后巩膜加固术后行LASIK者角膜后表面形态的变化

Dynamic changes of corneal posterior surface after LASIK on correction of high myopia following posterior scleral reinforcement

目的探讨后巩膜加固术后准分子激光原位角膜磨镶术(laser in situ keratomileusis,LASIK)对进行性近视角膜后表面形态的影响。方法随机选择进行性近视41例(77眼)进行后巩膜加固术(加固组),按等效球镜分为3组:Ⅰ组(-8.00～-9.00D)23眼;Ⅱ组(-9.25～-10.25D)29眼;Ⅲ组(-10.50～-11.50D)25眼。用眼前节全景仪测量术前及术后1、3个月时的角膜后表面屈光力及高度值。并在术后1年行LASIK,检测术前及术后1、3个月时的角膜后表面同样参数并进行分析。结果后巩膜加固术后1、3个月角膜后表面屈光力及后高度与术前比较无明显变化;LASIK术后1、3个月角膜后表面屈光力及后高度较术前增加(P<0.05)。结论后巩膜加固术对进行性近视患者的角膜后表面形态无明显影响,再行LASIK手术可改变进行性近视患者的角膜后表面屈光力及后高度。

Objective To explore the dynamic changes of corneal posterior surface after LASIK on correction of high myopia following posterior scleral reinforcement.Methods The 77 eyes of 41 cases were divided into Ⅰ group（from-8.00 to-9.00 D,23 eyes）,Ⅱ group（from-9.25 to-10.25 D,29 eyes） and Ⅲ group（from-10.50 to-11.50 D,25 eyes） according to the mean spherical equivalent.These curves and elevations of corneal posterior surface of eyes with high myopia were measured with Pentacam imaging system before surgery and at the first month and the third month after posterior scleral reinforcement and posterior scleral reinforcement combined with LASIK.The results of measurement in different time points were compared each other.Results There were no significant difference in the same group in different time points before and after posterior scleral reinforcement.However,there was significant difference in the curve and elevation of corneal posterior in every group before and after posterior scleral reinforcement combined with LASIK.The curve and elevation of corneal posterior surface at the first month after surgery were highest,they were decrease at the third month,but were higher than before surgery.Conclusion The curve and elevation of corneal posterior surface in high myopia will be increased after posterior scleral reinforcement combined with LASIK.