LASEK手术角膜厚度和后表面高度的变化  

Changes in corneal thickness and the posterior corneal surface elevation after LASEK

作　　者：郝更生[1] 胡卜丹 刘宗顺[1] 曾莉[1] 刘琼[1] 毛科[1] 

机构地区：[1]四川省乐山市人民医院眼科,614000

出　　处：《临床眼科杂志》2015年第6期524-527,共4页Journal of Clinical Ophthalmology

摘　　要：目的应用Pentacam眼前节分析系统测量近视眼准分子激光上皮下角膜磨镶术（LASEK）手术后角膜厚度和后表面高度的变化情况,评估LASEK手术的安全性。方法回顾性分析研究。收集LASEK近视及近视散光患者119例（237眼）,比较术前和术后6个月以后的随访期中应用Pentacam检测的角膜厚度和后表面高度及最佳拟合球面（BFS）半径的变化。结果术前角膜厚度（547.74±33.86）μm,预计术后角膜厚度（438.71±42.01）μm,术后实际角膜厚度（468.60±39.90）μm,角膜厚度预计值和术后实际值差异有统计学意义（t=34.30,P=0.000）。术前角膜后表面高度（0.17±2.71）μm,术后角膜后表面高度（0.63±4.47）μm,差异无统计学意义（t=-1.8341,P=0.068）。术后角膜后表面高度前移-8~12μm,平均（0.43±3.86）μm。术前BFS半径（6.37±0.22）mm,术后BFS半径（6.35±0.22）mm,差异有统计学意义（t=4.68,P=0.000）,术后比术前的曲率半径减少了0.02 mm。不同切削比分组比较,切削比〈0.20、0.21~0.29和≥0.30组间角膜后表面高度的前凸量差异有统计学意义。结论 LASEK手术后角膜实际厚度大于预计厚度,角膜后表面高度变化量微小。术前BFS半径小,角膜后表面高度较大时,需注意控制切削比。Objective To investigate the changes in corneal thickness and the posterior corneal surface elevation after laser-assisted subepithelial keratomileusis（ LASEK） using Oculus Pentacam,and to evaluate the safety of LASEK.Methods In this retrospective study,Authors examined 237 eyes of 119 patients who had LASEK. Topography of posterior corneal surface was obtained with a Pentacam system. Elevation of posterior corneal surface and the radius of best fit sphere（ BFS） were analyzed. Results Preoperative corneal thickness was 547. 74 ± 33. 86 μm. The estimated postoperative corneal thickness was 438. 71 ± 42. 01 μm. The actual postoperative corneal thickness was 468. 60 ± 39. 90 μm. There was a significant difference between the estimated and the actual postoperative corneal thickness（ t = 34. 30,P = 0. 000）. Posterior corneal elevation was 0. 17 ± 2. 71 μm before surgery and 0. 63 ± 4. 47 μm after surgery（ t =- 1. 8341,P =0. 068）. The posterior corneal surface had a forward shift of 0. 43 ± 3. 86 μm. The radius of the BFS was 6. 37 ± 0. 22 mm preoperatively and 6. 35 ± 0. 22 mm postoperatively（ t = 4. 68,P = 0. 000）. Patients were divided into three groups according to the ablation ratio. The posterior corneal elevation has a significant difference between the patients received laser ablation 0. 20 and those with ablation ≥0. 30,and between patients with ablation of 0. 21 ~ 0. 29 and with ablation ≥0. 30,respectively. Conclusion After the LASEK by MEL 80,the actual postoperative corneal thickness was thicker than predicted,and the posterior corneal surface has a tiny forward shift. Eyes with smaller radius of BFS and higher elevation posterior surface may have an increased tendency of a corneal forward shift,and the ablation ratio is needed to be controlled.

关 键 词：角膜厚度 后表面 高度 准分子激光手术 

分 类 号：R779.63[医药卫生—眼科]