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准分子激光角膜屈光手术后散射的变化及其相关因素分析 被引量：11

Analysis of light scatter changes and relevant factors after laser refractive surgery
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摘要 目的探讨眼内散射在机械法准分子激光上皮瓣下角膜磨镶术（Epi-LASIK）及准分子激光原位角膜磨镶术（LASIK）手术后的变化及相关因素分析。方法病例系列研究。对87例（87只眼）近视及近视散光患者行Epi．LASIK（45只眼）或LASIK（42只眼），使用C—quant散射仪分别在手术前、手术后1、4、10个月测量散射光计量值。应用单因素方差分析及Pearson相关进行数据分析。结果Epi．LASIK组及LASIK组手术前、手术后1、4、10个月眼内散射光计量值分别为（0．91±0．17）、（1．03±0．15）、（1．11±0．13）、（1．01±0．16）及（0．96±0．14）、（1．05±0．12）、（1．10±0．12）、（0．98±0．15），组间比较差异有统计学意义（F=12．29，8．11；P〈0．05）；与手术前相比两组各时间段的变化量分别为（0．12±0．18）、（0．19±0．20）、（0．08±0．16）及（0．09±0．13）、（0．15±0．17）、（-0．01±0．17）。Epi-LASIK组手术后4个月眼内散射光计量值与手术前屈光度、剩余基质床与中央最薄角膜厚度之比（RBT／CCT）、切削比有明显相关性（r=-0．344，-0．361，0．361；P〈0．05），LASIK组无明显相关性（r=0．186，0．162，-0．206；P〉0．05）。Epi—LASIK组手术后1～4个月发生2级、1级、0．5级haze分别有1、2、4只眼，其4个月时眼内散射光计量值变化量分别为0．52，（0．37，0．42），（0．06，0．09，0．07，0．17）。发生2级haze眼在haze消退后散射值变化量由4个月时的0．52降至10个月时的0．11。结论Epi．LASIK及LASIK术后早期眼内散射光计量值较术前均增高，随时间延长有下降趋势。角膜伤口愈合反应可能是Epi-LANK术后早期散射增加的主要因素，而LASIK术后早期增加的主要原因可能是界面相关因素。Epi-LASIK术后轻度以上haze眼散射明显增加。 Objective To investigate the changes and relevant factors of forward scatter after Epipelis laser in situ keratomileusis （Epi-LASIK）and laser in situ keratomileusis （LASIK）. Methods It was a prospective clinical comparative study. 45 patients （45 eyes） were scheduled for Epi-LASIK and 42 patients （42 eyes） for LASIK. Straylight examinations were performed using the C-Quant straylight meter before and 1, 4, 10 months after surgery. The data was analyzed for statistical significance by one-way ANOVA and the correlation was tested by Pearson＇s test by using SPSS 13.0 software. Results The straylight values were（0. 91 ±0. 17）, （1.03 ±0. 15） ,（1.11 ±0. 13） ,（1.01 ±0. 16） of Epi-LASIK group and （0. 96 ±0. 14）, （ 1.05 ±0. 12）, （ 1.10 ±0. 12）, （0. 98 ±0. 15） of LASIK group preoperatively and 1, 4,10 months postoperatively respectively ,which there were significant increase postoperatively in both groups （F = 12. 29,8. 11 ;P 〈 0. 05）. Compared with preoperative values, the changes in straylight values at 1, 4 and 10 months postoperatively were （0. 12 ±0. 18）, （0. 19 ±0. 20）, （0. 08 ±0. 16） of Epi-LASIK group and （0.09±0.13）, （0.15 ±0.17）, （-0.01±0.17） of LASIK group. In Epi-LASIK group, the preoperative refractive error, RBT/CCT, and ablation ratio have significant relevance with straylight values at 4 months postoperatively （ r = - 0. 344, - 0. 361,0. 361 ; P 〈 0. 05 ）, no such correlation was found in LASIK group （ r = 0. 186,0. 162, - 0. 206 ; P 〉 0. 05 ）. For corneal haze which was found from 1 to 4 months after Epi-LASIK, grade 2, 1,0. 5 appeared in 1,2, 4 eyes respectively and the changes of straylight values were0.52, （0.37, 0.42）, （0.06, 0.09, 0.07, 0.17） at 4 months postoperatively. 10 months postoperatively, the increases of straylight values for the eye with grade 2 haze declined from 0. 52 to 0. 11 after the haze disappeared. Conclusion Straylight values increase significantly at early time after Epi- LASIK and LASIK, but decrease partially as time going. Corneal wound healing response may be the reasons induced the increases of light scatter after Epi-LASIK. For LASIK, flap interface factors may be the reasons. Corneal haze especially above mild grade, can affect the straylight obviously. （
作者 李晶 王雁 左彤 刘丽清 侯杰 谢丽丽 杨晓艳 李智敏
机构地区 天津医科大学眼科临床学院天津市眼科医院天津市眼科学与视觉科学重点实验室天津市眼科研究所
出处 《中华眼科杂志》 CAS CSCD 北大核心 2011年第7期589-595,共7页 Chinese Journal of Ophthalmology
基金 天津市自然科学基金（07JCYBJC09500）
关键词 散光 近视 角膜磨镶术 激光原位 角膜切削术 上皮下 激光 视敏度 Astigmastism Myopia Keratomileusis, laser in situ Keratectomy subepithelial,laser-assisted Visual acuity
分类号 R779.63 [医药卫生—眼科]
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参考文献23

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二级参考文献25

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中华眼科杂志
2011年 第7期

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