首页|期刊导航|临床眼科杂志|FS-LASIK联合快速角膜交联术后角膜透明度的临床观察

FS-LASIK联合快速角膜交联术后角膜透明度的临床观察OACSTPCD

Clinical observation of corneal transparency after femtosecond LASIK combined with rapid corneal cross-linking

中文摘要英文摘要

目的 研究飞秒激光辅助准分子激光原位角膜磨镶术(FS-LASIK)联合快速角膜交联手术(CXL)矫正近视手术术后患者早期的角膜光密度(CD)、视力、屈光度的变化特点.方法 回顾性临床研究.本研究筛选了2019年至2021年在本院行FS-LASIK 联合快速角膜交联手术矫正近视和散光的30例(60只眼)患者,进行回顾性的分析,分别于术前、术后1个月、术后3个月进行常规检查,检查项目包括屈光度、裸眼视力(UCVA)、裂隙灯检查和Pentacam眼前节分析仪.观察记录手术前后角膜光密度的变化;观察记录等效球镜度数(SE)的变化,数据统计完成后,采用IBM SPSS 24.0统计软件进行分析,通过Kolmogorov-Smirnov测试对各组数据进行正态性检验.对符合正态分布的数据进行重复方差检验,进一步两两比较采用LSD-t检验,对于不符合正态分布的采用Friedman检验分析.结果 (1)术后1个月UCVA与术前最佳矫正视力(BCVA)相比,略微降低(P<0.05).术后3个月UCVA与术后1个月UCVA相比差异无统计学意义(P>0.05).术后3个月UCVA与术前BCVA相比,差异无统计学意义(P>0.05).(2)术后等效球镜度明显降低,较术前差异有统计学意义(P<0.05),术后1个月与术后3个月的SE之间差异无统计学意义(P>0.05).(3)从整体光密度上看,术后1个月的角膜光密度与术前相比差异无统计学意义.术后3个月的角膜光密度与术前相比略微降低(P<0.05),术后3个月与术后1月相比略微降低(P<0.05).(4)从不同直径范围的角膜光密度上看,术后1个月,角膜直径0~2 mm、2~6 mm区域内的角膜光密度与术前相比略微提高(均P<0.05),角膜直径6~10 mm内的角膜光密度与术前相比略降低(P<0.05);术后3个月,在角膜直径0~2 mm、2~6 mm区域内的角膜光密度与术前比差异均无统计学意义;角膜直径6~10 mm区域内的角膜光密度与术前相比略微降低(P<0.05).(5)从不同分层的角膜光密度上看,术后1个月,角膜前层(前120 µm)和角膜后层(后60 µm)的角膜光密度与术前相比差异无统计学意义(P>0.05);角膜中央层的角膜光密度与术前相比略微降低(P<0.05).术后3个月,角膜前层、中央层、后层角膜光密度与术前相比均略微降低(均P<0.05).结论 FS-LASIK Xtra术后早期可以维持较好的角膜透明度,具有较好的安全性、有效性与准确性.

Objective To study the early changes of corneal density(CD),visual acuity and diopter after femto-second laser in situ keratomileusis(FS-LASIK)combined with rapid corneal cross-linking surgery to correct myopia.Methods A retrospective case series study.30 patients(60 eyes)who underwent FS-LASIK combined with rapid corneal crosslinking surgery to correct myopia and astigmatism in our hospital were selected.Routine examinations were performed before the operation,at 1 month and 3 months after the operation.The examination items included diopter,naked eye vi-sion,slit lamp examination and Pentacam anterior segment analyzer.The changes of corneal optical density and spherical equivalent(SE)before and after the operation were observed and recorded.After the data statistics were completed,ana-lyze them with IBM SPSS 24.0 statistical software,and test the normality of each group of data through kolmogorov smirnov test.Repeated variance test was conducted for the data conforming to the normal distribution,and friedman test was used for the data not conforming to the normal distribution.Results(1)At 1 month after the operation,the naked visual acuity was slightly lower than the best corrected visual acuity(BCVA)before the operation(P<0.05).Uncorrected visual acuity(UCVA)at 3 months after the operation was slightly higher than that at 1 month after the operation,which was not statisti-cally significant(P>0.05).There was no significant difference between UCVA and BCVA at 3 months after the operation(P>0.05).(2)The postoperative equivalent sphericity was significantly lower than that before the operation(P<0.05).There was no significant difference in SE between 1 month and 3 months after the operation(P>0.05).(3)In terms of over-all optical density,the difference between corneal optical density 1 month after and that before the operation was small and not statistically significant.The corneal optical density at 3 months after the operation was slightly lower than that before the operation(P<0.05),and it was slightly lower than that in 1 month after the operation(P<0.05).(4)In terms of cor-neal optical density in the different diameter range,the corneal optical density in the area of corneal diameter 0~2 mm and 2~6 mm increased slightly and had statistical significance compared with that before the operation at 1 month after the operation(all P<0.05),and the corneal optical density in the area of corneal diameter 6~10 mm decreased slightly and had statistical significance compared with that before the operation(P<0.05).At 3 months after the operation,the differ-ence in corneal optical density in the area with corneal diameter of 0~2 mm and 2~6 mm was smaller than that before the operation,and there was no statistical significance.The corneal optical density in the area with corneal diameter of 6~10 mm decreased slightly compared with that before the operation(P<0.05).(5)From the corneal optical density of different layers,there was no significant difference between the corneal optical density of anterior layer(anterior 120 µm)and pos-terior layer(posterior 60 µm)at 1 month after the operation and that before operation(P>0.05).The corneal optical den-sity in the central layer of cornea decreased slightly compared with that before the operation(P<0.05).At 3 months after the operation,the optical density of the anterior,central and posterior cornea decreased slightly compared with that before the operation(P<0.05).Conclusions FS-LASIK Xtra can maintain good corneal transparency in the early postoperative period,with good safety,efficacy and accuracy.

祖培培;范华;季鹏;王兴荣;王庆宝;唐凯;毕宏生

250002 济南,山东中医药大学附属眼科医院250002 济南,山东中医药大学附属眼科医院250002 济南,山东中医药大学附属眼科医院250002 济南,山东中医药大学附属眼科医院250002 济南,山东中医药大学附属眼科医院250002 济南,山东中医药大学附属眼科医院250002 济南,山东中医药大学附属眼科医院

近视飞秒激光辅助准分子激光原位角膜磨镶术胶原交联手术角膜光密度

MyopiaFemtosecond laser in situ keratomileusisCollagen cross-linking surgeryCorneal optical density

《临床眼科杂志》 2024 (4)

304-309,6

山东省医药卫生科技发展计划项目(2019WS573)

10.3969/j.issn.1006-8422.2024.04.004

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