动态轮廓眼压计监测LASIK手术前后眼压变化

Comparison of dynamic contour tonometry taken with Goldmann applanation tonometer and non-contact tonometer in the eyes before and after LASIK

目的比较动态轮廓眼压计(DCT)、Goldmann压平式眼压计(GAT)及非接触式眼压计(NCT)测量接受准分子激光原位角膜磨镶术(LASIK)患者眼压值的差异。设计前瞻性临床试验研究。研究对象接受LASIK治疗的近视患者70例(140眼)。方法对上述患者于术前、术后1周,1、6个月用三种不同眼压计分别测量眼压,比较各时间点、各种眼压计之间的差异。同时记录手术前、后中央角膜厚度,取其两者差为角膜切削深度的值。主要指标眼压值(IOP)和角膜切削深度。结果术后1周,1、6个月DCT测量值(16.74±1.96mmHg、16.67±1.90mmHg、16.42±2.12mmHg)与其术前值(17.36±2.32mmHg)比较差异无统计学意义(F=1.346,P=0.06)。术后GAT和NCT测量值均呈下降趋势,与术前测量值比较差异有统计学意义(GAT:F=101.217,P=0.000;NCT:F=171.466,P=0.000),并且下降值与角膜切削深度成正相关关系(GAT:r=0.86,P=0.000;NCT:r=0.87,P=0.000),但术后三个时间段测量值比较差异无统计学意义(GAT术后三个时间点q值为0.216、0.677、0.461,P值分别为0.461、0.097、0.117;NCT术后三个时间点q值为0.215、0.585、0.370,P值分别为0.436、0.436、0.100)。结论LASIK术后GAT和NCT测量值明显下降,而DCT测量值无显著变化,其测量值较前两者更为可靠。(眼科,2007,16:344-347)

Objective To compare the intraocular pressure reading of dynamic contour tonometer （DCT） with those of Goldmann applanation tonometer （GAT） and non-contact tonometer （NCT） before and after LASIK, and compare the difference among their measurements. Design Prospective clinical trial. Participants Select 70 patients（140 eyes） who had received LASIK. Methods Measure the corneal central thicknesses and intraocular pressures of the 70 patients before LASIK and 1 week, 1 month and 6 months after LASIK using DCT, GAT and NCT. The results were analyzed with SPSS 13.0. Main Outcome Measures Intraocular pressure and ablated depth. Results Compared with preoperative readings（17.36±2.32mmHg）, the readings in group DCT did not differ significantly at 1 week （16.74±1.96mmHg）, 1 month（16.67±1.90mmHg） and 6 months（16.42±2.12mmHg） postoperatively （F=1.346, P=-0.06）. The readings measured with applanation tonometers descended postoperatively. Similar phenomenon was observed in NCT measurements. Conclusions LASIK appeared to influence GAT and NCT measurements but not DCT measurement, and the DCT measure is more reliable.