飞秒激光辅助LASIK术后早期角膜生物力学各指标的变化

Short- term changes of corneal biomechanical properties after FS- LASIK

目的:探讨准分子激光原位角膜磨镶术(LASIK)使用Femto LDV飞秒激光制瓣近视患者的角膜生物力学各指标的变化。方法:选取93例186眼近视患者均行飞秒激光辅助LASIK术。分别于术前;术后3,6mo应用眼反应分析仪(ocular response analyzer,ORA)检测角膜补偿眼压(corneal compensated intraocular pressure,Iopcc)、模拟Goldmann眼压(Goldmann correlated IOP value,Iopg)、角膜阻力因子(corneal resistance factor,CRF)、角膜滞后量(corneal hysteresis,CH)。超声角膜厚度测量。比较术后3mo与术前,术后6mo与术后3mo测量值的差异。结果:术后3mo中央角膜平均厚度为447.61±39.57μm与术前539.88±29.72μm比较,差异有显著统计学意义(t=-47.223,P=0.000);术后6mo 448.78±39.19μm较术后3mo厚度差异有统计学意义(t=2.15,P=0.033)。术后3mo Iopcc,Iopg分别为13.75±2.13,9.54±2.35mmHg较术前16.29±2.88,15.09±3.29mmHg显著降低(t=-13.604,-23.594;P=0.000,0.000)。Iopcc,Iopg分别较术前降低2.55±2.25,5.55±3.21mmHg。术后6mo 13.61±1.96,9.32±2.07mmHg与术后3mo比较差异无统计学意义(t=-0.977,1.447,P=0.33,0.15)。CRF,CH术后3mo测量值6.36±1.45,7.71±1.30mmHg较术前9.84±1.99,9.77±1.56mmHg显著降低(t=-24.116,-19.171;P=0.000,0.000)。CRF,CH分别较术前降低3.49±1.97,2.06±1.47mmHg。术后6mo 6.24±1.38,7.67±1.25mmHg与术后3mo比较差异无统计学意义(t=1.456,0.636,P=0.147,0.525)。结论:飞秒激光辅助LASIK术对角膜生物力学有显著影响,术后角膜生物力学各指标较术前显著降低。术后3mo内生物力学各指标基本稳定。

AIM： To investigate the changes of corneal biomechanics after Femto LDV laser flapping in laser in situ keratomileusis （LASIK）. METHODS： Preoperatively, 3 months, 6 months after LASIK, 93 myopia patients （ 186 eyes ） in flapping procedure by Femto LDV laser were examined by Ocular response analyzer （ORA）.The central corneal thickness （ CCT ） was also measured by ultrasonic pachymetry. Parameters were compared between postoperative （ 3 months） and preoperative, postoperative （6 months）. Comparisons included the corneal thickness and corneal compensated intraocular pressure （ Iopcc ） , Goldmann correlated IOP value （ Iopg ） , corneal resistance factor （ CRF） , corneal hysteresis （ CH） . RESULTS： The CCT （ 447.61 ±39.57μm ） were significantly changed comparing with preoperative （539.88±29.72μm） （t=-47.223;P=0.000）.The CCT of 6 months postoperative （ 448.78 ±39.19μm ） was slightly thicker than that of 3 months＇（t=2.15,P=0.033）.Iopcc, Iopg of 3 months after LASIK （13.75±2.13, 9.54±2.35） mmHg were significantly changed comparing with preoperative （16.29±2.88, 15.09±3.29 ）mmHg （t=-13.604,-23.594;P=0.000, 0.000）.The difference was （2.55 ±2.25, 5.55 ± 3.21） mmHg.There were no significant changes between Iopcc, Iopg of 6 months （13.61±1.96,9.32±2.07）mmHg and that of 3 months after LASIK. CRF and CH of 3 months after LASIK （6.36±1.45,7.71±1.30）mmHg were significantly changed comparing with preoperative＇s （9.84±1.99,9.77±1.56）mmHg （t=-24.116, -19.171; P=0.000, 0.000）.The difference was （3.49 ±1.97, 2.06 ± 1.47 ） mmHg. There were no statistical differences between 6 months （6.24 ±1.38, 7.67 ±1.25） mmHg and 3 months（t=1.456, 0.636;P=0.147, 0.525）. CONCLUSION： The corneal biomechanical properties after FS-LASIK are lower than that of preoperative. Corneal biomechanics sustains steadily about 3 months after LASIK.