影响准分子激光屈光性角膜切削术后眼压的因素

Correlations between factors and intraocular pressure following photorefractive keratectomy

目的分析影响准分子激光屈光性角膜切削术（ｅｘｃｉｍｅｒｌａｓｅｒｐｈｏｔｏｒｅｆｒａｃｔｉｖｅｋｅｒａｔｅｃｔｏｍｙ，ＰＲＫ）术后眼压的因素。方法采用非接触式眼压计（ｎｏｎｃｏｎｔａｃｔｔｏｎｏｍｅｔｒｙ，ＮＣＴ）测量眼压，对ＰＲＫ前、后随访半年以上８６例（１５０只眼）患者眼压差与角膜切削厚度、术前术后角膜曲率差之间进行多元回归分析。结果术前眼压明显高于ＰＲＫ术后１周、３及６个月的眼压，差异有非常显著性（ｔ检验，Ｐ＜０．０１），与术后１个月时眼压比差异无显著性（Ｐ＞０．０５）。术后１个月时的眼压高于术后其他时间眼压（Ｐ＜０．０１）。ＰＲＫ后眼压降低与角膜厚度减少及角膜前表面曲率的降低有关（ｒ＝０．３６１，Ｐ＜０．０１；ｒ＝０．１８８，Ｐ＜０．０５），建立二元回归方程如下：Ｙ＝－０．０５９－０．０３８Ｘ１＋０．００９Ｘ２。Ｙ：术前术后眼压差（ｋＰａ），Ｘ１：术前术后角膜曲率差（Ｄ），Ｘ２：角膜切削厚度（μｍ）。结论ＰＲＫ后ＮＣＴ测量眼压低于术前，术后眼压与氟甲脱氧泼尼松龙（ｆｌｕｏｒｏｍｅｔｈｏｌｏｎｅ）的用药次数和时间、角膜切削厚度、角膜曲率有关。

Objective To evaluate the factors related to intraocular pressure (IOP) after excimer laser photorefractive keratectomy (PRK). Methods 86 cases 150 eyes of myopia followed over six months after PRK were studied with noncontact tonometer (NCT). Result After PRK, a decrease in the IOP was observed. Postoperatively, the IOP reading at 1st month was the highest. The reduction of IOP may be related to the decrease in corneal thickness and corneal curvature (r= 0.361, P<0.01; r=0.188, P<0.05). Regression equation for IOP drop (kPa) =-0.059-0.038X1+0.009X2 [X1=ablation depth (μm), X2=decrease in corneal curvature (D)]. Conclusion IOP readings after PRK are influenced by corneal thickness, corneal curvature and eye drug times.