SMILE手术矫治中高度近视术后角膜上皮重塑及其与屈光度的关系

发布时间：2018-06-18 01:59

本文选题：近视 + 飞秒激光　；参考：《眼科新进展》2017年11期

【摘要】：目的探讨飞秒激光小切口角膜微透镜取出术(small incision lenticule extraction,SMILE)矫治中高度近视术后角膜上皮厚度变化及其与术后屈光度变化的关系。方法收集2016年1月至2017年3月接受SMILE手术的近视及近视散光患者共46例(92眼),按照屈光度分为两组,其中中度近视组29例(58眼),高度近视组17例(34眼)。分别于术前、术后1个月及6个月应用傅立叶域眼前节OCT对患者角膜中央0~2 mm、角膜2~5 mm、角膜5~6 mm的角膜上皮厚度进行测量,对比术后角膜上皮厚度变化特点并分析其与屈光度的相关性。结果术前患者角膜上皮厚度为(55.68±3.61)μm,术后6个月角膜中央0~2 mm、角膜2~5 mm、角膜5~6 mm的角膜上皮厚度较术前分别增厚(3.85±3.99)μm、(3.46±3.29)μm及(2.85±3.18)μm,三个区域比较差异有统计学意义(P0.05)。术后6个月高度近视组角膜上皮增厚较中度近视组更明显,且差异有统计学意义(P=-0.047)。术后6个月,两组角膜中央2 mm上皮厚度变化与术后屈光度变化均未发现显著相关性(中度组:r=0.219,P=0.633;高度组:r=0.197,P=0.585)。结论SMILE术后角膜上皮发生重塑,主要表现为角膜上皮厚度的增厚,屈光度越高,增厚越显著,这种重塑效应未对术后屈光度稳定性造成影响。
[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 卤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 卤3.99 渭 m and 2.85 卤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.
【作者单位】：济南市明水眼科医院眼视光科;
【分类号】：R779.63

【相似文献】