飞秒激光近视术后眼压影响因素分析及眼压校正公式验证  

Factors influencing intraocular pressure after femtosecond laser surgery and verification of intraocular pressure correction formulas

作　　者：周传海 王丽君 文龙 范浩博 叶泽欣 Zhou Chuanhai;Wang Lijun;Wen Long;Fan Haobo;Ye Zexin(Department of Ophthalmology,the Third People s Hospital of Chengdu,Chengdu 610000,Sichuan Province,China;Eye School of Chengdu University of TCM,Chengdu 610000,Sichuan Province,China;Pharmaceutical Preparation Section,Shang Jin Hospital of West China Hospital,Sichuan University,Chengdu 610000,Sichuan Province,China)

机构地区：[1]中国四川省成都市第三人民医院眼科,610000 [2]成都中医药大学眼科学院,中国四川省成都市610000 [3]四川大学华西医院上锦医院药剂科,中国四川省成都市610000

出　　处：《国际眼科杂志》2025年第3期506-510,共5页International Eye Science

基　　金：四川省自然科学基金项目(No.2022NSFSC1331);四川省成都市金牛区医学科研课题(No.JNKY2024-94)。

摘　　要：目的:分析飞秒激光小切口角膜基质透镜取出术(SMILE)后影响非接触式眼压(IOP_(NCT))测量值的部分因素,探讨SMILE术后IOP_(NCT)与角膜中央厚度(CCT)及角膜曲率之间的相关性,并构建相应的回归模型,为临床评估SMILE术后患者眼压真实状况提供科学依据。方法:回顾性分析2023-06/2024-05在成都市第三人民医院眼科行SMILE的近视患者107例206眼和行飞秒激光原位角膜磨镶术(FS-LASIK)的近视患者107例201眼,收集患者术前,术后1、3 mo的IOP_(NCT)测量值、CCT、角膜曲率等资料,通过重复测量数据的方差分析、Pearson相关性分析对手术前后的IOP_(NCT)、CCT、角膜曲率进行分析,并构建多元线性回归模型评估术后IOP_(NCT)与CCT、角膜曲率变化值之间的关联性。结果:SMILE与FS-LASIK术后患者的IOP_(NCT)、CCT、角膜曲率在时间上均存在显著差异(均P<0.001),组间和交互比较无差异(均P>0.05),两组术后1、3 mo IOP_(NCT)、CCT、角膜曲率均显著低于术前(均P<0.05)。SMILE患者术后1、3 mo IOP_(NCT)与CCT之间呈正相关(r=0.261、0.267,均P<0.001),而与角膜曲率无显著相关(均P>0.05)。SMILE术后1 mo IOP_(NCT)与CCT、角膜曲率之间的回归方程为:Y=3.426+0.019X_(1)-0.058X_(2)(Y代表IOP_(NCT),X_(1)代表CCT,X_(2)代表角膜曲率),方程差异有统计学意义(F=7.654,P=0.001);术后3 mo的回归方程为:Y=2.056+0.020X_(1)-0.038X_(2)(Y代表IOP_(NCT),X_(1)代表CCT,X_(2)代表角膜曲率),方程差异有统计学意义(F=7.903,P<0.001)。SMILE术前术后IOP_(NCT)变化值(△IOP_(NCT))与术中切削角膜厚度(△CCT)、角膜曲率变化值在术后1 mo的回归方程为:Y=-2.252+0.008X_(1)+0.587X_(2)(其中Y代表△IOP_(NCT),X_(1)代表△CCT,X_(2)代表角膜曲率变化值),方程差异有统计学意义(F=17.550,P<0.001);术后3 mo的回归方程为:Y=-2.168+0.024X_(1)+0.281X_(2)(Y表示△IOP_(NCT),X_(1)表示△CCT,X_(2)表示角膜曲率变化值),方程差异有统计学意义(F=16.030,P<0.001)�AIM:To analyze the factors affecting non-contact intraocular pressure(IOP_(NCT))measurements after femtosecond laser-assisted small incision lenticule extraction(SMILE),explore the correlation of IOP_(NCT) with central corneal thickness(CCT)and corneal curvature after SMILE,and construct the corresponding regression model which will provide scientific basis for clinical evaluation of the true IOP of patients after SMILE.METHODS:Data from a retrospective analysis of 107 myopic patients(206 eyes)who underwent SMILE and 107 myopic patients(201 eyes)received femtosecond laser-assisted in situ keratomileusis(FS-LASIK)surgery from June 2023 to May 2024 were examined.IOP_(NCT),CCT,and corneal curvature before surgery and at 1 and 3 mo were collected.The preoperative and postoperative IOP_(NCT),CCT and corneal curvature were analyzed by ANOVA and Pearson correlation analysis,and multiple linear regression models were constructed to evaluate the association of postoperative changes of IOP_(NCT),CCT and corneal curvature.RESULTS:There were significant differences in IOP_(NCT),CCT,and corneal curvature of both SMILE and FS-LASIK patients(all P<0.001),there was no significant difference between two groups and interaction effects(all P>0.05),and the IOP_(NCT),CCT and corneal curvature at 1 and 3 mo post-surgery were significantly lower than preoperative(all P<0.05).Pearson correlation analysis showed a positive correlation between IOP_(NCT) and CCT at 1 and 3 mo after SMILE(r=0.261,0.267,all P<0.001),but no significant correlation with corneal curvature(all P>0.05).Multiple linear regression analysis of IOP_(NCT) with CCT and corneal curvature at 1 mo after SMILE indicated that the regression equation was:Y=3.426+0.019X_(1)-0.058X_(2)(Y represents IOP_(NCT),X_(1)represents the CCT,and X_(2)represents the corneal curvature),with statistical significant difference in the equation(F=7.654,P=0.001);the regression equation for 3 mo after surgery was:Y=2.056+0.020X_(1)-0.038 X_(2)(Y represents IOP_(NCT),X_(1)represents the CCT,and

关 键 词：飞秒激光小切口角膜基质透镜取出术 非接触眼压 影响因素 相关性 

分 类 号：R779.63[医药卫生—眼科]