全飞秒激光近视矫正术中切削比与全眼像差及角膜生物力学效应的相关性研究  

Study on Correlation of Ablation Ratio with Total Ocular Aberrations and Corneal Biomechanical Effects in Total Femtosecond Laser Myopia Correction

作　　者：李忠政 张历浊 金蕊 LI Zhongzheng;ZHANG Lizhuo;JIN Rui(Department of Refractive Correction Center,Qinhuangdao Optometry Ophthalmology Hospital,Qinhuangdao 066000,China)

机构地区：[1]秦皇岛视光眼科医院屈光矫正中心,秦皇岛市066000

出　　处：《中国激光医学杂志》2022年第2期89-94,共6页Chinese Journal of Laser Medicine & Surgery

基　　金：秦皇岛市科学技术局基金项目(201902A247)。

摘　　要：目的探讨全飞秒激光近视矫正术中切削比与全眼像差及角膜生物力学效应的相关性。方法回顾性分析2018年2月至2020年6月,行小切口角膜基质透镜取出术(small incision lenticule extraction,SMILE)的患者87例148只眼的临床资料。激光治疗能量110~150 nJ,光学区6.5 mm,角膜帽直径7.5 mm、厚度120μm。根据术中切削比不同分为三组,分别为A组患者28例48只眼,切削比<0.16;B组患者30例52只眼,切削比0.16~0.21;C组29例48只眼,切削比>0.21。比较三组术前和术后1个月的裸眼视力、最佳矫正视力、球镜度数、柱镜度数、全眼像差和角膜生物力学参数。分析切削比与全眼像差及角膜生物力学的相关性。结果治疗后1个月,三组患者的裸眼视力、最佳矫正视力均较术前增加;球镜度数、柱镜度数较术前降低(P<0.05)。三组术前、术后1个月裸眼视力、最佳矫正视力、球镜度数、柱镜度数的组间比较,差异无统计学意义(P>0.05)。术后1个月,三组全眼总像差(total aberrations,TA)、总低阶像差(total low order aberrations,tLOAs)、离焦、散光、角膜滞后量、角膜阻力因子、校正角膜滞后量、校正角膜阻力因子较术前减小,总高阶像差(total high order aberrations,tHOAs)、球差、彗差较术前增大(P<0.05)。术后1个月,B组与C组的tHOAs、球差高于A组,同时C组高于B组(P<0.05);B组与C组的校正角膜滞后量、校正角膜阻力因子低于A组,同时C组低于B组(P<0.05)。结论SMILE术中切削比会影响术后全眼像差及角膜生物力学,切削比与SMILE术后tHOAs、球差呈正相关,与校正角膜滞后量、校正角膜阻力因子呈负相关。Objective To explore the correlation of ablation ratio with total eye aberrations and corneal biomechanical effects in the total femtosecond laser myopia correction.Methods The clinical data of 87 patients(148 eyes)given SMILE surgery over the period from Feb.2018 to Jun.2020 were retrospectively analyzed.According to the intraoperative ablation ratio,the patients were divided into group A(ablation ratio<0.16,28 cases with 48 eyes),group B(ablation ratio:0.16-0.21,30 cases with 52 eyes),and group C(ablation ratio>0.21,29 cases with 48 eyes).The naked vision,best corrected visual acuity,spherical power,cylinder power,total eye aberration parameters and corneal biomechanics parameters of the three groups before and 1 month after the operation were compared respectively.The correlation between ablation ratio,total eye aberration and corneal biomechanics was analyzed.Results One month after the treatment,the naked eye vision and best corrected visual acuity of the three groups were higher than those before the treatment,while the spherical power and cylindrical power being lower(P<0.05).The difference between the three groups in uncorrected visual acuity,best corrected visual acuity,spherical power or cylinder power was not statistically significant(P>0.05)both before the operation and 1 month after the operation.One month after the surgery,in all the three groups,total aberrations(TA),total low-order aberrations(tLOAs),defocus,astigmatism,corneal lag,corneal resistance factor,corrected corneal lag and corrected corneal resistance factor were lower than those before the operation,but total high-order aberrations(tHOAs),spherical poor and coma larger(P<0.05).One month after the surgery,the tHOAs and spherical aberrations of group B and C were higher than those of group A,while those of group C being higher than those of group B(P<0.05).In addition,the corrected corneal lag and corrected corneal resistance factor of group B and C were lower than those of group A while those of group C being lower than those of group B(

关 键 词：小切口角膜基质透镜取出术 切削比 全眼像差 角膜生物力学 

分 类 号：R779.63[医药卫生—眼科] R778.11[医药卫生—临床医学]