应用OCT对LASIK术患者角膜情况的早期临床观察

发布时间：2018-03-17 19:17

本文选题：LASIK　切入点：OCT　出处：《中南大学》2012年硕士论文　论文类型：学位论文

【摘要】：目的：通过对LASIK术患者角膜全层及角膜瓣厚度的测量,探讨OCT在早期评估LASIK手术角膜瓣安全性中的应用。方法：选择湘雅三医院门诊行LASIK手术的患者38例(76眼),按等效球面屈光度分成中低度近视组(SE为-2.25～-6.00D)与高度近视组(SE为-6.00D～-9.50D)。分别测量其术前中央角膜厚度,术后第1天与第7天的角膜瓣厚度,术前、术后第1天与术后第7天的中央角膜上皮厚度,并观察术后视力的变化。分析OCT在术前角膜测量值与A超测量值之间的差异；Moria90型角膜刀实测值与预设值的差别结果：术前中央角膜厚度的OCT测量值小于A超测量值,两者具有很好的相关性,不同屈光度组差异无统计学意义;90角膜刀术后第1天的中央角膜瓣厚度OCT实测平均值为136.96±12.06μm,高于预设值,术后第7天的平均中央角膜瓣厚度为132.71±13.17μm,也高于预设值,并且两者角膜瓣厚度比较有统计学意义。中低度近视组与高度近视组之间差异无统计学意义；术前(50.83±3.71μm)、术后第1天(55.52±6.32μm)、术后第7天(53.435±4.62μm)的中央角膜上皮厚度有差异,术后第1天最高,术后第7天有所下降,但仍高于术前,中低度近视组与高度近视组差异无统计学意义, 结论：1.OCT可作为LASIK术前中央角膜厚度测量,以及术后早期中央角膜瓣厚度测量以及角膜上皮测量的一种方法。 2.术前中央角膜厚度的OCT测量值比A超测量值小,差异具有统计学意义。 3. Moria90刀的实测值高于预设值,术中应准确估计角膜刀的切削深度,预留更多的剩余角膜基质层厚度。
[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 卤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 卤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 卤3.71 渭 m before operation, 55.52 卤6.32 渭 m on the first day after operation, 53.435 卤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.
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R779.63

【参考文献】