翼状胬肉大小与角膜地形图的相关性研究

Study of correlation between pterytium size and corneal topography

目的 :研究翼状胬肉的长度、宽度及胬肉覆盖角膜的面积对角膜表面形态的影响以及术后的改善情况。方法 :对翼状胬肉 33例 ,4 5只眼患者术前进行检影验光及角膜地形图检查 ,术中测量翼状胬肉的宽度及长度 ,对翼状胬肉的宽度、长度及面积与角膜表面规则指数 (SRI)、不对称指数 (SAI)及角膜散光进行相关性研究 ;随访 2 3例 ,2 8只眼翼状胬肉患者进行术后的角膜地形图检查 ,观察各项指标的变化 ,从而找出最好的手术时机。结果 :术前翼状胬肉的长度与角膜散光 (r =0 30 4 ,P=0 0 4 2 ) ,SRI(r =0 4 78,P =0 0 0 1)和SAI(r =0 5 0 7,P <0 0 0 1)具有明显的相关性 ;翼状胬肉的宽度及面积与SRI(r =0 4 90 ,P =0 0 0 1;r =0 5 99,P <0 0 0 1)和SAI(r =0 5 0 8,P <0 0 0 1;r =0 5 83,P <0 0 0 1)有明显的相关性 ;而散光却与SRI及SAI(r=0 2 5 3,P =0 0 93;r=0 2 6 8,P =0 0 75 )无明显的相关性。术后只有角膜散光的改善具有显著性差异 (P =0 0 2 3) ,而SRI及SAI的改善无显著性差异 (P =0 4 2 3;P =0 14 3)。结论 :翼状胬肉的出现、生长及其手术切除对角膜的球面性、规则性以及散光均有影响 ,而有些影响是不能通过手术解除 。

Objective:To evaluate the corneal refractive status before and after pterygium surgery and its relationship with preoperative pterygium size.Methods:Astigmatism,surface regularity index (SRI) and surface asymmetry index (SAI) of cornea were measured in 45 eyes before and after excision of pterygia.Preoperative pterygium length,width and area,were recorded too.28 eyes were followed up (56 44±20 89) days.Results:Before surgery,length of pterygium significantly correlated with astigmatism (r=0 304,P=0 042),SRI(r=0 478,P=0 001),and SAI(r=0 507,P<0 001).Width and area of pterygium significantly correlated with SRI(r=0 490,P=0 001;r=0 599,P<0 001),SAI(r=0 508,P<0 001;r=0 583,P<0 001),except astigmatism (r=0 253,P=0 093;r=0 268,P=0 075).The surgery significantly decreased the astigmatism(P=0 023),whereas SRI,and SAI were not changed significantly(P=0 423;P=0 143).Conclusion:The presence of pterygium and its removal significantly influence the corneal refraction including spherical power,astigmatism,asymmetry,and irregularity,with the larger pterygium exerting the greater influences.This finding helps to identify those patients who may benefit from the surgical intervention.