LASIK患者眼压测量的多因素分析

Influencing factors of tonometry of intraocular pressure following LASIK

目的通过分析近视眼人群准分子激光原位角膜磨镶术(LASIK)手术前后非接触式眼压值的影响因素,得出预测术后眼压值变化的回归公式,并对其进行效能检验。方法筛选行双眼LASIK手术矫正近视的病例235例,作左右眼自身配对实验设计,随机分组的前瞻性观察研究,分析影响LASIK术前术后非接触式眼压值的多种因素,探寻其规律,建立计算术后眼压值变化的多元回归公式,并检验其效能。结果术前非接触式眼压值与性别、眼别、年龄、角膜曲率无明显相关(P>0.05),与中央角膜厚度及等效球镜绝对值呈正相关。LASIK术后非接触式眼压变化值与年龄、角膜曲率、基质床厚度无明显相关(P>0.05),与术前非接触式眼压值、中央角膜厚度、等效球镜绝对值、消融深度、消融比呈正相关;逐步回归分析可得公式:非接触式眼压变化值=术前非接触式眼压值×0.552+消融比×0.158-6.219(R^2=0.561,P<0.01)。经检验,运用公式所得非接触式眼压变化的预估值与实测值差异无统计学意义(t=-0.129,P=0.897)。结论 LASIK术前非接触式眼压值与性别、眼别、年龄、角膜曲率无明显相关,与中央角膜厚度及等效球镜绝对值呈正相关;LASIK术后非接触式眼压变化值与年龄、角膜曲率、基质床厚度无明显相关,与术前非接触式眼压值、中央角膜厚度、等效球镜绝对值、消融深度、消融比呈正相关;术后眼压变化值可运用回归公式预测。

Objective To establish and validate the regression formula of intraocular pressure （IOP） by analyzing the influencing factors of IOP following laser assisted in situ keratomileusis （LASIK）. Methods A prospective case study was performed on 235 myopia patients receiving LASIK. After self-contrast of randomized paired design, the influencing factors of IOP noncontact tonometer （ IOPNcr ） were analyzed. The multiple regression formula to forecast the changes of IOPNcT after LASIK was established and verified. Results The preoperative IOPNCT was not related to gender, dominant eye, age or keratometry of the patients （ P 〉 0.05 ）, but positively related to the central corneal thickness （CCT） and absolute value of spherical equivalent. The IOPNcr changes after LASIK （△IOPNCT） were not related to age, keratometry or stroma bed thickness of the patient （P 〉 0.05）, but positively related to the preoperative IOPNCT, CCT, ablation depth, ablation rate （AR） and absolute value of spherical equivalent. The multiple linear regression formula of the IOPNCT changes after LASIK was： △IOPNCT = IOPNCT-preop ×0. 552 ＋ AR ×0. 158 -6. 219 （R^2 =0. 561, P 〈0.01 ）. After Verification by practical cases, there was no statistically significant difference between the estimated values and measured values of the IOPNCT changes after LASIK （ t = - 0. 129, P = 0. 897）. Conclusion The IOPNcT of pre-LASIK is not related to gender, dominant eye, age or keratometry of the patient, but positively related to the central corneal thickness and absolute value of spherical equivalent. The △IOPNCT is not related to age, keratometry or stroma bed thickness of the patient, but positively related to the IOPNCT of pre-LASIK, central corneal thickness, absolute value of spherical equivalent, ablation depth and rate. The values of △IOPNCT can be estimated by the regression formula.