角膜地形图分析在圆锥角膜早期诊断中的重要作用  

The important effect of the corneal topographic analysis in the early keratoconus diagnosis

作　　者：夏卫东[1] 陈积中[1] 宋汝庸[2] 

机构地区：[1]安徽医科大学第一附属医院眼科,合肥230022 [2]安徽省立医院眼科

出　　处：《临床眼科杂志》2002年第6期515-517,共3页Journal of Clinical Ophthalmology

摘　　要：目的　评价角膜地形图分析在圆锥角膜早期诊断中的重要作用。方法　对矫正视力较为理想 ,裂隙灯显微镜及角膜曲率计检查均无阳性发现的 2 0例 (36只眼 )患者 ,利用计算机辅助角膜地形检测仪 (eyesys2 0 0 0 ,美国产 )对角膜影像的参数进行分析 ,并分别于 3个月、6个月、1年进行随访检测明确诊断。结果　早期圆锥角膜患者的 SRI、SAI、角膜中央的屈光力、I- S值、单眼病例两眼角膜中央屈光力的差值、Sim K值及 Sim K的差值、角膜屈光力的变化范围等均增高 ,有助于诊断早期圆锥角膜 ,特别是角膜最大屈光力的位置、角膜屈光力的变化范围对诊断早期圆锥角膜非常敏感。根据文献及笔者临床实践认为以下四个指标更有利于圆锥角膜患者的早期诊断。(1)角膜中央屈光力 >4 6 .0 0 D;(2 )同一病例两眼角膜中央屈光力的差值 >1.0 0 D;(3) I- S值 >2 .0 0 D;(4)最大一环与最小一环屈光力的差值≥ 4 .5 0 D。其中有两项或两项以上发现异常 ,应定期随访 ,如有进行性发展即可确诊圆锥角膜。结论　提示角膜地形图检测是圆锥角膜早期诊断中具有高度敏感性的、可靠的定量分析方法 ,证实了角膜地形图检测在圆锥角膜早期诊断中具有重要的作用 。Objective Appraise the important effect of the corneal topographic analysis in the early keratoconus diagnosis.Methords 36 eyes of 20 patients whose corrective vision in satisfactory for slit-lamp microscope and keratometer's examination being normal have been made analysis with the corneal topograph on the computer(eyesys 2000,USA) for the ratio of the corneal image,following up examination for one month,six months,one year,diagnosed clearly.Results The increase of SRI,SAI,the center refractive power of the cornea,I S value,difference both centrer corneal refractive power in alone eye case,Simk value,difference of Simk and the change range of the corneal refractive power in the eraly keratoconus'patients diagnoses the early keratoconus helpfully.Paritcularly,the place of the cornal maximum refractive power,change scope of the corneal refractive power are the most sensitive for diagnosing early keratoconus,The Author think on the document and clinical practive that following 4 marks diagnoses helpfully the early keratoconus(1)the center refractive power of the cornea>46.00D.(2)difference of both center refractive power of cornea in one case>1.00D.(3)I S value>2.00D.(4)difference of refractive power of maximum cicle and minimum cicle≥4.50D.If both items or up in it are abnormal,it should be follow up regularly.If it develops further,it can diagnose keratoconus.Conclusion Advancing the corneal topographic examination is the most sensitive,dependable quantity analysis in the early keratoconus diagnosis.Confirm the corneal topographic examination has important effect in the early keratoconus diagnosis.It is the most effective methord of the early diagnosis.

关 键 词：早期诊断 圆锥角膜 角膜地形图 

分 类 号：R772.2[医药卫生—眼科]