LASIK术后角膜基质床及全角膜厚度的变化及相关因素分析

Analysis of the changes of the thickness of corneal stromal bed and whole cornea and correlation factors after LASIK

目的:通过观察LASIK手术的患者术前、术中及术后1wk;1,3,6mo角膜厚度及屈光状态的变化,探讨LASIK术后屈光度数回退的原因及影响因素。方法:选择我院进行LASIK手术的患者856例856眼,分别测量其术前角膜厚度、术中角膜瓣及基质床厚度;术后1wk;1,3,6mo角膜厚度,观察屈光状态的变化,分析实际切削深度与预计切削深度的差异,屈光回退的可能原因。结果:实际角膜切削深度较准分子激光机显示理论角膜切削深度深22.15±7.23μm。角膜中央厚度变化在术后6mo以后趋于稳定。屈光度数回退量与年龄、角膜床厚度呈负相关,与术前屈光度呈正相关。结论:LASIK手术中实际切削深度与预计切削深度稍有差异,充分考虑这点有助于提高手术的安全性。准确掌握术中的实际切削深度是提高手术安全性的保障。

AIM ： To explore the reasons of refractive regression and its influence factors after LASIK by observing corneal thickness and refractive changes preoperatively, intraoperatively and 1 week, 1 month, 3 and 6 months postoperatively. METHODS： Eight hundred and fifty-six patients （856 eye） who had LASIK in our hospital were enrolled in this study and the preoperative corneal thickness, intraoperative corneal flap thickness and stromal bed, 1 week, 1 month, 3 months corneal thicknesses and the refractive changes were measured. The differences between actual cutting thickness and the expected cutting depth were analyzed, so were the possible causes of refractive regression. RESULTS： The actual cutting depth was 22.15 ± 7.23μm deeper than the theoretical cutting depth, and the central corneal thickness changes became stable 6 months after LASIK. Regression was negatively correlated with age and corneal bed thickness but positively correlated with the preoperative refractive error. CONCLUSION： Besides cap sickness we should also consider the actual cutting depth and its affecting factors in the operation which will make the operation securer. Mastering of the actual cutting depth can improve the safety of the operation.