玻璃体视网膜术后角膜厚度在角膜地形图上的变化

Changes of corneal thickness on corneal topography after different vitreous and retinal surgery

目的探讨玻璃体视网膜疾病不同的手术方式对角膜厚度的影响。方法根据病变程度不同,对61例(61眼)玻璃体视网膜疾病的患者分别行单纯玻璃体切割术、玻璃体与联合硅油填充术及硅油取出术、玻璃体与晶状体切割联合硅油填充术及硅油取出术。用OrbscanⅡ角膜地形图系统进行角膜厚度的测量,分别测量术前和术后1周、1个月、3个月及6个月的角膜中央、鼻侧、颞侧、上方及下方的角膜厚度,并比较手术前后角膜厚度的变化。结果3组患者术后1周单纯玻璃体切割组中央角膜厚度及周边平均角膜厚度分别增加(5.70±0.98)%、(6.04±1.02)%;玻璃体切割硅油填充组分别增加(6.92±1.25)%、(6.25±1.42)%;玻璃体与晶状体切割联合硅油填充组分别增加(8.66±1.75)%、(7.67±1.53)%.术后各期与术前相比在统计学上均无显著性差异。术后1～6个月角膜厚度恢复到术前水平。3组患者术后同期角膜厚度之间的比较在统计学上无显著性差异。结论玻璃体视网膜手术可引起角膜厚度发生可逆性的变化,术后1周角膜厚度有不同程度的增加。术后1～6个月角膜厚度恢复到术前水平。

Objective To observe the effect of different vitreous and retinal surgeries on corneal thickness. Methods Sixty-one patients （61 eyes） who had vitreous and retinal diseases underwent different surgeries according to the degree of diseases, simple vitrectomy （ 22 eyes）, vitrectomy with tamponade of silicone oil （ 21 eyes ）, vitrectomy and lensectomy with tamponade of silicone oil （ 18 eyes）. The corneal thickness of center, nasal, temporal, superior and inferior were measured with Orbscan Ⅱ corneal topography pre-operatively and at 1 week, 1 month,3 months and 6 months post-operatively. Results In all three groups,both central and peripheral corneal thickness were increased at different degrees. The mean central corneal thickness and peripheral corneal thickness increase for simple vitrctomy group 1 week post-operatively were （ 5.70 ± 0.98 ） % , （6.04 ± 1.02 ） % ,respectively; The mean central corneal thickness and the peripheral corneal thickness increase for vitrctomy with tamponade of silicone oil group 1 week post-operatively were （6.92 ± 1.25 ） % , （ 6.25 ± 1.42 ） % , respectively; The mean central corneal thickness and the peripheral corneal thickness increase for vitrectomy and lensectomy with tamponade of silicone oil group 1 week post-operatively were （ 8.66 ± 1.75 ） % , （ 7.67 ± 1.53 ）% , respectively; The corneal thickness came to the same degree at 1 month,3 months and 6 months post-operatively as that of pre-operation. There were no significant differences among the three groups at the same postoperative period by comparing with the corneal thickness of pre-operation. Conclusion In all three groups, the surgery can induce reversible corneal thickness change. The corneal thickness comes to the same degree at 1 month, 3 months and 6months post-operatively as that of pre-operation.