应用CorvisST测量仪评估白内障超声乳化手术前后角膜生物力学的变化

Change of corneal biomechanical properties caused by phacoemulsification using corneal visualization Scheimpflug technology

目的通过应用可视化角膜生物力学分析仪（Corvis ST）测量并比较白内障超声乳化手术前后角膜生物力学的变化，探讨3.0 mm透明角膜切口对角膜生物力学的影响。方法采用患眼手术前后自身对照研究设计。于2015年3—5月纳入在天津市眼科医院行白内障超声乳化摘出联合后房型人工晶状体植入术的患者36例36眼，采用Corvis ST分别测量患眼术前、术后1周、术后1个月的第一/第二次压平时间、第一/第二次压平长度、第一/第二次压平速度、最大压陷时间、峰距（PD）、最大形变幅度（DA）、最大压陷曲率、眼压、矫正眼压和中央角膜厚度（CCT），所有检查均在7：00～10：00进行。采用重复测量单因素方差分析对不同时间点受检眼各生物力学参数进行比较。结果受检眼术前、术后1周、术后1个月第一次压平长度、第二次压平长度、眼压、PD、DA以及CCT测量值的总体比较差异均有统计学意义（F＝3.42、5.24、4.21、3.82、3.91、4.03、3.62，均P〈0.05）。术后1周，受检眼第一次压平长度值较术前增加，第二次压平长度值下降，眼压和矫正眼压值升高，PD和DA值均增加，CCT变厚，差异均有统计学意义（均P〈0.05）。术后1个月，受检者第一次压平长度值较术前1周下降，第二次压平长度值增加，眼压和矫正眼压值降低，PD和DA值均变小，CCT变薄，差异均有统计学意义（均P〈0.05）。术后1个月第一次压平长度值、第二次压平长度值、眼压、矫正眼压、PD、DA和CCT均至术前水平，与术前比较差异均无统计学意义（均P〉0.05）。结论白内障超声乳化术后早期角膜生物力学特性发生改变，术后1个月术前角膜生物力学特性恢复至术前水平。

ObjectiveTo explore the corneal biomechanical characteristics change in cataractous eyes before and after phacoemulsification using corneal visualization Scheimpflug technology （Corvis ST） and evaluate the influence of 3 mm clear corneal incision on corneal biomechanics.MethodsA self-control study was performed.Thirty-six eyes of 36 patients who received phacoemulsification were enrolled in Tianjin Eye Hospital from March to May 2015.The first/second applanation time, the first/second applanation length, the first/second applanation velocity, the highest concavity time, the highest concavity radius, peak distance（PD）, deformation amplitude （DA）, intraocular pressure, corrected intraocular pressure and central corneal thickness（CCT） were measured in preoperation, postoperative 1 week and postoperative 1 month.This study protocal was approved by Ethic Committee of Tianjin Eye Hospital, and written informed consent was obtained from each patient prior to any medical examination.ResultsThe first/second applanation length, intraocular pressure, corrected intraocular pressure, PD, DA and CCT were significantly different among preoperation, postoperative 1 week and postoperative 1 month （F=3.42, 5.24, 4.21, 3.82, 3.91, 4.03, 3.62; all at P〈0.05）. Compared with the preoperative parameters, the first applanation length value was increased, and the second applanation length was reduced; the intraocular pressure and corrected intraocular pressure were elevated, and PD and DA values were increased, and the CCT was thicked in 1 week postoperative, with significant differences between the two time points （all at P〈0.05）. Compared with the postoperative 1 week, the first applanation length value was reduced, and the second applanation length value was increased; the intraocular pressure and corrected intraocular pressure were lowed, and PD and DA values were smaller, and the CCT was thinner in postoperative 1 month, showing significant differences between the two time points （all at P〈0.05）. The first applanation length, the second applanation length, the intraocular pressure, corrected intraocular pressure, PD, DA and CCT in postoperative 1 month returned to the preoperative levels（all at P〉0.05）.ConclusionsCorneal biomechanical properties occur change in the early stage after phacoemulsification and return to normal in postoperative 1 month .