SMILE手術(shù)矯治中高度近視術(shù)后角膜上皮重塑及其與屈光度的關(guān)系
本文選題:近視 + 飛秒激光 ; 參考:《眼科新進展》2017年11期
【摘要】:目的探討飛秒激光小切口角膜微透鏡取出術(shù)(small incision lenticule extraction,SMILE)矯治中高度近視術(shù)后角膜上皮厚度變化及其與術(shù)后屈光度變化的關(guān)系。方法收集2016年1月至2017年3月接受SMILE手術(shù)的近視及近視散光患者共46例(92眼),按照屈光度分為兩組,其中中度近視組29例(58眼),高度近視組17例(34眼)。分別于術(shù)前、術(shù)后1個月及6個月應(yīng)用傅立葉域眼前節(jié)OCT對患者角膜中央0~2 mm、角膜2~5 mm、角膜5~6 mm的角膜上皮厚度進行測量,對比術(shù)后角膜上皮厚度變化特點并分析其與屈光度的相關(guān)性。結(jié)果術(shù)前患者角膜上皮厚度為(55.68±3.61)μm,術(shù)后6個月角膜中央0~2 mm、角膜2~5 mm、角膜5~6 mm的角膜上皮厚度較術(shù)前分別增厚(3.85±3.99)μm、(3.46±3.29)μm及(2.85±3.18)μm,三個區(qū)域比較差異有統(tǒng)計學(xué)意義(P0.05)。術(shù)后6個月高度近視組角膜上皮增厚較中度近視組更明顯,且差異有統(tǒng)計學(xué)意義(P=-0.047)。術(shù)后6個月,兩組角膜中央2 mm上皮厚度變化與術(shù)后屈光度變化均未發(fā)現(xiàn)顯著相關(guān)性(中度組:r=0.219,P=0.633;高度組:r=0.197,P=0.585)。結(jié)論SMILE術(shù)后角膜上皮發(fā)生重塑,主要表現(xiàn)為角膜上皮厚度的增厚,屈光度越高,增厚越顯著,這種重塑效應(yīng)未對術(shù)后屈光度穩(wěn)定性造成影響。
[Abstract]:Objective to investigate the changes of corneal epithelial thickness and the relationship between corneal epithelial thickness and postoperative diopter after small incision lenticule extraction with femtosecond laser. Methods from January 2016 to March 2017, 46 patients with myopia and myopic astigmatism who underwent Smile operation were divided into two groups according to diopter: 29 patients with degree myopia (n = 29) and 17 patients with high myopia (n = 34). Fourier domain anterior segment Oct was used to measure the thickness of corneal epithelium in the central cornea of the patients before, 1 month and 6 months after operation, respectively. The thickness of corneal epithelium of the patients was 2 mm, 2 mm, 5 mm and 5 mm, respectively. The changes of corneal epithelium thickness were compared and the correlation between corneal epithelial thickness and diopter was analyzed. Results the thickness of corneal epithelium was 55.68 鹵3.61 渭 m before operation. The thickness of corneal epithelium in 6 months after operation was 0.20 mm in the central cornea, 5 mm in the cornea and 5 mm in the cornea. The thickness of corneal epithelium was 3.85 鹵3.99 渭 m and 2.85 鹵3.18 渭 m, respectively. The difference among the three regions was statistically significant (P 0.05). The corneal epithelium thickening in high myopia group was more obvious than that in moderate myopia group 6 months after operation, and the difference was statistically significant (P < 0. 047). 6 months after operation, there was no significant correlation between the thickness of corneal central 2 mm epithelium and the postoperative diopter in both groups (moderate group: 0.219g P0. 633; height group: 0. 197 P0. 585g). Conclusion the corneal epithelium remodeling after Smile is mainly manifested by the thickening of corneal epithelium, the higher the diopter is, the more significant the thickness is, and this remodeling effect has no effect on the stability of refractive index.
【作者單位】: 濟南市明水眼科醫(yī)院眼視光科;
【分類號】:R779.63
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