眼轴长度和角膜屈光力对准分子激光屈光性角膜切削术疗效的影响

Analysis of influence of axial length and keratometric value on the curative effects of excimer laser photorefracive keratectomy for myopia

目的 探讨眼轴长度、角膜屈光力对准分子激光屈光性角膜切削术 (photorefractivekeratectomy,PRK)疗效的影响。方法 应用美国Keracor 117型准分子激光仪对 80例 ( 12 1只眼 )近视患者进行治疗。按眼轴 (axailength ,AL)及角膜屈光力 (keratometricvalue,KV)进行分组 :1组 49只眼 ,AL >2 6mm ,KV≤ 45D ;2组 36只眼 ,AL≤ 2 6mm ,KV >45D ;3组 36只眼 ,AL≤ 2 6mm ,KV≤ 45D。同时对手术后的结果进行分析。结果 术后平均裸眼视力为 1 0 5± 0 31,3组间比较差异无显著性 (P>0 0 5 )。术后裸眼视力≥ 0 5者 ,1组与 2、3组间比较差异有显著性 ( χ2 =6 30 ,P <0 0 5 )。多元线性回归和相关分析显示眼轴增长为影响术后视力提高的不利因素 ,而角膜屈光力增加为影响术后视力的有利因素。结论 PRK治疗近视是一种安全、有效的方法 ,但当近视度数相同时 。

Objective To evaluate the influence of axial length (AL) and keratometric value (KV) on the curative effects of excimer laser photorefractive keratectomy (PRK) for myopia Method A Keracor17 excimer laser was used to treat 80 patients (121 eyes) with myopia The cases were divided into three groups according to the AL and KV: The first group AL>26 mm, KV≤45 D, 49 eyes; the second group AL ≤26 mm, KV > 45 D, 36 eyes; the third group AL ≤26 mm, KV ≤45 D, 36 eyes The curative effects were investigated Results The mean uncorrected visual acuity was 105±031, which had no significant difference among three groups (P>005) The cases with uncorrected visual acuity ≥05 had significant difference between the first and the second group and between the first and the third group (χ2=630,P<005) Multiple linear regression and correlative analysis showed that the increase in ocular axis was an unfavorable factor to visual acuity, while the increase in keratometric value was a favorable factor to visual acuity Conclusion PRK for treatment of myopia is an effective and safe refractive surgery When the myopic degrees are identical, the postoperative outcome of myopia with increase in keratometric value as the main pathogeny is better than the myopia with increase in axial length as the main pathogeny