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接受准分子激光原位角膜磨镶术(LASIK)的眼睛中,角膜后表面无向前移位。

No forward shifting of posterior corneal surface in eyes undergoing LASIK.

作者信息

Nishimura Ryo, Negishi Kazuno, Saiki Megumi, Arai Hiroyuki, Shimizu Satomi, Toda Ikuko, Tsubota Kazuo

机构信息

Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.

出版信息

Ophthalmology. 2007 Jun;114(6):1104-10. doi: 10.1016/j.ophtha.2006.09.014. Epub 2007 Jan 18.

Abstract

PURPOSE

To evaluate structural changes in the cornea and anterior chamber (AC) after LASIK for myopia.

DESIGN

Retrospective nonrandomized study.

PARTICIPANTS

One hundred sixty-one eyes of 83 patients (mean age, 34.5+/-8.3 years) who underwent uneventful LASIK for myopia and myopic astigmatism. The preoperative refractive error (spherical equivalent) and corneal thickness were -6.02+/-2.10 diopters (D) and 549.9+/-29.3 mum, respectively.

METHODS

The AC volume (ACV), AC depth (ACD), corneal thickness, central corneal true net power, and posterior corneal tangential curvature were measured using a rotating Scheimpflug camera before and 1 week and 1 month after surgery. In 84 eyes of 42 cases, anterior and posterior corneal elevations and corneal thicknesses also were measured by scanning-slit topography before and 1 month after surgery.

MAIN OUTCOME MEASURES

Time course of the ACV, ACD (central, midperiphery, periphery), corneal thickness, central corneal true net power, posterior corneal tangential curvature using the Scheimpflug camera, and amount of forward shifting of the posterior corneal surface at the center of the difference map using scanning-slit topography.

RESULTS

Preoperative and 1-month postoperative mean ACVs were 198.1 mm3 and 196.4 mm3, respectively, and preoperative and postoperative mean ACDs (center, midperiphery, periphery) were 3.24, 2.65, and 1.89 mm, and 3.21, 2.63, and 1.87 mm, respectively. The corneal thickness within the optical zone, subjective refraction, and central corneal true net power significantly changed by tissue subtraction after LASIK (P<0.0001). There were no significant differences in the ACV, ACDs (center, midperiphery, periphery), peripheral corneal thickness, and posterior corneal tangential curvature from preoperatively to 1 month after LASIK. However, using scanning-slit topography, the posterior corneal surface displayed a mean forward shift of 29.0+/-19.0 microm 1 month after surgery.

CONCLUSION

The posterior corneal curvature, peripheral corneal thickness, ACDs, and ACV were consistent. These observations indicated that neither forward shifting of the central posterior corneal surface (bulging) nor backward shifting of the peripheral posterior corneal surface due to corneal swelling after ablation occurred after LASIK.

摘要

目的

评估近视患者准分子激光原位角膜磨镶术(LASIK)后角膜和前房(AC)的结构变化。

设计

回顾性非随机研究。

研究对象

83例患者的161只眼(平均年龄34.5±8.3岁),均接受了成功的近视及近视散光LASIK手术。术前屈光不正(等效球镜)和角膜厚度分别为-6.02±2.10屈光度(D)和549.9±29.3μm。

方法

使用旋转式Scheimpflug相机在手术前、术后1周和1个月测量前房容积(ACV)、前房深度(ACD)、角膜厚度、中央角膜真实净屈光力和后角膜切线曲率。在42例患者的84只眼中,还通过扫描裂隙地形图在手术前和术后1个月测量前后角膜高度和角膜厚度。

主要观察指标

使用Scheimpflug相机测量ACV、ACD(中央、中周边、周边)、角膜厚度、中央角膜真实净屈光力、后角膜切线曲率的时间变化过程,以及使用扫描裂隙地形图测量差异图中心处后角膜表面的前移量。

结果

术前和术后1个月的平均ACV分别为198.1mm³和196.4mm³,术前和术后的平均ACD(中央、中周边、周边)分别为3.24、2.65和1.89mm,以及3.21、2.63和1.87mm。LASIK术后通过组织减法测量,光学区内角膜厚度、主观验光和中央角膜真实净屈光力有显著变化(P<0.0001)。LASIK术后1个月时,ACV、ACD(中央、中周边、周边)、周边角膜厚度和后角膜切线曲率与术前相比无显著差异。然而,使用扫描裂隙地形图测量,术后1个月后角膜表面平均前移29.0±19.0μm。

结论

后角膜曲率、周边角膜厚度、ACD和ACV保持一致。这些观察结果表明,LASIK术后既未发生消融后角膜肿胀导致中央后角膜表面前移(膨隆),也未发生周边后角膜表面后移。

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