准分子激光原位角膜磨镶术后远期角膜生物力学评估

Evaluation of long-term corneal biomechanics parameters(ORA)after laser in situ keratomileusis surgery

目的应用眼反应分析仪(ORA)评估准分子激光原位角膜磨镶术(LASIK)术后远期角膜生物力学变化及相关性。方法回顾性研究。收集113例(225只眼)LASIK手术后远期患者(6~18年)进行角膜生物力学测量,平均随访年限(9.12±4.38)年。收集在我院行手术前检查并行LASIK手术患者85例(170只眼),手术前及手术后3个月作为未手术对照组及手术后早期对照组。应用ORA检查可获得角膜滞后量(CH)和角膜阻力因子(CRF)等角膜生物力学参数,分析LASIK手术后远期角膜生物力学参数变化特点。结果LASIK手术后远期、手术后早期、未手术组CH分别为8.54±1.09、7.18±1.27、9.77±1.31;CRF分别为7.50±1.33、6.37±1.26、10.02±1.43。与未手术角膜组对比,LASIK手术后远期、手术后早期CH(F=139.62,P<0.01)、CRF(F=242.60,P<0.01)均有统计学差异。手术后远期、手术后早期相比,远期CH、CRF值均高于近期对照组,有统计学差异(P<0.01)。结论LASIK手术后角膜生物力学有所下降,手术后远期、早期改变趋势一致。LASIK术后远期较早期相比角膜生物力学更加稳定。

Objective To evaluate the long term changes in corneal biomechanical properties after Laser in Situ Keratomileusis(LASIK)by Ocular Response Analyze(ORA).Methods In this retrospective study,113 patients(225 eyes)who underwent LASIK more than six years ago at Xi'an No.4 Hospital were enrolled in this study as the long-term LASIK group.Another 85 myopic patients(170 eyes)without any ophthalmic surgical history were included as the normal control group.These 85 patients then received LASIK in our hospital and follow-up for 3 months after the surgery,and were included as the short-term LASIK group.Changes in the corneal biomechanics parameters,including cornea hysteresis(CH)and corneal resistance factor(CRF),were measured in all eyes with the ORA(Reichert,America).Results The CH values in long-term LASIK group,short-time LASIK control group and normal control group were 8.54±1.09,7.18±1.27,9.77±1.31,respectively.And the CRF was 7.50±1.33,6.37±1.26,10.02±1.43,respectively.ORA showed significant differences in CH(F=139.62,P<0.01)and CRF(F=242.60,P<0.01)values among groups.Compared to the normal control group,the CH and CRF were significant higher in the long-term LASIK group and the short-time group(P<0.01).Conclusions The corneal biomechanical parameters decreased after LASIK,and the long-term and short-term corneal biomechanics changes were consistent.The long-term corneal biomechanics after LASIK is more stable.