内蒙古地区蒙汉族近视眼角膜曲率及中央角膜厚度的研究

Comparison of myopic patients＇ corneal curvature and CCT measurement in gender of Mongolia and Han nationality in Inner Mongolia region

目的探讨内蒙古地区蒙古族和汉族近视眼患者角膜曲率及中央角膜厚度值的差异。方法临床病例对照研究。于2010年6月至2014年12月在内蒙古医科大学附属医院眼科选取拟行LASIK或SBK手术的近视患者蒙古族600例（1196只眼），其中男性317例（631只眼），女性283例（565只眼）。汉族531例（1062只眼），其中男性282例（564只眼），女性249例（498只眼）。采用pentacam测量角膜曲率，并分别采用Pentacam、Orbscan角膜地形图系统和超声角膜测厚仪三种仪器测量中央角膜厚度值（CCT），并对不同民族、不同性别的结果进行统计学分析。结果蒙古族男女角膜曲率差异有统计学意义（P〈0．05）。蒙古族男性Pentacam、Orbscan及超声测厚仪的中央角膜厚度值分别为（538．33±24．17）、（545．58±24．16）和（549．06±23．74）um；Pentacam分别与Orbscan和超声测厚仪比较，差异均有统计学意义（P〈0．05）；Orbscan与超声测厚仪比较，差异无统计学意义（P〉0．05）。蒙古族女性三种仪器的中央角膜厚度值分别为（557．53±27．92）、（565．47±33．02）和（565．02±30．63）um，三种测量方法两两比较，差异均无统计学意义（P〉0．05）。汉族男性三种仪器测量的中央角膜厚度值分别为（554．48±35．03）、（571．08±37．12）和（570．71±35．98）um，Pentacam与Orbscan、超声测厚仪比较，差异均有统计学意义（P〈0．05）；Orbscan与超声测厚仪比较，差异无统计学意义（P〉0．05）。汉族女性三种仪器测量的中央角膜厚度值分别为（546．17±29．80）、（562．40±34．39）和（557．69±29．48）um，Pentacam与Orbscan和超声比较差异有统计学意义（P〈0．05）；Orbscan与超声测厚仪比较，差异均无统计学意义（P〉0．05）。结论近视眼患者中，蒙古族女性角膜曲率明显高于男性，汉族男女角膜曲率无明显差异。Pentacam测量中央角膜厚度值较Orbsean与超声测厚仪测量值均小，可作为LASIK手术前中央角膜厚度值的测量工具之一。OrbscanN量的蒙古族男女中央角膜厚度值差异有统计学意义。内蒙古地区近视眼患者CCT值高于已报道的国人CCT值。

Objective To evaluate and compare corneal curvature and central corneal thickness （CCT） in different gender of Mongolian and Han nationality for myopia. Methods In a prospective study, measurement agreement was assessed in 2 258 eyes of 1131 pre-LASIK patients using Pen- tacam, Orbscan and ultrasound, there were 600 Mongolian nationality patients （1196 eyes）, in which 317 male patients （631 eyes） and 283 females （565 eyes）; and 531 Han nationality patients （1 062 eyes）, 282 male cases （564 eyes）, 249 female cases （498 eyes）. Pentacam was used to measure the corneal curvature. Pentacam, Orbscan and Ultrasound were used to measure the significant preopera-tive central corneal thickness, and the results were analyzed statistically. Results There was differ- ence between Mongolian men and women （P 〈0.05）. The average measurements of central corneal thickness （CCT） by Pentacam, Orbscan and ultrasound in Mongolian male： （538.33±24.17） um, （545.58±24.16）um, （549.06±23.74）um, compared Pentacam and Orbscan, Pentacam and ultrasound, P 〈 0.05, there was significant difference between them. To compare Orbscan and ultrasound, P 〉0.05, there was no difference between them respectively; In Mongolian female： （557.53±27.92）um, （565.47± 33.02）um, （565.02±30.63）um, compared Pentacam and Orbscan, Pentacam and ultrasound and Orbscan and ultrasound, P 〉0.05, there were no difference respectively; The average measurements of CCT by Pentacam, Orbscan and ultrasound in Han male： （554.48±35.03）um, （571.08±37.12）um, （570.71±35.98）um, compared Pentacam and Orbscan, Pentacam and ultrasound, P 〈0.05, there was significant difference between them. To compare Orbscan and ultrasound, P 〉0.05, there was no difference between them respectively; In Han female： （546.17±29.80）um, （562.40±34.39）um, （557.69± 29.48）um, compared Pentacam and Orbscan, Pentacam and ultrasound, P 〈0.05, there was significant difference between them. To compare Orbscan and ultrasound, P 〉0.05, there were no difference re- spectively. Conclusions The corneal curvature of Mongolian women values is higher than Mongolian man. The central corneal thickness measurements using Pentacam are smaller than that of Orbscan and ultrasonic measurements. Pentacam can be used for detectjing central corneal thickness before corneal refractive surgery as one of the tools. Orbscan measurement of Mongolian men and women central corneal thickness value difference is statistically significant. Inner Mongolia region near-sighted CCT value higher than normal are already reported countrymen CCT values.