LASIK术后角膜生物力学变化与眼压测量值的相关性

Correlation analysis between change of corneal biomechanical parameters and measurement of intraocular pressure after LASIK

目的观察LASIK术后角膜生物力学参数和眼压测量值的变化及角膜生物力学变化与眼压的相关性。设计前瞻性病例系列。研究对象哈尔滨医科大学附属第一医院2014年1-12月LASIK手术患者81例(162眼)。方法应用非接触眼压计(non-contact tonometer,NCT)分别在术前及术后3个月测量眼压。同时应用眼反应分析仪(ocular response analyzer,ORA)测量角膜滞后量(corneal hysteresis,CH)、角膜阻力因子(corneal resistance factor,CRF)、模拟Goldmann眼压(Goldmann intraocular pressure,IOPg)和角膜补偿眼压(corneal-compensated intraocular pressure,IOPcc)。比较手术前后各参数的变化并分析术后角膜生物力学参数变化与眼压测量值的相关性。主要指标手术前后NCT、IOPcc、IOPg、CH、CRF。结果 LASIK术后3个月CH、CRF、IOPcc、IOPg、NCT测量值与术前比较均显著降低,术后IOPcc与IOPg和NCT之间比较差异均有统计学意义(P<0.05);△CH、△CRF与△IOPcc、△IOPcc-IOPg和△IOPcc-△NCT均成负相关,△CH、△CRF与△IOPg和△NCT均成正相关(P<0.05);CH和CRF的减少量与眼压测量值下降具有相关性(P<0.05)。结论 LASIK术后角膜生物力学参数和眼压测量值均较术前显著降低,眼压测量值下降与CH和CRF的减少量具有相关性,说明眼压下降的程度可能受角膜生物力学特性的影响。

Objective To observe the relationship between the change of corneal biomechanical parameters and the measurement of intraocular pressure after LASIK. Design Prospective case series. Participants Eighty-one patients（162 eyes）with myopia were performed LASIK from Janurary to December in 2014 in the First Affiliated Hospital of Harbin Medical University. Methods The corneal hysteresis（CH）, corneal resistance factor（CRF）, Goldmann-correlated IOP value（IOPg） and corneal-compensated intraocular pressure（IOPcc） were examined with ocular response analyzer（ORA） before and after LASIK. The intraocular pressures were measure using non-contact tonometer（NCT） as well. Main Outcome Measures NCT,IOPcc,IOPg,CH,CRF before and after LASIK. Results Postoperative 3 months, CH, CRF, IOPcc, IOPg, and NCT measured values decreased significantly compared with those preoperatively. The comparison among IOPcc, IOPg and NCT postoperatively shows the significant distinction（P〈0.05）. There is a negative correlation between △CH, △CRF and △IOPcc, △IOPcc-IOPg and △IOPcc-△NCT. There is a positive correlation between △CH, △CRF and△IOPg and △NCT（P〈0.05）. Conclusion The corneal biomechanics and the measurement of intraocular pressure after LASIK were lower than preoperatively. There is a correlation between the decline of the measurement of intraocular pressure and the decrement of CH and CRF. The level of intraocular pressure drop may be affected by corneal biomechanical properties.