角膜屈光手术中静态和动态眼球旋转的方向和程度变化分析

Analysis of the direction and degree of static cyclotorsion component and dynamic cyclotorsion component in corneal refractive surgery

目的:角膜屈光手术中静态眼球旋转(static cyclotorsion component,SCC)和动态眼球旋转(dynamic cyclotorsion component,DCC)的方向和程度变化分析。方法:回顾性分析在本院行角膜屈光手术的患者130例260眼,根据手术方式分为飞秒准分子激光原位角膜磨镶(femtosecond laser-assisted laser in situ keratomileusis,FSLASIK)组和准分子激光角膜切削术(T-photorefractive keratectomy,T-PRK)组,比较两组患者术后各参数的差异;比较两组患者术中的SCC成功率、SCC、DCC、眼球旋转方向的差异;以及SCC、DCC与患者术后的各参数的相关性分析。结果:T-PRK组术后的高阶像差和球差高于FS-LASIK组,且差异具有统计学意义(P<0.05);T-PRK组术中SCC成功98眼,成功率为81.7%,FS-LASIK组术后SCC成功82眼,成功率为58.6%,两组患者术中的SCC成功率的差异具有统计学意义(P<0.05);T-PRK组术中SCC为(3.52°±2.17°),与FS-LASIK组(3.49°±2.26°)的差异无统计学意义(P>0.05);T-PRK组术中DCC为(2.86°±1.14°),高于FS-LASIK组(2.17°±1.09°),且差异具有统计学意义(P<0.05);两组患者术中眼球旋转方向的分布无统计学差异(P>0.05)。研究对象术中SCC与裸眼视力、最佳矫正视力、等效球镜屈光度、高阶像差呈正相关(P<0.05);研究对象术中DCC与裸眼视力、高阶像差呈正相关(P<0.05)。结论:T-PRK手术中SCC成功率高于LASIK手术,T-PRK手术中的DCC高于LASIK手术,准确的测量静态及动态眼球旋转可有效的对其进行补偿。

AIM： To analyze the direction and degree of static cyclotorsion component （SCC） and dynamic cyclotorsion component （DCC） in corneal refractive surgery. METHODS：Retrospective analysis. Totally 130 patients （260 eyes） with corneal refractive surgery in our hospital, according to the operation method were divided into femtosecond laser - assisted laser in situ keratomileusis （FS-LASIK） group and T-photorefractive keratectomy （T-PRK） group, the differences of the parameters of the two groups were compared; the differences of SCC success rate, SCC, DCC, and the eyeball rotation direction were compared between the two groups; correlation analysis on SCC, DCC and the parameters of postoperative patients were performed. RESULTS： High order aberrations and spherical aberration in the T-PRK group after operation was higher than those of FS - LASIK group, and the difference was statistically significant （P〈0. 05）; in T-PRK group SCC in the operation was successful in 98 eyes, the success rate was 81. 7%; in FS-LASIK group SCC in the operation was successful in 82 eyes, the success rate is 58. 6%, the difference of SCC success rate between the two groups was statistically significant （ P 〈 0. 05 ）; SCC in T - PRK group was 3. 52° ±2. 17° and FS-LASIK group was 3. 49°±2. 26°, there was no significant difference （P〉0. 05）; DCC in T-PRK group （2. 86°±1. 14°） was higher than that of FS-LASIK group （ 2. 17° ± 1. 09°）, and the difference was statistically significant （P〈0. 05）. There was no statistical＆amp;nbsp;difference in the direction of rotation of the eyeball in operation between the two groups （P〉0. 05）. The SCC of subjects in operation was positively correlated with UCVA, BCVA, spherical equivalent refraction and high order aberrations （ P 〈 0. 05 ）; the DCC of subjects in operation was positively correlated with UCVA and high order aberrations （P〈0. 05）. CONCLUSION： The success rate of SCC in T - PRK surgery is higher than that in LASIK, DCC in T - PRK surgery is higher than that in LASIK, and accurate measurement of SCC and DCC can be effective to compensate for it.