高度近视调节所致晶状体的变化量甚至高于术前水平.Objective To evaluate the difference of anterior segment changes resulted from accommodation before and after LASIK in myopia.Methods Sixty myopic patients with the age from 18 to 39 years who were going to undergo standard LASIK were enrolled in this study and were divided into two groups：low to moderate myopic group （〉-6.0D）,and high myopic group （≤-6.0D）.Anterior segment measurements were performed by anterior segment optic coherence tomography （OCT） in undominant eye under three different accommodative state of relax （0.0 D） and 3.0 D before LASIK and one week,one month,and 3 months after LASIK.The changes in posterior corneal curvature （PCC）,anterior chamber depth （ACD）,lens thickness （LT）,pupil diameter （PD） with accommodation at different time after LASIK were compared with those measured before LASIK.Results There were no significant differences between preoperative PCC,ACD,LT,PD and those of post-operation at the state of non-accommodated in both groups （all P 〉0.05）.Compared with pre-operation,the mean changes of LT induced by 3.0D accommodation were significantly decreased in both groups at 1 week postoperatively （all P 〈0.05）.There were no significant differences between preoperative alteration in anterior segment induced by accommodation and 1-month postoperative alteration in both groups （all P 〉0.05）.Changes of LT were significantly increased in 3 months after surgery in high myopia.Conclusions The changes of LT induced by accommodation in myopia seem to be decreased in the early days after LASIK and may recover or even increase at one to three months,which may be the mechanism that accommodative function changes after LASIK.

关 键 词：角膜磨镶术 激光原位 近视 调节 

分 类 号：R779.63[医药卫生—眼科]