飞秒激光制瓣LASIK手术后角膜生物力学变化研究（英文）

Corneal biomechanical properties after femtosecond laser assisted LASIK with the corneal visualization Scheimpflug technology and ocular response analyzer

目的:应用可视化角膜生物力学分析仪(Corvis ST)及眼反应分析仪(ORA)评估飞秒激光制瓣准分子激光原位角膜磨镶术(laser in situ keratomileusis,LASIK)术后角膜生物力学变化,并分析与其他参数的相关性。方法:收集63例飞秒制瓣LASIK手术患者,所有收集对象采用右眼数据进行分析。角膜生物力学测量仪器应用可视化角膜生物力学分析仪Corvis ST及眼反应分析仪ORA,手术前及手术后1mo进行生物力学数据采集分析。配对t检验或Mann-Whitney U检验进行手术前后生物力学对比分析。Pearson或Spearman统计学方法进行相关性分析。结果:与FS-LASIK手术前相比,手术后1stA-time,Vin,2ndA length,Vout以及Radius下降,有统计学差异(P=0.00,P=0.00,P=0.00,P=0.00,P=0.00)。2ndA-time,DA以及PD手术后增加,有统计学差异(P=0.00,P=0.00,P=0.00)。1stA length以及HC time手术后改变不明显,无统计学差异(P=0.96,P=0.08)。与FS-LASIK手术前相比,手术后CH,CRF下降,有统计学差异(P=0.00,P=0.00)。手术后1stA-time,2ndA-time,DA and Radius变化量与手术前角膜中央厚度有明显相关性(P=0.01,P=0.04,P=0.03,P=0.01)。结论:飞秒激光LASIK手术后角膜生物力学参数有较明显改变,可通过Corvis ST及ORA生物力学参数计算得出相应变化,手术后生物力学参数变化与角膜厚度相关性明显。

AIM：To investigate the changes of corneal biomechanical properties before and after femtosecond laser assisted LASIK（FS- LASIK） using Corneal Visualisation Scheimpflug Technology（Corvis ST） and Ocular Response Analyzer（ORA）,and the correlation with other myopic parameters.METHODS：Sixty three patients（63 eyes） who had myopic femtosecond laser assisted LASIK（FS-LASIK）were enrolled in the study.The right eye of each patient was analyzed in this study.The corneal biomechanical parameters pre-operative and 1mo post-operative was measured with the Corvis ST（Oculus,Wetzlar,Germany）and ORA（Reichert,Buffalo,New York,USA）.Comparison of the biomechanical property values before and after surgery was peformed using Paired t-test or MannWhitney U.Pearson or Spearman correlations were used to evaluate the relationship between parameters.RESULTS：The postoperative 1^（st） A-time,Vin,2^（nd） A length,Vout,HC time and Radius demonstrate significant decreases comparing with preoperative values（P=0.00,P=0.00,P=0.00,P=0.00,P=0.00,P=0.00 respectively）.The postoperative 2^（nd） A-time,DA and PD significantly increases（P=0.00,P=0.00,P=0.00）,however,the 1^（st） A length had no significant difference after surgery.The CH and CRF were significantly lower after FS-LASIK（P =0.00,P = 0.00）.A statistically significant correlation coefficient was found between preoperative central corneal thickness（CCT） with postoperative-preoperative changes of 1^（st） A-time,2（nd） A-time,DA and Radius respectively（P=0.01,P=0.04,P=0.03,P=0.01）.CONCLUSION：There were significantly changes of corneal biomechanical properties after FS-LASIK surgery.The changes of corneal biomechanical properties after FS-LASIK can be reflected by some parameters of Corvis ST and ORA.The mainly influence of corneal biomechanical alteration was possibly correlation with corneal thickness.