正常角膜生物力学伴异常角膜后表面高度的影响因素  

Factors influencing abnormal posterior corneal surface elevation with normal corneal biomechanical parameters

作　　者：周健慧 余鹏 ZHOU Jianhui;YU Peng(Nanjing Aier Eye Hospital,Nanjing 210004,Jiangsu Province,China;Wuxi Huaxia Eye Hospital,Wuxi 214002,Jiangsu Province,China)

机构地区：[1]南京爱尔眼科医院,江苏省南京市210004 [2]无锡华厦眼科医院,江苏省无锡市214002

出　　处：《眼科新进展》2024年第3期223-229,共7页Recent Advances in Ophthalmology

摘　　要：目的 研究正常角膜生物力学状态下近视人群中角膜后表面异常高度的影响因素。方法 回顾性系列病例对照研究。选取2022年4月至2022年12月于南京爱尔眼科医院拟接受屈光手术的术前检查近视患者99例(99只右眼)为研究对象。患者均行常规术前检查,并使用Pentacam联合Corvis ST进行角膜形态学及生物力学检查。角膜生物力学参数(CBI,即使用Corvis ST测量的角膜生物力学指数)正常者,根据Pentacam三维眼前节分析系统的BAD III-Belin/Ambrósio增强扩张(BAD,角膜扩张分析)显示的后表面高度变化值(BD,即增强后表面高度与正常后表面高度差值)进行后表面高度分组研究,分组标准为:A组(33例33眼)为BD值<12μm,即对照分组;B组(32例32眼)为12μm≤BD值≤16μm,即角膜可疑分组;C组(34例34眼)为BD值>16μm,即角膜异常分组。收集患者性别、年龄等基本资料;纳入眼部基本参数,包括眼压、等效球镜度(SE)、角膜最薄点厚度(THP)、前房深度(ACD);纳入Pentacam获得的角膜形态学参数,包括角膜水平直径(HWTW)、BD值、前表面曲率、后表面曲率(PSK)、BAD系统相关指标[包括角膜前表面高度偏差值(Df)、角膜厚度进展偏差值(Dp)、角膜最薄点偏差值(Dt)、总偏差值(Do)等]以及角膜厚度进展相关指标(PPI);纳入Corvis ST角膜生物力学整合参数,包括硬度参数、综合半径(IR,反向凹面半径曲线下的面积)、水平方向Ambrósio相关厚度(ARTh,为最薄点厚度/厚度变化率)、形变幅度比值进行研究。使用单因素方差分析及H检验进行组间差异性比较,使用Spearman秩相关分析各分组的BD值与眼部参数间相关性,并建立多元Logistic回归模型进一步明确角膜生物力学正常状态下影响BD值分类的主要因素,根据Logistic回归方程绘制正常角膜生物力学伴异常角膜后表面高度的概率分布图,最后使用ROC曲线分析Logistic回归方程的诊断效率。结果 三组患�Objective To investigate the influence factors of abnormal posterior corneal surface elevation of myopia patients under normal corneal biomechanical state.Methods A retrospective case-control study was conducted.A total of 99 myopia patients(99 right eyes)who were going to undergo refractive surgery in Nanjing Aier Eye Hospital from April 2022 to December 2022 were included.All patients received routine preoperative examinations,and the corneal morphological and biomechanical examinations were performed by Pentacam combined with Corvis ST.For patients with normal Corvis biomechanical index(CBI,corneal biomechanical indexes measured by Corvis ST),corneal back difference(BD,difference between the enhanced posterior surface elevation and the normal posterior surface elevation)obtained by BAD III-Belin/Ambrósio Enhanced Ectasia Display(BAD)of the Pentacam 3D anterior segment analysis system was used to divide the posterior corneal surface elevation into group A(BD<12μm,33 patients,33 eyes,control group),group B(12μm≤BD≤16μm,32 patients,32 eyes,suspicious corneal abnormality group),and group C(BD>16μm,34 patients,34 eyes,corneal abnormality group).Basic information about the patients,such as gender and age,was collected;ocular parameters,such as intraocular pressure,spherical equivalent(SE),thinnest pachymetry(THP)and anterior chamber depth(ACD),were included;corneal morphological parameters obtained by Pentacam,such as corneal horizontal diameter(HWTW),BD,anterior Sim Ks(ASK),posterior Sim Ks(PSK),BAD system-related indicators[including deviation of normality of the front elevation(Df),deviation of normality of pachymetric progression(Dp),deviation of normality of corneal thinnest point(Dt),and overall deviation of normality(Do)]and pachymetric progression index(PPI),were enrolled;corneal biomechanical integration parameters obtained by Corvis ST,such as stiffness parameters,integrated radius(IR,area under the inverse concave radius curve),Ambrósio relational thickness to the horizontal profile(ARTh,THP/thi

关 键 词：近视 角膜后表面高度变化值 角膜形态学 角膜生物力学 

分 类 号：R778.1[医药卫生—眼科]