角膜屈光手术对角膜生物力学影响的研究进展  

Research progress on the effect of corneal refractive surgery on corneal biomechanics

作　　者：包刀知漫(综述) 燕振国(审校) 王钰焕(综述) 江媛媛(综述) 丁建(综述) BAO Daozhiman;YAN Zhenguo;WANG Yuhuan;JIANG Yuanyuan;DING Jian(First School fo Clinical Medical,Gansu University of Chinese Medicine,Gansu Provincial Hospital,Lanzhou 730000,China;Lanzhou Huaxia Eye Hospital,Gansu University of Chinese Medicine,Lanzhou 730000,China)

机构地区：[1]甘肃中医药大学第一临床医学院,甘肃省人民医院,兰州730000 [2]甘肃中医药大学附属兰州华夏眼科医院,兰州730000

出　　处：《眼科学报》2024年第5期266-274,共9页Eye Science

摘　　要：角膜屈光手术是目前屈光手术的主流术式,随着全飞秒、全激光手术方式的发展,手术变得更加安全精准,不仅角膜创伤小,术后恢复时间也进一步缩短。角膜具有屈光特性和典型的生物软组织力学特性,角膜力学特性不仅参与维持角膜形态,影响角膜手术尤其屈光手术的效果及预后,而且还与部分角膜疾病的发生和发展密切相关。近年来生物力学研究发展迅速,其在眼部疾病的诊疗中发挥着越来越重要的作用。角膜生物力学的变化与术前角膜的形态、不同手术方式的选择、术后角膜厚度的改变等多种因素相关,但手术导致的角膜自身形态改变是不可逆的,若术后角膜生物力学的变化较大,可能会引起医源性角膜扩张、继发性圆锥角膜等并发症的发生。为了规避术后角膜扩张风险和指导个性化的术式选择,了解角膜生物力学特性的影响至关重要。文章对角膜的基础结构、角膜生物力学特性、生物力学测量方法和不同术式及不同角膜瓣厚度术后生物力学变化的研究进展进行综述,为近视患者的个性化精准治疗提供理论指导。Corneal refractive surgery is currently main stream of refractive surgery.With the development of femtosecond and laser surgery,the surgery has become safer and more accurate,resulting in less corneal trauma and a shorter postoperative recovery time.In recent years,biomechanics research has rapidly progressed,and its clinical application has gradually increased.The cornea not only possesses refractive properties but also exhibits typical biological soft tissue mechanical properties.Corneal mechanical properties not only play a role in maintaining corneal morphology but also influence the outcome and prognosis of corneal surgery,especially refractive surgery,and are closely related to the occurrence and development of some corneal diseases.Corneal refractive surgery involves cutting the cornea according to the patient's diopter,which disrupts the integrity of the cornea and inevitably affects its biomechanical stability.Changes in corneal biomechanics are associated with various factors,such as preoperative corneal morphology,the selection of different surgical methods,and postoperative changes in corneal thickness.However,the self-morphology changes caused by surgery are irreversible.If the postoperative changes in corneal biomechanics are significant,it may lead to complications such as postoperative corneal dilation and secondary keratoconus.To avoid postoperative iatrogenic corneal dilation and guide personalized surgical choice,it is crucial to understand the limits of influence of corneal biomechanical properties.This article reviews the research progress regarding corneal biomechanical properties and changes associated with corneal refractive surgery.

关 键 词：角膜屈光手术 角膜生物力学 眼反应分析仪 可视化角膜生物力学分析仪 

分 类 号：G712[文化科学—职业技术教育学] R77[文化科学—教育学] C975[医药卫生—眼科]