高度近视眼LASIK术后远期屈光回退的相关因素分析

Correlation analysis of refractive regression after laser in situ keratomileusis

目的探讨高度近视[准分子激光原位角膜磨镶术(laserinsitukeratomileusis,LASIK)后远期的屈光回退的相关因素,并对其进行角膜共聚焦显微镜(confocalmicroscopethroughfocusing,CMTF)的观察和分析。方法对发生屈光回退的35名高度近视患者的66[,进行了随访观察及回顾分析。结果屈光回退的度数与角膜曲率的变化值呈负相关(P<0.05);屈光回退的度数与角膜中央厚度变化值呈负相关(P<0.05);角膜共聚焦显微镜观察发现,回退患者的基质层厚度为(403.14±22.30)μm,与对照组(347.58±42.64)μm相比,统计学差异有显著性。回退患者的最前层基质细胞的数目为(704.50±35.9)个/mm2与对照组(1087.0±67.0)个/mm2相比,统计学差异具有显著性。结论LASIK术后远期的屈光回退与手术前后角膜曲率的变化有关,回退患者基质层的增厚可能引起角膜曲率的变化,从而产生屈光回退。前基质细胞的减少或许参与了此过程。

Objective The aim of this study was to investigate the relationship between various factors and refractive regression of high myopic subjects who underwent laser in situ keratomileusis （LASIK） over one year ago. The patients were followed up and examined by confocal microscope through focusing （CMTF）. Methods The study was a retrospective analysis of 66 eyes of 35 subjects （mean preoperative refraction -8.53± 2.82D） who underwent LASIK from October 2001 to August 2002 and had refractive regression. Results Refractive regression was negatively correlated with the amount of change in corneal curvature. A negative correlation was found between regression and the amount of change in central pachymetry. There were significant differences between the thickness of stromal and the control group. Conclusions The change of corneal curvature may be caused by increase of stromal thickness, which produced regression.Loss of the most anterior keratocytes and apoptosis may be responsible for the increase of stromal thickness.