巩膜宽环扎术前后角膜光学形态变化

Changes in corneal contour and thickness after wide scleral buckling

目的观察巩膜宽环扎手术前后角膜形态学变化,进一步探讨巩膜宽环扎术对角膜光学形态的影响。方法用博士伦Obscan-Ⅱ角膜地形图仪测量孔源性视网膜脱离15例15眼术前、术后1周的角膜前表面曲率、角膜厚度及角膜后表面曲率。结果术后1周,在直径3 mm和5 mm区,角膜总屈光力、角膜前表面屈光力、角膜后表面屈光力及中央角膜厚度与术前相比,差异无显著性,在角膜前表面直径5 mm区、角膜后表面直径3 mm和5 mm区散光增加,角膜形状系数(shape factor,SF)减小。结论巩膜宽环扎术后早期,角膜5 mm区内屈光力改变不明显,但可导致角膜前后表面散光增加;角膜中央向周边逐渐变平坦的幅度变小。

Objective To investigate effects of surgical treatment with wide scleral buckling for retinal detachment on corneal shape. Methods Fifteen eyes from 15 patients suffering from retinal detachment were. treated with wide scleral buckling, Cormeal topography and thichness of each patient＇s eye were measured using Obscan- Ⅱ corneal topographic system prior to and 1 week after surgery. The results at these 2 time-points were compared statistically. Results Total refractive power, refractive power in amterior corneal surface and posterior corneal surface at 3 mm and 5 mm areas did not significantly damage （P 〉 0.05） 1 week after surgery. The astigmatism in anterior surface at 5 mm area and posterior .surface at 3 mm and 5 mm areas increased 1 week after surgery （ P 〈 0.05 ）. The corneal shape factor reduced significantly at 1 week after （ P 〈 0.05）. Conclusion Wide scleral buckling does not change, refractive power of the cornea at 5 mm area but increases astigmatism in the anterior and posterior surface. There is a redueed cornea flattening from central to poriphe.ry of the cornea.