机械刀前弹力层下角膜磨镶术后角膜混浊的相关因素分析

Analysis of related factors of corneal opacity after sub-Bowman keratomileusis by mechanical microkeratome

目的:筛选引起机械微角膜刀前弹力层下角膜磨镶术(subBowman keratomileusis,SBK)后角膜混浊的相关因素,为优化SBK术后效果提供参考。方法:回顾性病例研究。法国Moria公司OUP90刀头制瓣的SBK术后896眼,术后3mo复查,记录有无角膜混浊。根据角膜混浊与否分为两组,对两组性别、年龄、术前眼压、术前角膜中央厚度、K1、K2、平均角膜曲率、术前等效球镜值进行统计学分析。结果:角膜混浊组男52眼,女48眼,年龄(24.5±6.1)岁,眼压(14.26±2.24)mmHg,角膜中央厚度(487.27±18.52)μm,K1(44.24±1.23)D,K2(43.33±1.13)D,平均曲率(43.79±1.15)D,等效球镜度(-4.65±1.44)D;角膜无混浊组男412眼,女384眼,年龄(24.3±5.8)岁,眼压(16.72±7.01)mmHg,角膜中央厚度(533.11±28.74)μm,K1(43.90±1.47)D,K2(42.88±1.35)D,平均曲率(43.39±1.37)D,等效球镜度(-5.04±1.96)D;两组中性别(χ2=0.002,P=0.964)、年龄(t=0.404,P=0.686)、等效球镜度(t=1.949,P=0.052)差异无统计学意义;而术前眼压(t=-3.486,P=0.001)、术前角膜中央厚度(t=-15.543,P=0.000)、K1(t=2.249,P=0.025)、K2(t=3.172,P=0.002)及平均角膜曲率(t=2.763,P=0.006)差异有统计学意义。结论:术前中央角膜薄、眼压低、角膜曲率高者机械刀SBK术后角膜混浊发生率高,性别、年龄、术前屈光度与机械刀SBK术后角膜混浊无关。

AIM： To provide a reference to improve postoperative effects by screening the related factors causing corneal opacity after sub- Bowman keratomileusis （SBK） by mechanical microkeratome. METHODS： In this retrospective cases study, 896 eyes underwent sub-Bowman keratomileusis with and they were followed up for 3mo postoperatively. Record was made on whether the corneal opacity occurred. These eyes were divided into 2 groups corneal opacity group and clear cornea group. The gender, age, preoperative intraocular pressure （lOP）, preoperative central cornea thickness （CCT）, K1, K2, mean K, preoperative spherical equivalent （SE） were statistically analyzed. RESULTS：There were 52 males and 48 females in haze group, mean age were （24.5±6.1）year, preoperative lOP were （14.26±2.24） mmHg, preoperative CCT were （487.37± 18.52）tjm, K1, K2, mean Kwere （44.24±1.23）D, （43.33± 1.13） D, （43.79± 1.15） D, respectively, preoperative SE were （4.65±1.44）D. There were 412 males and 384 females in without haze group, mean age were （24.3± 5.8）year, preoperative lOP were （16.72±7.01） mmHg, preoperative CCT were （533.11 ±28.74） IJ m, K1, K2, mean Kwere （43.90±1.47）D, （42.88±1.35）D, （43.39±1.37）D, respectively, preoperative SE were （-5.04±1.96） D. The difference of sex （X,2 = 0. 002, P= 0. 964）, age （ t= 0. 404, P= 0. 686）, preoperative SE （ t= 1. 949, P= 0. 052） between the2 groups were insignificant. The difference of preoperative lOP （ t= -3.486, P= 0. 001 ）, preoperative CCT （t=-15.543, P=0.000）, K, （ t= 2. 249, P=0.025）, K2（t= 3.172, P=0.002）, mean K （t=2.763, P=0.006） between the two groups of haze after mechanical microkeratome SBK. CONCLUSION： The incidence of corneal opacity is high in patients with thin preoperative CCT, low lOP and high corneal curvature after SBK surgery by microkeratome. Gender, age and preoperative spherical equivalent are not related to the incidence of corneal opacity after SBK surgery.