准分子激光屈光性角膜切削术治疗近视术后眼压分析

Analysis of IOP measurement following photorefractive keratectomy by non contact tonometer

目的 探讨非接触眼压计测量准分子激光屈光性角膜切削术治疗近视术后眼压变化及相关因素。方法 选取 - 1.5 0 D～ - 12 .0 0 D近视眼 32 1例 ,按预矫正等值球镜屈光度分为 2组 : 组为 - 1.5 0 D～ - 6 .0 0 D183眼 , 组 - 6 .2 5 D～ - 12 .0 0 D138眼 ,用非接触眼压计测量术前及术后 1、6 m o眼压 ,并分析术后眼压变化与角膜屈光度、厚度变化 ,年龄、基础眼压等因素的关系。结果 2组术后 1、6 mo眼压均明显低于术前 (P<0 .0 5 )。 1mo时 、 组分别较术前下降 0 .70 k Pa± 0 .2 8k Pa、0 .95 k Pa± 0 .35 k Pa,6 mo时 、 组分别下降 0 .5 8k Pa±0 .37k Pa、0 .83k Pa± 0 .39k Pa。术后随访显示高度组眼压降低幅度明显大于低、中度组 (P<0 .0 5 )。 6 m o时眼压降低与角膜曲率变化、基础眼压、年龄呈线性正相关 ,偏回归系数分别为0 .36 9、0 .42 0、0 .0 98(P值分别为 0 .0 335、0 .0 0 0 0、0 .0 36 5 )。结论 非接触眼压计测量 PRK术后眼压值应进行修正。

Objective To determine the accuracy of IOP measurement by non contact tonometer following PRK for treatment of myopia.Methods Three hundred and twenty one eyes were divided into 2 groups according to their preoperative spherical equivalent(-1 50^-6 00D,183eyes;-6.25^-12.00D,138eyes).IOPs were measured by non contact tonometer before and 1,6 months after surgery.The results and correlation factors were analyzed.Results The IOP readings of both groups decreased 1 and 6 months after the operations compared to the preoperative readings( P <0.05). One month after the operations there was a mean decrease of 0.70kPa±0 28kPa、0.95kPa±0.35kPa and 6 months after the operations of 0.58kPa±0.37kPa、 0.83kPa±0.39kPa in group Ⅰand Ⅱ,respectively.During the follow up,group Ⅱ was observed to decrease more than group Ⅰ( P <0.05).The change in IOP 6 months after the operations was correlated with baseline IOP,age and refractive power change.Conclusion IOP measured after PRK for myopia may be reduced related to degree of refractive treatment and need correction in the management of future glaucoma.