小梁切除术后角膜地形图分析

The Analysis on Corneal Topography of Trabeculectomy

目的应用角膜地形图仪分析小梁切除术前、术后角膜地形图改变，探讨术后引起散光的原因。方法随机选择３０例（３０只眼）急性闭角型青光眼患者，作常规小梁切除术，分别于术前１天，术后３个月作角膜地形图，同时作视力、眼轴及眼压测定。结果角膜地形图改变分３种情况：１６只眼角膜变陡峭、５只眼角膜变平坦、９只眼角膜地形图改变不规则，无论是角膜变陡峭还是变平坦均产生循规性散光。结论滤过性手术可产生角膜曲率的改变。

Objective To investigate the changes of corneal topography before and after trabeculectomy and analyze the cause of astigmatism after trabeculectomy. Methods A standard trabeculectomy procedure(4mm × 5mm scleral trap door) was performed at the 90 degree meridian in 30 eyes of 30 patients and followed up for 3 months. Computer assisted topographic analysis was performed preoperatively and on 3 months postoperatively. Additional data included axial length, intraocular pressure and visual acuity. Result Variation of corneal topography indicated three types of astigmatic findings: a relative superior corneal steepening,perior flattening and complex regional changes. In the superior steepening and superior flattening groups there was the astigmatism with the rule. There was no correlation between the change of corneal topography and intraocular pressure. Conclusion Changes in corneal curvature are induced by filtering surgery,not by changing of intraocular pressure. Computer assisted corneal topography is the best way to analyse the complex changes in corneal curvature.