DCT和GAT对LASIK手术前后眼压的比较性研究

Analysis of the changes ofintraocular tension after myopic laser in situ keratomileusis using DCT and GAT

目的评价动态轮廓眼压计（DCT）和Goldmann压平眼压计（GAT）对在准分子激光原位角膜磨镶术（LASIK）手术前后眼压测量值的变化。方法取71例141只眼近视患者在LASIK术前和术后一周分别进行角膜厚度（CCT）、GAT、DCT测量。结果①LASIK手术前后DCT测得值无显著性差异（陆0．062），GAT测得值有显著性差异（P〈0．001），CCT测得值有显著性差异（P〈0001）。（2）Bland—Ahman分析示LASIK手术前后DCT与GAT两种测量方法均呈现高度一致性。术前DCT测量值高于GAT测量值1．1mmHg，95％可信区间为（-0．6，2．8）mmHg；术后DCT测量值高于GAT测量值8．2mmHg，95％可信区间为（5．3，11．1）mmltg。③△GAT与△CCT呈正相关，△DCT与△CCT无统计相关性。结论DCT测量值不受LASIK手术切削的影响，更适合于LASIK手术前后眼压的测量。

Objective To compare IOP measurements using Goldmann applanation tonometry （GAT） and Dynamic contour tonometer （DCT） in eyes undergoing LASIK for correction of myopia. Methods In prospective, 71 patients （ 141 eyes） were treated by LASIK for myopia, central corneal thickness （CCT） and IOP were measured in patients before and after surgery. IOP was measured using GAT and DCT. The un- treated eyes before surgery served as paired controls.Results （1） A significant difference in IOP readings measured by GAT was detected before and after LASIK, as well as CCT readings. In contrast, no significant change in IOP readings was recorded by DCT. （2） There was good concordance between the two tonometers in 141 normal eyes before and after LASIK. Bland-Altman analysis of individual pairs of DCT and GAT measurements before and after LASIK revealed a bias of 1.1 mmHg, [95 % confidence interval from -0.6 mmHg to 2.8mmHg] and a bias of 8.2 mmHg [95 % confidence interval from 5.3 mmHg to 11. 1mmHg]. （3） Corneal ablation reduced lOP readings as measured by GAT. In contrast, no significant change in IOP readings was recorded by DCT. Conclusions lOP readings recorded by DCT were not be affected by LASIK for myopia. Thus, DCT is more suitable to measure lOP before and after surgery.