Pascal动态轮廓眼压计在角膜屈光手术前后的应用

Application of Pascal dynamic contour tonometer before and after corneal refractive surgery

目的探讨Pascal动态轮廓眼压计(dynamic contour tonometer,DCT)在角膜屈光手术前后的应用。方法随机收集我院2009年1月至6月拟接受角膜屈光手术的屈光不正患者127例(254眼),其中男51例(102眼),女76例(152眼);年龄18~47岁,平均(22.48±3.57)岁。中央角膜厚度(central corneal thickness,CCT)为450~600μm,平均等效球镜度数为-0.75^-10.00D。术前及术后1个月分别采用DCT和非接触式眼压计(non-contact tonometer,NCT)测量眼压,角膜超声测厚仪测量CCT,并分析眼压与CCT变化的关系。结果术前:450μm<CCT≤500μm、500μm<CCT≤550μm和CCT>550μm时,NCT测得眼压平均值分别为(11.51±3.25)mmHg(1kPa=7.5mmHg)、(17.58±2.97)mmHg、(19.74±3.12)mmHg,DCT测得眼压平均值分别为(16.89±2.56)mmHg、(17.33±3.32)mmHg、(17.58±2.74)mmHg,当450μm<CCT≤500μm、CCT>550μm时,DCT与NCT测得的眼压平均值比较,差异均有统计学意义(均为P<0.05),而500μm<CCT≤550μm时,二者测量结果差异无统计学意义(P>0.05);术后1个月:当△CCT≤50μm、50μm<△CCT≤100μm和△CCT>100μm时,NCT测得眼压较术前分别下降(1.46±0.81)mmHg、(3.87±1.21)mmHg、(4.19±2.68)mmHg,与术前相比差异均有统计学意义(P<0.05、P<0.01、P<0.01);DCT测得眼压较术前分别下降(0.65±0.28)mmHg、(0.53±0.37)mmHg、(0.67±0.41)mmHg,与术前相比,差异均无统计学意义(均为P>0.05)。结论 DCT受角膜厚度影响较小,是角膜屈光手术前后眼压测量的一种好方法,尤其对于手术前眼压偏高的患者意义更大。

Objective To investigate the application of Pascal dynamic contour tonometer（DCT）before and after corneal refractive surgery.Methods A total of 127 ametropic patients（254 eyes）were randomly collected to take corneal refractive surgery from January,2009 to June,2009.There were 51 male patients（102 eyes）and 76 female patients（152 eyes）with 18 to 47 years old,averaged in（22.48±3.57）years old.The central corneal thickness（CCT）was from 450 μm to 600 μm,average spherical equivalent was from-0.75 D to-10.00 D.Intraocular pressure（IOP）was measured with DCT and non-contact tonometer（NCT）,CCT was measured with ultrasound corneal thickness tester at pre-operation and postoperative 1 month.The relationship between IOP and CCT was observed.Results At pre-operation,when CCT was 450 μm to 500 μm,500 μm to 550 μm and more than 550 μm,the IOP measured by NCT were（11.51±3.25）mmHg（1 kPa=7.5 mmHg）,（17.58±2.97）mmHg and（19.74±3.12）mmHg,respectively,were（16.89±2.56）mmHg,（17.33±3.32）mmHg and（17.58±2.74）mmHg by DCT,respectively.There were statistical differences in average IOP between DCT and NCT in the first group and the third group（both P0.05）,while no difference was found in the second group（P0.05）.At postoperative 1 month,when △CCT was ≤50 μm,50 μm△CCT≤100 μm,△CCT100 μm,IOP measured by NCT were lowered（1.46±0.81）mmHg,（3.87±1.21）mmHg and（4.19±2.68）mmHg compared with that at pre-operation,there were statistical differences（P0.05,P0.01,P0.01）;IOP measured by DCT were lowered（0.65±0.28）mmHg,（0.53±0.37）mmHg and（0.67±0.41）mmHg compared with that at pre-operation,while no difference was found（all P0.05）.Conclusion CCT has less effect on DCT,which is a better way for measuring IOP before and after corneal refractive surgery,especially for patients with ocular hypertension before surgery.