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准分子原位角膜磨镶术前后的角膜生物力学测量

Corneal biomechanical measurements before and after laser in situ keratomileusis.

作者信息

Chen Michael C, Lee Nancy, Bourla Nirit, Hamilton D Rex

机构信息

Jules Stein Eye Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA.

出版信息

J Cataract Refract Surg. 2008 Nov;34(11):1886-91. doi: 10.1016/j.jcrs.2008.06.035.

Abstract

PURPOSE

To study the correlation between corneal biomechanical properties and surgical parameters in myopic patients before and after laser in situ keratomileusis (LASIK).

SETTING

UCLA Laser Refractive Center of the Jules Stein Eye Institute, Los Angeles, California, USA.

METHODS

In 43 eyes of 43 patients, the Ocular Response Analyzer was used to measure corneal hysteresis (CH), corneal resistance factor (CRF), Goldmann-correlated intraocular pressure (IOPg), and corneal-compensated IOP (IOPcc) before and 1 month after LASIK. Manifest refraction spherical equivalent (MRSE), preoperative central corneal thickness (CCT), flap thickness (FT), and ablation depth (AD) were also recorded. Changes in these parameters after LASIK were calculated and the correlations between the change in CH (DeltaCH), change in CRF (DeltaCRF) and the AD, change in MRSE (DeltaMRSE), and CCT were examined. The relationship between DeltaCRF and DeltaMRSE was examined by linear regression analysis.

RESULTS

The preoperative mean CH and mean CRF (11.52 mm Hg +/- 1.28 [SD] and 11.68 +/- 1.40 mm Hg, respectively) were significantly higher than postoperative values (9.48 +/- 1.24 mm Hg and 8.47 +/- 1.53 mm Hg, respectively) (P < .0001). A higher attempted correction was correlated with a larger DeltaCH and DeltaCRF (AD, r = 0.47 and r = 0.65, respectively; DeltaMRSE, r = 0.51 and r = 0.66, respectively). No correlation was found between DeltaCH, DeltaCRF, and preoperative CCT.

CONCLUSIONS

Changes in CH and CRF after LASIK suggest alteration in corneal biomechanics correlating with attempted correction. The CRF parameter may be more useful than the CH parameter in assessing biomechanical changes resulting from LASIK.

摘要

目的

研究准分子原位角膜磨镶术(LASIK)前后近视患者角膜生物力学特性与手术参数之间的相关性。

设置

美国加利福尼亚州洛杉矶市朱尔斯·斯坦因眼科研究所的加州大学洛杉矶分校激光屈光中心。

方法

对43例患者的43只眼,使用眼反应分析仪在LASIK术前及术后1个月测量角膜滞后(CH)、角膜阻力因子(CRF)、Goldmann相关眼压(IOPg)和角膜补偿眼压(IOPcc)。还记录了显验光球镜等效值(MRSE)、术前中央角膜厚度(CCT)、瓣厚度(FT)和切削深度(AD)。计算LASIK术后这些参数的变化,并检查CH变化(ΔCH)、CRF变化(ΔCRF)与AD、MRSE变化(ΔMRSE)和CCT之间的相关性。通过线性回归分析检查ΔCRF与ΔMRSE之间的关系。

结果

术前平均CH和平均CRF(分别为11.52 mmHg±1.28[标准差]和11.68±1.40 mmHg)显著高于术后值(分别为9.48±1.24 mmHg和8.47±1.53 mmHg)(P<.0001)。较高的预期矫正量与较大的ΔCH和ΔCRF相关(AD,r分别为0.47和0.65;ΔMRSE,r分别为0.51和0.66)。未发现ΔCH、ΔCRF与术前CCT之间存在相关性。

结论

LASIK术后CH和CRF的变化表明角膜生物力学改变与预期矫正相关。在评估LASIK引起的生物力学变化方面,CRF参数可能比CH参数更有用。

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