1017例近视患者的Kappa角分布特点及其相关因素分析

Distribution characteristics of angle kappa and its related factors in 1017 myopia patients

目的研究1017例近视患者Kappa角的分布特点及其与角膜前表面像差的相关性分析。方法横断面研究。选取2021年1~6月于徐州市第一人民医院屈光手术中心行术前检查的患者1017例(1017只眼),均为右眼,其中男性660例,女性357例,平均年龄(22.97±5.02)岁。采用Pentacam AXL眼前节分析系统进行测量,获得以角膜顶点为原点的直角坐标系中瞳孔中心的坐标值(X,Y),其中X表示水平方向,Y表示垂直方向,利用三角函数计算出瞳孔中心到角膜顶点的偏心距(mm)表示Kappa角的大小,同时记录6 mm范围的角膜前表面像差。采用Mann-Whitney秩和检验以及Spearman相关分析进行数据处理。结果该近视人群Kappa角大小为(0.18±0.12)mm;X轴偏移量为(0.11±0.09)mm;Y轴偏移量为(0.12±0.11)mm,其中Kappa角≤0.40 mm的患者占95.18%,X轴、Y轴偏移量在0.20 mm范围的分别占84.85%、82.01%;女性的Kappa角大于男性,差异有统计学意义(Z=-3.98,P<0.05);X轴偏移与水平彗差(Z^(1)_(3))具有正相关性(r=0.16,P<0.05);Y轴偏移与垂直彗差(Z^(-1)_(3))具有负相关性(r=-0.17,P<0.05)。结论近视人群Kappa角绝大部分小于0.40 mm并且水平及垂直偏移量均集中在0.20 mm内;女性的Kappa角大于男性;水平方向上瞳孔中心越偏向鼻侧,水平彗差越大,垂直方向上越靠向下方,垂直彗差越大。

Objective To investigate the distribution characteristics of angle kappa and its correlation with anterior corneal surface aberration.Methods A cross sectional study.A total of 1017 patients(all with right eye)who underwent preoperative examination in refractive surgery center of Xuzhou First People's Hospital from January 2021 to June 2021 were selected,including 660 males and 357 females,with an average age of(22.97±5.02)years.Pentacam AXL anterior segment analysis system was used for measurement,and the coordinate value(X,Y)of the pupil center in the rectangular coordinate system with the corneal vertex as the origin was obtained,where X represented the horizontal direction and Y represented the vertical direction.The distance(mm)from the pupil center to the corneal vertex was calculated by using trigonometric function to represent the size of angle kappa.At the same time,the anterior corneal surface aberration in the range of 6 mm was recorded.The rank sum test and Spearman’s correlation analysis were used for data processing.Results The angle kappa of the myopia was(0.18±0.12)mm.The X-axis offset was(0.11±0.09)mm.Y-axis offset was(0.12±0.11)mm,of which 95.18%patients with angle kappa≤0.40 mm,and 84.85%and 82.01%patients with X-axis and Y-axis offset in the range of 0.20 mm,respectively.The angle kappa of female was larger than that of male,and the difference was statistically significant(Z=-3.98,P<0.05).X-axis deviation was positively correlated with horizontal coma(Z^(1)_(3))(r=0.16,P<0.05).Y-axis deviation was negatively correlated with vertical coma(Z^(-1)_(3))(r=-0.17,P<0.05).Conclusions Most of the angle kappas in myopic patients were less than 0.40 mm and the horizontal and vertical offsets were concentrated within 0.20 mm.The angle kappa of female was larger than that of male.The more the center of the pupil is tilted horizontally to the side of the nose,the greater the horizontal coma,and the more vertically it is tilted downward the greater the vertical coma.