目的:观察近视LASIK术后角膜生物力学参数与形态参数变化的相关性。方法:近视患者69例136眼,于LASIK术前及术后1mo行眼反应分析仪(ORA)测量角膜滞后(CH)和角膜阻力因子(CRF),Pentacam眼前节分析仪测量眼前节参数。计算术后角膜生物力学参数变化ΔCH及ΔCRF,Pentacam测量角膜中央厚度变化ΔCCT,中央2,4,6mm平均角膜厚度变化(ΔCCT2mm,ΔCCT4mm和ΔCCT6mm),角膜容积变化ΔCV,角膜前后表面曲率半径变化ΔRa和ΔRp,分析ΔCH和ΔCRF与角膜形态参数的相关性。结果:LASIK术前平均CH及CRF(9.99±1.38和9.96±1.30mmHg)明显高于术后1moCH和CRF(7.90±1.16和6.49±1.28mmHg),差异具有统计学意义(P<0.05)。LASIK术后ΔCH和ΔCRF与ΔRp和ΔCCT6mm无相关性,ΔCH和ΔCRF与ΔCCT,ΔCCT2mm,ΔCCT4mm和ΔCV呈正相关(r:0.513,0.397,0.329和0.314,P<0.05;r:0.616,0.504,0.484和0.466,P<0.01);ΔCRF与ΔRa呈负相关(r:-0.374,P<0.01)。结论:近视LASIK术后角膜CH和CRF变化与角膜厚度及容积有关,CRF评价LASIK术后角膜生物力学变化比CH更有价值。

AIM:To investigate the relationship between the change of corneal biomechanical parameters and corneal topography after laser in situ keratomileusis (LASIK). ·METHODS:Sixty-nine patients 136 eyes after LASIK surgery were included in this study. Ocular response analyszer (ORA) was used to measure corneal hysteresis (CH) and corneal resistance factor (CRF); Pentacam were used to measure the corneal topography before and one month after LASIK. The changes of ΔCH and ΔCRF,central corneal thickness (ΔCCT),ΔCCT2mm,ΔCCT4mm,ΔCCT6mm,corneal volume (ΔCV),radius of curvature of the anterior and posterior corneal surface (ΔRa and ΔRp) were calculated. Pearson correlation analysis was applied to study the relationship between ΔCH and ΔCRF with corneal topography index. ·RESULTS:The CH and CRF were decreased significantly from 9.99±1.38mmHg and 9.96±1.30mmHg to 7.90±1.16mmHg and 6.49±1.28mmHg (P<0.05). No statistically significantly difference was found in both ΔCH and ΔCRF with ΔRp and ΔCCT6mm(P>0.05). The positive correlation between ΔCH and ΔCCT(r:0.513),ΔCCT2mm(r:0.397),ΔCCT4mm(r:0.329) and ΔCV(r:0.314) were significant(P<0.005). The positive correlation between ΔCRF and ΔCCT(r:0.616),ΔCCT2mm(r:0.504),ΔCCT4mm(r:0.484) and ΔCV(r:0.466) were significant(P<0.01). The negative correlation between ΔCRF and ΔRa(r:-0.374) was significant(P<0.01). ·CONCLUSION:Changes in CH and CRF after LASIK suggest that alteration in corneal biomechanics is correlated with CCT and CV. The CRF parameter may be more useful than the CH parameter in assessing biomechanical changes resulting from LASIK.

R779.63

中国2009年浙江省大学生科技创新活动计划资助项目(No.2009R413055)~~