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翼状胬肉手术对角膜前后表面及眼前节参数的影响。

Effects of pterygium surgery on front and back corneal surfaces and anterior segment parameters.

作者信息

Kheirkhah Ahmad, Safi Hamid, Nazari Rahman, Kaghazkanani Reza, Hashemi Hassan, Behrouz Mahmoud Jabbarvand

机构信息

Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Qazvin Square, South Kargar Street, Tehran, Iran.

出版信息

Int Ophthalmol. 2012 Jun;32(3):251-7. doi: 10.1007/s10792-012-9560-2. Epub 2012 Apr 7.

Abstract

The purpose of this study was to evaluate the effects of pterygium surgery on front and back corneal surfaces and anterior segment parameters. This prospective study included 96 eyes with primary pterygium that underwent surgery. Preoperatively and at 1, 3, and 6 months postoperatively, Pentacam was used to evaluate front and back corneal surfaces, anterior chamber depth (ACD), anterior chamber angle (ACA) and anterior chamber volume (ACV). Mean simulated keratometry at the front corneal surface increased from 42.73 ± 2.21 D preoperatively to 44.45 ± 2.05 D at 1 month (P < 0.001); it then decreased to 44.32 ± 2.07 D at 3 months (P < 0.001) and 44.19 ± 2.10 D at 6 months (P = 0.01). There was no statistically significant change in mean simulated keratometry at the back corneal surface. Radius of the front corneal best-fit sphere (BFS) decreased from 7.99 ± 0.29 mm preoperatively to 7.77 ± 0.25 mm at 1 month postoperatively (P < 0.001), without further change up to 6 months. Radius of the back corneal BFS increased from 6.42 ± 0.24 mm preoperatively to 6.50 ± 0.24 mm at 1 month (P < 0.001), without further change. Postoperative changes in mean simulated keratometry and radii of BFS had statistically significant positive correlations with pterygium extension onto the cornea and grade of pterygium morphology but, not with the surgical technique. There were no significant changes in ACD, ACA, and ACV values after pterygium surgery. Furthermore, the spherical equivalent of manifest refraction changed from +0.75 ± 1.06 D preoperatively to -0.72 ± 1.33 D at 1 month postoperatively (P = 0.001), with no further significant change. In conclusion, after pterygium surgery there were significant changes in front mean keratometry and front and back corneal radii of BFS. These were correlated with preoperative pterygium size and morphology grade. No significant changes in anterior segment parameters were noted postoperatively.

摘要

本研究的目的是评估翼状胬肉手术对角膜前后表面及眼前节参数的影响。这项前瞻性研究纳入了96例行手术治疗的原发性翼状胬肉患眼。术前以及术后1个月、3个月和6个月,使用Pentacam评估角膜前后表面、前房深度(ACD)、前房角(ACA)和前房容积(ACV)。角膜前表面平均模拟角膜曲率术前为42.73±2.21D,术后1个月增至44.45±2.05D(P<0.001);3个月时降至44.32±2.07D(P<0.001),6个月时为44.19±2.10D(P=0.01)。角膜后表面平均模拟角膜曲率无统计学显著变化。角膜前表面最佳拟合球面(BFS)半径术前为7.99±0.29mm,术后1个月降至7.77±0.25mm(P<0.001),直至6个月无进一步变化。角膜后表面BFS半径术前为6.42±0.24mm,术后1个月增至6.50±0.24mm(P<0.001),无进一步变化。术后平均模拟角膜曲率和BFS半径的变化与翼状胬肉向角膜的延伸及翼状胬肉形态分级呈显著正相关,但与手术技术无关。翼状胬肉手术后ACD、ACA和ACV值无显著变化。此外,明显验光等效球镜度术前为+0.75±1.06D,术后1个月变为-0.72±1.33D(P=0.001),无进一步显著变化。总之,翼状胬肉手术后角膜前表面平均角膜曲率以及角膜前、后表面BFS半径有显著变化。这些变化与术前翼状胬肉大小及形态分级相关。术后未观察到眼前节参数有显著变化。

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