本文選題：Pentacam + 前房成像系統(tǒng)　； 參考：《北京協(xié)和醫(yī)學院》2010年博士論文

【摘要】：目的 驗證Pentacam眼前節(jié)成像系統(tǒng)與超聲測厚儀和傳統(tǒng)角膜地形圖所測量結(jié)果的一致性,并應用Pentacam眼前節(jié)成像系統(tǒng)分析準分子激光手術(shù)后角膜后表面的變化特點,評價手術(shù)方式、切削深度、切削比、殘留基質(zhì)厚度以及眼內(nèi)壓對角膜后表面變化的影響。 方法 入選2010年2月至2010年5月在我院行準分子激光屈光手術(shù)的患者,按照各組要求分別選取若干例近視眼患者進行分析。術(shù)前應用Pentacam、超聲測厚儀以及傳統(tǒng)角膜地形圖儀對每只眼進行測量,并完善眼壓等其余術(shù)前常規(guī)檢查。按手術(shù)方式將患者分為LASIK組和LASEK組,紀錄患者術(shù)中的切削深度,殘留基質(zhì)厚度,計算切削比,屈光手術(shù)后3-5周復查Pentacam。 結(jié)果 1. Pentacam與超聲測厚儀測量角膜中央厚度結(jié)果相符率達97.62%,Poisson相關(guān)系數(shù)0.96; 2. Pentacam與傳統(tǒng)角膜地形圖儀測量角膜前表面平均屈光度相符率達100%,Poisson相關(guān)系數(shù)0.98； 3. LASIK組平均角膜后表面前移2.46m, LASEK組平均角膜后表面前移0.6μm,兩組中后表面前移量均隨AD和AD/CT增大而增大,隨RBT增大而減小,與IOP沒有明顯相關(guān)。 結(jié)論 1. Pentacam系統(tǒng)測量中心角膜厚度與A超儀測量結(jié)果較為符合。作為一項新型的、安全無創(chuàng)的眼科檢查儀器,Pentacam系統(tǒng)測量結(jié)果準確,可在準分子激光屈光手術(shù)前使用。 2.對與無特殊眼疾的病人,Pentacam檢查可以替代傳統(tǒng)Placido盤系統(tǒng)的角膜地形檢查,且能獲得全角膜厚度、角膜后表面地形、晶狀體等更多更全面的數(shù)據(jù)。 3. LASEK和LASIK手術(shù)后角膜后表面均存在微小前移,其中接受LASEK手術(shù)的患者前移量較小。 4.屈光手術(shù)后角膜后表面前移量與切削深度、切削比和剩余基質(zhì)床厚度有關(guān)。角膜組織消融得越多,保留的角膜厚度越少,對角膜原有的結(jié)構(gòu)破壞越大.則對角膜后表面形態(tài)影響愈大,前移量越大。眼壓高低不對角膜后表面前移產(chǎn)生影響。
[Abstract]:Purpose To verify the consistency of Pentacam anterior segment imaging system with ultrasound thickness measuring instrument and traditional corneal topography, and to use Pentacam anterior segment imaging system to analyze the changes of corneal surface after excimer laser surgery, and to evaluate the operation mode. The influence of cutting depth, cutting ratio, thickness of residual matrix and intraocular pressure on the change of corneal surface. Method The patients who underwent excimer laser refractive surgery in our hospital from February 2010 to May 2010 were selected and analyzed according to the requirements of each group. Each eye was measured with Pentacammeter, ultrasonic thickness meter and traditional corneal topography before operation, and other routine examinations such as intraocular pressure were improved. The patients were divided into LASIK group and LASEK group according to the operation method. The depth of operation, the thickness of residual matrix, the cutting ratio were calculated, and Pentacam was reexamined 3-5 weeks after refractive surgery. Result 1. The coincidence rate between Pentacam and ultrasonic thickness measurement was 97.62% and 0.96% respectively. 2. The mean refractive index of corneal surface measured by Pentacam was 0.98. 3. The average posterior surface displacement of LASIK group was 2.46 m, while that of LASEK group was 0.6 渭 m. In both groups, the amount of posterior surface displacement increased with the increase of AD and AD/CT, and decreased with the increase of RBT, but had no significant correlation with IOP. Conclusion 1. The corneal thickness measured by Pentacam system was in good agreement with that measured by A-ultrasound. As a new, safe and non-invasive ophthalmic instrument, Pentacam system is accurate and can be used before excimer laser refractive surgery. 2. Pentacam can be used as a substitute for the traditional Placido system for corneal topography, and more comprehensive data can be obtained, such as total corneal thickness, corneal posterior surface topography, lens, and so on. 3. After LASEK and LASIK, there was a slight anterior displacement on the posterior surface of cornea, in which the patients undergoing LASEK operation had a small amount of anterior displacement. 4. After refractive surgery, the anterior displacement of corneal posterior surface was related to the depth of cutting, the cutting ratio and the thickness of the residual matrix bed. The more corneal tissue is ablated, the less the corneal thickness remains, and the greater the damage to the original structure of the cornea. The greater the effect on the surface morphology of the cornea, the greater the amount of forward displacement. Intraocular pressure does not affect the anterior displacement of the posterior corneal surface.
【學位授予單位】：北京協(xié)和醫(yī)學院
【學位級別】：博士
【學位授予年份】：2010
【分類號】：R772.2

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相關(guān)期刊論文 前1條

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