圆锥角膜生物力学在Corvis ST与ORA下的变化特点  

The characteristics of keratoconus biomechardcal properties measuring by Corvis ST and ORA

作　　者：李勇[1] 魏升升[1] 李晶[1] 刘建国[1] 叶璐[1] 万雅群[1] 李娟[1] 杜婧[1] 

机构地区：[1]西安市第四医院眼科激光视力矫正中心,陕西省西安市710004

出　　处：《中国实用眼科杂志》2015年第8期881-884,共4页Chinese Journal of Practical Ophthalmology

基　　金：陕西省社会发展攻关项目（2013K14-02-18）;西安市社会发展引导项目（SF1315（3））

摘　　要：目的应用可视化角膜生物力学分析仪（corneal visualization scheimpflug technology，Corvis ST）和眼反应分析仪（ocular response analyze，ORA）分析圆锥角膜生物力学变化，并与正常角膜作对照，总结圆锥角膜生物力学变化特点。方法临床病例对照研究。选取2009年3月至2014年6月在西安市第四医院眼科就诊的患者，应用角膜生物力学眼压分析仪（Corvis ST）和眼反应分析仪（ORA）分别对34例（42只眼）圆锥角膜和61例（61只眼）正常角膜进行生物力学的测量。应用Corvis ST测定角膜的第一次压平长度（1stA length）；第一次压平速率（Vin）；第二次压平长度（2ndA length）；第二次压平速率（Vout）；角膜最大变形幅度（Def．Ampl）；顶点距离（P．Dist）和曲率半径（Radius）。用眼反应分析仪ORA测定圆锥角膜及正常角膜CH和CRF。采用独立样本t检验或两独立样本非参数检验对圆锥角膜与正常角膜的ORA和Corvis ST的测量所得多项指标进行对比分析。采用Pearson或Spearman相关分析Corvis ST与ORA测量生物力学参数之间相关性。结果：与正常角膜对比，圆锥角膜生物力学指标Corvis ST测量结果中，第一次压平长度、曲率半径下降，差异有统计学意义（t=-0．51，-6．54；P=0．01，0．00）；第二次压平速率绝对值、角膜最大变形幅度升高，差异有统计学意义（Z=-2．25，t=4．27；P=0．03，0．00）。圆锥角膜生物力学指标ORA测量结果中角膜滞后量（CH）、角膜阻力因数（CRF）与正常角膜相比均下降，有统计学意义（t=-5．20，-7．06；P=0．00，0．00）。ORA测量CH与Corvis ST测量第一次压平长度、第二次压平速率、角膜最大变形幅度、曲率半径，差异有统计学意义（r=-0．75，-0．54，-0．39，0．51；P=0．00，0．04，0．03，0．00）；ORA测量CRF与Corvis ST测量第一次压平长度、第二次压平速率、角膜最大变形幅�Objective To investigate the characteristics of keratoconus biomechanical properties by comparing normal eyes. Methods In this case control study, patients from March 2009 to June 2014 were included. The corneal biomechanical properties of 34 keratoconus patients （42 eyes） and 61 normal patients （61 eyes） were measured with Corneal Visualization Scheimpflug Technology （Corvis ST） and Ocular Response Analyze （ORA）. The Length of Appl 1 （1st A length）, Velocity of Appl 1 （Vin）, Length of Appl 2 （2nd A length）, Velocity of Appl 2 （Vout）, Deformation Amplitude （DA）, EDist and Radius were measured with Corvis ST. CH and CRF were measured with ORA. Comparison of keratoconic and normal eye＇s measurement values from ORA and Corvis ST were performed using Paired t test or Two independent tests. Pearson or Spearman correlations were used to evaluate the relationship between Corvis ST and ORA in measurement of keratoconus biomechanical. Results Comparing normal eye＇s biomechanical properties measurement values, the 1stA length and Radius significantly decreased in keratoconus eyes, and there were significantly statistical difference （t =-0.51,-6.54; P =0.01,0.00）, however, the Vout absolute value and Def.Ampl increased in keratoconus eyes, and there were significantly statistical difference （Z =-2.25, t =4.27; P =0.03,0.00）. The CH and CRF of ORA also decreased in keratoconus eyes, and there were significantly statistical difference （t =-5.20,-7.06; P =0.00, 0.00）. There were significant correlations between CH of ORA and lstA length, Vout, Def.Ampl and Radius of Corvis ST （P =0.00, 0.04, 0.03, 0,00）. There were significant correlations between CRF of ORA and lstA length, Vout, Def.Ampl and Radius of Corvis ST （P =0.02, 0.03, 0.00, 0.00）. Conclusions Comparing normal eyes, the biomechanical properties parameters changed obviously in keratoconus eyes. There are significant relationships in measurement of keratoconus biomechanical changes with Corvis ST and ORA.

关 键 词：圆锥角膜 生物力学 Corvis ST ORA 

分 类 号：R684.7[医药卫生—骨科学]