不同角膜曲率近视眼患者行LASIK后的屈光状态分析  

Analysis of Refractive State of Different Corneal Curvature after LASIK in Patients with Myopia

作　　者：林宁宁 崔珊珊 赵丹丹 LIN Ning-ning;CUI Shan-shan;ZHAO Dan-dan(Department of Ophthalmology,Central Hospital of Chaoyang,Chaoyang 122000,Liaoning,China;Department of Ophthalmology,Southeast Eye Hospital of Nanjing,Nanjing 210000,Jiangsu,China)

机构地区：[1]辽宁省朝阳市中心医院眼科,辽宁朝阳122000 [2]南京东南眼科医院眼科,江苏南京210000

出　　处：《中国现代手术学杂志》2020年第6期442-446,共5页Chinese Journal of Modern Operative Surgery

摘　　要：目的研究准分子激光原位角膜磨镶术(excimer laser in situ keratomileusis,LASIK)对不同曲率近视眼患者的临床治疗效果,并分析其影响因素。方法回顾性分析2017年6月至2018年12月期间我院收治的132例(264眼)近视患者,均行LASIK手术。根据患者术前角膜曲率将其分为低曲率(K1≤41.00 D)、常见曲率(K1>41.00 D且K2<46.00 D)以及高曲率组(K2≥46.00 D)。其中低曲率组、常见曲率组、高曲率组分别有44例(88眼)、50例(100眼)、38例(76眼)。比较三组患者术前、术后6个月的裸眼远视力,检查眼压、屈光状态,记录并发症发生情况,并采用多元线性回归方法分析手术过矫、欠矫的影响因素。结果低曲率组患者年龄显著低于常见曲率组、高曲率组,常见曲率组瞳孔直径显著低于低曲率组、高曲率组(P<0.05)。高曲率组中有18例(47.37%)患者继发圆锥角膜,发生率显著高于低曲率组、常见曲率组(P<0.05)。4 mm直径范围常见曲率组的Error值明显大于低曲率组、高曲率组(P<0.05)。多元线性回归分析显示4 mm直径范围内术前等效球镜度数以及术后球差是影响屈光状态、角膜曲率相互关系的重要因素(P<0.05),得到线性回归方程为:手术前后4 mm直径范围Error=-23.262+0.386×术前等效球镜度数+2.685×术后球差。结论近视眼患者不同角膜曲率会影响LASIK术后屈光状态,高曲率患者易继发圆锥角膜,并出现过度矫正,低曲率患者易出现矫正不足。Objective To study the clinical effect of LASIK on myopia with different curvature,and to analyze the influencing factors.Methods 132 cases(264 eyes)of myopia hospitalized from June 2017 to December 2018 were analyzed retrospectively.According to the preoperative corneal curvature,the patients were divided into low(K1≤41.00D),common(K1>41.00D and K2<46.00D)and high curvature group(K2≥46.00D),with 44 cases(88 eyes),50 cases(100 eyes)and 38 cases(76 eyes)for each.The uncorrected distance visual acuity of the patients in the three groups were compared before and 6 months after operation.Intraocular pressure and refractive status were examined and the complications were recorded.The influencing factors of over correction and under correction were analyzed using multiple linear regression method.Results The age of the low curvature group was significantly lower than that of the common curvature group and the high curvature group,and the pupil diameter in the common curvature group was significantly lower than that of the low curvature group and the high curvature group(P<0.05).In the high curvature group,18 patients(47.37%)had secondary keratoconus,and the incidence was significantly higher than that of the low curvature group and the common curvature group(P<0.05).The error value of common curvature group in 4 mm diameter range was significantly higher than that of low curvature group and high curvature group(P<0.05).Multiple linear regression analysis showed that the preoperative equivalent spherical lens power and postoperative spherical aberration were the important factors affecting the relationship between the refractive status and corneal curvature(P<0.05).The linear regression equation of 4mm diameter range before and after operation Error=-23.262+0.386×preoperative equivalent spherical power+2.685×postoperative spherical aberration.Conclusion Different corneal curvatures in patients with myopia can affect the refractive status after LASIK.Patients with high curvature are likely to have secondary keratoc

关 键 词：近视 角膜曲率 准分子激光原位角膜磨镶术 屈光 

分 类 号：R778.1[医药卫生—眼科] R779.63[医药卫生—临床医学]