不同近视程度患者的新型角膜生物力学参数与眼部生物参数的关系

Study on the Changes of New Corneal Biomechanical Parameters with Ocular Biometric Parameters in Patients with Different Degrees of Myopia

目的:研究不同程度近视患者的新型角膜生物力学参数与眼部生物参数的关系。方法:横断面研究。随机纳入2021年3—11月于佛山市第二人民医院眼视光中心拟行角膜屈光手术的近视患者206例(206眼),均取右眼数据。按等效球镜度(SE)分为低度近视组、中度近视组与高度近视组,所有患者通过Corvis ST测量获取相关参数,包括2 mm位置变形幅度比值(DA 2 ratio)、综合半径(IR)、断层生物力学指数(TBI)、最薄点与水平方向角膜厚度变化率比值(ARTh)、第1次压平硬度指数(SP-A1);通过电脑验光仪、Pentacam和Lenstar分别测量眼部生物参数,包括SE、中央角膜厚度(CCT)、生物力学校正眼压(bIOP)、角膜前表面平均曲率(Km)、角膜水平直径(CD)、眼轴长度(AL)。采用Pearson或Spearman方法以及多元线性回归方法分析角膜生物力学参数与眼部生物参数之间的关系。结果:低度近视组中,Km越大,DA 2 ratio和IR均越大(R^(2)=0.20,P<0.001;R^(2)=0.05,P=0.038);CD越大,ARTh越大(R^(2)=0.11,P=0.005)。中度近视组中,Km越大,DA 2 ratio越大(R^(2)=0.09,P=0.003);年龄越大且AL越小,IR越大(R^(2)=0.14,P=0.001);CD越大,ARTh越大(R^(2)=0.12,P=0.001);AL越大,SP-A1越大(R^(2)=0.07,P=0.008)。高度近视组中,Km越大,IR越大(R^(2)=0.05,P=0.041);CD越大,TBI越小(R^(2)=0.11,P=0.005);CD越大且SE越小,ARTh越大(R^(2)=0.32,P<0.001)。结论:不同近视程度患者的年龄、SE、AL、Km和CD与新型角膜生物力学参数存在显著相关性,在屈光术前筛查时应综合考虑这些参数的共同影响。

Objective:To determine the relationship between new corneal biomechanical parameters and ocular biological parameters in patients with different degrees of myopia.Methods:This was a cross-sectional study.Totally 206 myopic patients(206 right eyes)who planned to undergo corneal refractive surgery at the Ophthalmic Center of the Second People's Hospital of Foshan from March to November 2021 were randomly included.They were divided into low myopia group,moderate myopia group,and high myopia group according to the equivalent spherical diopter(SE).Deformation amplitude 2 ratio(DA 2 ratio),integrated radius(IR),tomographic biomechanical index(TBI),Ambrosio relation thickness horizontal(ARTh),and stiffness parameter(SP-A1)were measured by using Corvis ST.Ocular biological parameters were measured by computerized optometry,Pentacam and Lenstar,respectively,including spherical equivalent(SE),central corneal thickness(CCT),biomechanically corrected intraocular pressure(bIOP),medium curvature(Km),horizontal corneal diameter(CD),and axial length(AL).Pearson or Spearman correlation analysis and multiple linear regression were used to analyze the relationship between corneal biomechanical parameters and ocular biological parameters.Results:In the low myopia group,the greater DA 2 ratio and IR were associated with the larger Km(R^(2)=0.20,P<0.001;R^(2)=0.05,P=0.038).The larger the ARTh was associated with the larger CD(R^(2)=0.11,P=0.005).In the moderate myopia group,the larger DA 2 ratio was associated with the Km(R^(2)=0.09,P=0.003).The greater IR was associated with the older and smaller AL(R^(2)=0.14,P=0.001).The larger ARTh was associated with the larger CD(R^(2)=0.12,P=0.001).The larger SP-A1 was associated with the larger AL(R^(2)=0.07,P=0.008).In the high myopia group,the greater IR was associated with the larger Km(R^(2)=0.05,P=0.041).The smaller the TBI was correlated the larger CD(R^(2)=0.11,P=0.005).The smaller SE and the larger ARTh was correlated with the larger CD(R^(2)=0.32,P<0.001).Conclusions:There were significant correlations of the age,SE,AL,Km,and CD with the novel corneal biomechanical parameters in patients with different degrees of myopia.The common effects of these parameters should be comprehensively considered in preoperative screening for refractive surgery.