FS-LASIK手术中动态眼球旋转的相关影响因素  

Factors that Affect the Dynamic Cyclotorsion Component during Femtosecond Laser in Situ Keratomileusis

作　　者：陈世豪 文佩 瞿佳 胡晓建 张佳 Shihao Chen;Pei Wen;Jia Qu;Xiaojian Hu;Jia Zhang(Eye Hospital, Wenzhou Medical University, Wenzhou 325027, Chin)

机构地区：[1]温州医科大学附属眼视光医院,325027

出　　处：《中华眼视光学与视觉科学杂志》2018年第4期198-203,共6页Chinese Journal Of Optometry Ophthalmology And Visual Science

摘　　要：目的：评估飞秒激光制瓣准分子激光原位角膜磨镶术（FS-LASIK）术中动态眼球旋转（DCC）的相关影响因素。方法：回顾性系列病例研究。选取2015 年6 月至2016 年7 月在温州医科大学附属眼视光医院接受FS-LASIK手术的近视散光患者500例（1 000眼），术中采用阿玛仕准分子激光仪进行激光切削，测量并记录手术过程中DCC值。左右眼DCC的差异比较采用配对t检验；年龄、眼别、性别、术前等效球镜度（SE）、术前球镜度、术前柱镜度、切削直径、切削时间、中央切削深度、激光腔内平均温度及湿度等对DCC的影响采用多元线性回归进行分析。截断点的取得使用受试者工作特征曲线（ROC）分析。结果：术中测得平均DCC幅度为1.61°±0.90°，其中右眼DCC为1.50°±0.85°，左眼为1.71°±0.94°，左右眼差异有统计学意义（t=-4.85，P 〈 0.001）。平均DCC旋转角度范围为1.44°±0.93°，其中右眼的DCC旋转角度范围为1.32°±0.91°，左眼为1.56°±0.95°，左右眼差异有统计学意义（t=-4.87，P 〈 0.001）。多元线性回归分析显示切削时间（β=0.022，P 〈 0.001）、年龄（β=-0.026，P 〈 0.001）、眼别（β=-0.213，P 〈 0.001）、激光腔内湿度（β=-0.018，P=0.008）对DCC幅度有影响；眼别（β=-0.238，P 〈 0.001）、年龄（β=-0.019，P=0.001）、激光腔内湿度（β=-0.016，P=0.025）对DCC旋转角度范围有影响。结论：FS-LASIK术中，年龄、眼别、切削时间及激光腔内平均湿度会对DCC产生影响。Objective： To analyze the factors that affect the dynamic cyclotorsion component （DCC） during femtosecond laser in situ keratomileusis （FS-LASIK）. Methods： In this retrospective study, we analyzed 500 patients （1 000 eyes） who underwent bilateral FS-LASIK for correction of myopic astigmatism from June 2015 to July 2016 at Eye Hospital, Wenzhou Medical University. Ablation was performed using the SCHWIND AMARIS （750S） excimer laser system, and the magnitude of dynamic cyclotorsion was recorded during the operation. Differences of DCC between left and right eyes were compared with paired t-tests. The factors that affect DCC were analyzed using multivariate linear regression. The main factors were age, eye （right or left）, gender, spherical equivalent （SE）, pre-ablation spherical and astigmatism,ablation zone, ablation time, central ablation depth, and temperature and humidity in the laser cavity. The cut-off points were measured using receiver operating characteristic curves. Results： The mean DCC amplitude was 1.61°±0.90°, with 1.50°±0.85° in right eyes and 1.71°±0.94° in left eyes （t=-4.85, P〈0.001）.The mean dynamic cyclortorsion degree （absolute value） was 1.44°±0.93°, with 1.32°±0.91° in right eyes and 1.56±0.95° in left eyes （t=-4.87, P〈0.001）. Ablation time （β=0.022, P〈0.001）, age （β=-0.026,P〈0.001）, eye （right or left, β=-0.213, P〈0.001）, and humidity in the laser cavity （β=-0.018, P=0.008） were statistically significant factors for the DCC amplitude. Eye （right or left, β=-0.238, P〈0.001）, age （β=-0.019, P=0.001）, and humidity in the laser cavity （β=-0.016, P=0.025） were significant factors for the absolute degree of DCC. Conclusions： Ablation time, age, eye （right or left）, and humidity in the laser cavity can affect the DCC during binocular FS-LASIK.

关 键 词：飞秒激光 准分子激光原位角膜磨镶术 动态眼球旋转 

分 类 号：R779.63[医药卫生—眼科]