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應(yīng)用OCT對LASIK術(shù)患者角膜情況的早期臨床觀察

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  本文選題:LASIK 切入點(diǎn):OCT 出處:《中南大學(xué)》2012年碩士論文 論文類型:學(xué)位論文


【摘要】:目的:通過對LASIK術(shù)患者角膜全層及角膜瓣厚度的測量,探討OCT在早期評估LASIK手術(shù)角膜瓣安全性中的應(yīng)用。 方法:選擇湘雅三醫(yī)院門診行LASIK手術(shù)的患者38例(76眼),按等效球面屈光度分成中低度近視組(SE為-2.25~-6.00D)與高度近視組(SE為-6.00D~-9.50D)。分別測量其術(shù)前中央角膜厚度,術(shù)后第1天與第7天的角膜瓣厚度,術(shù)前、術(shù)后第1天與術(shù)后第7天的中央角膜上皮厚度,并觀察術(shù)后視力的變化。分析OCT在術(shù)前角膜測量值與A超測量值之間的差異;Moria90型角膜刀實(shí)測值與預(yù)設(shè)值的差別 結(jié)果:術(shù)前中央角膜厚度的OCT測量值小于A超測量值,兩者具有很好的相關(guān)性,不同屈光度組差異無統(tǒng)計學(xué)意義;90角膜刀術(shù)后第1天的中央角膜瓣厚度OCT實(shí)測平均值為136.96±12.06μm,高于預(yù)設(shè)值,術(shù)后第7天的平均中央角膜瓣厚度為132.71±13.17μm,也高于預(yù)設(shè)值,并且兩者角膜瓣厚度比較有統(tǒng)計學(xué)意義。中低度近視組與高度近視組之間差異無統(tǒng)計學(xué)意義;術(shù)前(50.83±3.71μm)、術(shù)后第1天(55.52±6.32μm)、術(shù)后第7天(53.435±4.62μm)的中央角膜上皮厚度有差異,術(shù)后第1天最高,術(shù)后第7天有所下降,但仍高于術(shù)前,中低度近視組與高度近視組差異無統(tǒng)計學(xué)意義, 結(jié)論:1.OCT可作為LASIK術(shù)前中央角膜厚度測量,以及術(shù)后早期中央角膜瓣厚度測量以及角膜上皮測量的一種方法。 2.術(shù)前中央角膜厚度的OCT測量值比A超測量值小,差異具有統(tǒng)計學(xué)意義。 3. Moria90刀的實(shí)測值高于預(yù)設(shè)值,術(shù)中應(yīng)準(zhǔn)確估計角膜刀的切削深度,預(yù)留更多的剩余角膜基質(zhì)層厚度。
[Abstract]:Objective: to investigate the application of OCT in the early evaluation of corneal flap safety in LASIK patients by measuring the thickness of the whole cornea and corneal flap in patients undergoing LASIK. Methods: Thirty-eight patients (76 eyes) who underwent LASIK operation in Xiangya third Hospital were divided into middle and low myopia group (SE = -2.25) and high myopia group (SE = -6.00 DX -9.50 DX) according to equivalent spherical diopter. The preoperative central corneal thickness was measured. The thickness of corneal flap on the 1st and 7th day after operation, the central corneal epithelium thickness before operation, on the first day after operation and on the seventh day after operation, To analyze the difference between preoperative corneal measurement value and A-ultrasound value of OCT and the difference between Moria90 corneal knife test and preset value, and to observe the change of visual acuity after operation. Results: the OCT value of central corneal thickness before operation was less than that of A ultrasound, and there was a good correlation between them. There was no significant difference in the thickness of central corneal flap between different diopter groups (136.96 鹵12.06 渭 m) on the first day after operation. The mean thickness of central corneal flap on the 7th day after operation was 132.71 鹵13.17 渭 m, which was also higher than the preset value. There was no significant difference in corneal flap thickness between the middle and low myopia group and the high myopia group, the central corneal epithelium thickness was 50.83 鹵3.71 渭 m before operation, 55.52 鹵6.32 渭 m on the first day after operation, 53.435 鹵4.62 渭 m on the 7th day after operation, and the highest was on the first day after operation. On the 7th day after operation, there was a decrease, but it was still higher than that before operation. There was no significant difference between moderate and low myopia group and high myopia group. Conclusion 1. Oct can be used as a method to measure the central corneal thickness before LASIK, as well as the central corneal flap thickness and corneal epithelium in the early postoperative period. 2. The OCT value of central corneal thickness before operation was smaller than that of A ultrasound, and the difference was statistically significant. 3. The measured value of Moria90 knife is higher than that of preset, so the depth of keratectomy should be estimated accurately, and more residual corneal stromal thickness should be reserved.
【學(xué)位授予單位】:中南大學(xué)
【學(xué)位級別】:碩士
【學(xué)位授予年份】:2012
【分類號】:R779.63

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