睑板腺囊肿切除术后角膜高阶像差的早期变化

Study on the early changes of corneal higher-order aberrations after chalazion resection

摘要:

目的：探究睑板腺囊肿切除术后角膜高阶像差和角膜屈光度的变化。

方法：选取2021-01/2022-01在我院行手术治疗的单侧上睑睑板腺囊肿患者49例49眼进行前瞻性研究，按囊肿直径大小分为1组(24例24眼，囊肿直径3～5mm)和2组(25例25眼，囊肿直径>5mm)。所有患者均于术前、术后2mo通过Siruis眼前节分析系统测量6mm直径范围内角膜总高阶像差、彗差、三叶草像差、球面像差及角膜SimK值、平轴散光(Minimum SimK)、陡轴散光(Maximum SimK)。

结果：术后2mo，2组患者角膜总高阶像差、三叶草差及彗差与同组术前比较均有差异(P<0.05)，而球差与同组术前比较无差异(P>0.05)； 1组患者Maximum SimK值和Minimum SimK值分别与同组术前比较均无差异(P>0.05)，而2组患者Maximum SimK值和Minimum SimK值分别与同组术前比较均有差异(P<0.05)。

结论：大的睑板腺囊肿手术治疗后角膜高阶像差特别是三叶草差和彗差明显减小，散光较术前减小，故对于拟行屈光手术的睑板腺囊肿患者特别是病灶大于5mm的患者建议切除囊肿后再行详细的屈光术前检查。

Abstract:

AIM: To investigate the difference of corneal higher-order aberrations and corneal diopter before and after chalazion resection.

METHODS: A total of 49 patients(49 eyes)with unilateral upper eyelid chalazion who underwent surgical treatment in our hospital from January 2021 to January 2022 were selected for prospective study. They were divided into two groups according to the size of the cyst, with 24 patients(24 eyes)in 3-5mm group and 25 patients(25 eyes)in >5mm group. The total higher-order aberrations, coma, trefoil, spherical aberrations, corneal SimK values, and horizontal axis astigmatism(Minimum SimK)and steep axis astigmatism(Maximum SimK)of the cornea before and at 2mo after the resection of the chalazion with a diameter of 6mm were measured by Sirius anterior segment analysis system.

RESULTS: The total higher-order aberrations, trefoil and coma aberrations of the patients in the >5mm group at 2mo after operation were statistically significant compared with those before operation(P<0.05), while the spherical aberrations were not statistically significant(P>0.05). There was no statistically significant difference in the 3-5mm group in the comparison between the Maximum SimK value and the Minimum SimK value before and after the operation(P>0.05), while the difference was statistically significant in the >5mm group(P<0.05).

CONCLUSION: The corneal higher-order aberrations, especially trefoil and coma aberration, and astigmatism of large chalazion after surgical treatment are significantly reduced. Therefore, it is recommended that patients with chalazion, especially those with lesions larger than 5mm, should resect the chalazion before detailed refractive examination.