应用谱域OCT观察LASIK对黄斑区视网膜厚度的影响

Measurements of macular thickness changes after laser in situ keratomileusis using spectral domain optical coherence tomography

目的 使用谱域OCT（SD-OCT）观察LASIK对手术患者黄斑区视网膜厚度的影响.方法 系列病例研究.使用随机数字表选择2012年10月至2013年5月接受LASIK的30例（60眼）屈光不正患者,采用SD-OCT观察患者术前、术后10 d以及术后30 d的黄斑总容积（TMV）和中央视网膜厚度（CRT）的变化.数据分析采用重复测量设计和Pearson相关分析法.结果 30例（60眼）患者术前BCVA （logMAR）为-0.063±0.041,TMV为（7.31±0.31）mm^3,CRT为（220.3±21.1）μm,术后10 d时相应的指标分别为-0.043±0.081、（7.32±0.26）mm^3、（221.6±20.8）μm,术后30 d时相应的指标分别为-0.074±0.061、（7.35±0.29）mm^3、（219.8±22.9） μm.患者术后视力满意,术后10 d的CRT较之术前、术后30 d的差异均有统计学意义（P＜0.05）,而术后10 d的TMV仅与术后30 d的差异有统计学意义（P＜0.05）,同时术前术后的TMV、CRT的改变程度与术前等效球镜度不相关.结论 LASIK术后短时间内黄斑区存在一定程度的视网膜水肿,程度与等效球镜度无关,并且不影响预后视力.

Objective To evaluate the effect of laser in situ keratomileusis （LASIK） for myopia as well as changes in the macula after surgery.Methods This was a prospective clinical study.Thirty patients （60 eyes） were selected randomly to undergo LASIK.Spectral domain optical coherence tomography （SD-OCT） was used to evaluate the total macular volume （TMV） and central retinal thickness （CRT） before surgery,and 10 days and 1 month after surgery.Data were analyzed by a repeated measures design and Pearson correlation analysis.Results Preoperatively,mean BCVA was -0.063±0.041,mean TMV was 7.31±0.31 mm^3,and mean CRT was 220.3±21.1 μm.Ten days after surgery,mean BCVA was-0.043±0.081,mean TMV was 7.32±0.26 mm^3,and mean CRT was 221.6± 20.8 tm.One month after surgery,mean BCVA was-0.074±0.061,mean TMV was 7.35±0.29 mm^3,and mean CRT was 219.8±22.9 μm.CRT had changed significantly 10 days postoperatively compared to preoperative measurements and postoperative measurements at 30 days （P＜0.05）,and TMV measurements changed significantly between 10 and 30 days postoperatively （P＜0.05）.The variations in TMV and CRT do not correlate significantly with the change in spherical equivalent.Conclusion Mild macular edema is common shortly after LASIK,but no association with a loss of BCVA has been established.