不同瞳孔直径下角膜前表面散光与全角膜散光的差异及影响因素  

Difference between the anterior and total corneal astigmatism under different pupil diameters and associated risk factors

作　　者：邓嘉进 邵东平 张劲松 Deng Jiajin;Shao Dongping;Zhang Jinsong(Department of Ophthalmology, Nanhai Hospital Affiliated to Southern Medical University,Foshan 528200,China;Department of Ophthalmology,Shenyang Aier Excellent Eye Hospital,Shenyang 110001,China)

机构地区：[1]佛山市南海区人民医院眼科,佛山528200 [2]沈阳爱尔卓越眼科医院眼科,110001

出　　处：《临床眼科杂志》2021年第5期423-427,共5页Journal of Clinical Ophthalmology

基　　金：佛山市卫生和计生局医学科研课题项目(20190272)。

摘　　要：目的探讨在不同瞳孔直径下角膜前表面散光与全角膜散光的差异,及其影响因素。方法前瞻性病例对照研究。记录在南方医科大学附属南海医院行LUMENIS眼前段分析仪检查的430例(796只眼)患者在不同瞳孔直径下角膜前表面散光值及散光轴位、全角膜散光值及散光轴位,记录每个检查患者的年龄、角膜平均屈光力、角膜散光值、角膜中央厚度、中央前房深度。采用Wilcoxon秩检验对比不同瞳孔直径下角膜前表面散光和全角膜散光的一致性,分析不同瞳孔直径下两组散光值差、轴位差的频数分布,并用回归分析探讨在8 mm瞳孔直径下的角膜前表面散光和全角膜散光差异的影响因素。结果瞳孔直径在1、3、5、8 mm时,角膜前表面、全角膜散光值相比差异均有统计学意义(均为P<0.001)。瞳孔直径在8 mm时,两组散光轴位差相比差异有统计学意义(均P<0.05)。大部分患者两组散光值差、轴位差相差较小,但在大瞳孔直径下,两组散光值差异明显的比例较多,而在不同瞳孔直径下,两组散光轴位差异明显的比例差别不大。瞳孔直径在8 mm时,角膜前表面、全角膜散光值的差值与年龄呈正相关(P<0.001),与中央前房深度呈负相关(P=0.01),两组散光轴位的差值与年龄呈正相关(P<0.001),与角膜中央厚度呈正相关(P<0.05),与角膜散光值呈负相关(P<0.001)。结论在不同瞳孔直径下,角膜前表面散光值均不能替代全角膜散光值,而在大瞳孔直径下,角膜前表面散光轴位不能替代全角膜散光轴位。在大瞳孔直径下,两组散光值差明显的比例较大。当瞳孔直径在8 mm时,两组散光值的差值随年龄增大而增大,随前房深度增加而减少;两组散光轴位的差值随年龄、角膜厚度增大而增大,随散光值增大而减少。Objective To investigate the difference between the anterior corneal astigmatism and total corneal astigmatism under different pupil diameters and associated risk factors.Methods The magnitude and meridian of anterior corneal astigmatism and total corneal astigmatism in 430 patients(796 eyes)at the Nanhai Hospital affiliated to Southern Medical University were detected by the LUMENIS front segment analyzer.The corresponding age,value of astigmatism,anterior chamber depth,corneal thickness,refraction of cornea were also recorded.The Wilcoxon rank test was used to compare the difference between the anterior corneal astigmatism and total corneal astigmatism under different pupil diameters,and to analyze the frequency distribution of the difference in astigmatism value and axis position between the two groups under different pupil diameter.Regression analysis was used to explore the risk factors for the difference between anterior corneal astigmatism and total corneal astigmatism under 8 mm pupil diameter.Results When the pupil diameter was 1 mm,3 mm,5 mm and 8 mm,there were statistically significant differences between the anterior corneal astigmatism and total corneal astigmatism value(P<0.001).When the pupil diameter was 8 mm,the difference of astigmatism axis between the two groups was statistically significant(P<0.05).Most subjects had small between-groups differences of astigmatism value or axis.However under large pupil size,a larger between-group difference in astigmatism value was observed.The difference of astigmatism axis between the two-groups did not vary significant under different pupil diameters.The difference of astigmatism value was positively correlated with age(P<0.001),and negatively correlated with anterior chamber depth(P=0.01).The difference of astigmatism axis between two groups was positively correlated with age(P<0.001)and corneal thickness(P<0.05),and negatively correlated with the astigmatism value(P<0.001).Conclusions Under different pupil diameters,the anterior corneal astigmatism value

关 键 词：角膜散光 瞳孔直径 相关因素 

分 类 号：R47[医药卫生—护理学]