Pentacam前房成像系统测量角膜厚度、地形图及屈光手术后角膜后表面

发布时间：2018-04-28 16:59

本文选题：Pentacam + 前房成像系统　；参考：《北京协和医学院》2010年博士论文

【摘要】：目的验证Pentacam眼前节成像系统与超声测厚仪和传统角膜地形图所测量结果的一致性,并应用Pentacam眼前节成像系统分析准分子激光手术后角膜后表面的变化特点,评价手术方式、切削深度、切削比、残留基质厚度以及眼内压对角膜后表面变化的影响。方法入选2010年2月至2010年5月在我院行准分子激光屈光手术的患者,按照各组要求分别选取若干例近视眼患者进行分析。术前应用Pentacam、超声测厚仪以及传统角膜地形图仪对每只眼进行测量,并完善眼压等其余术前常规检查。按手术方式将患者分为LASIK组和LASEK组,纪录患者术中的切削深度,残留基质厚度,计算切削比,屈光手术后3-5周复查Pentacam。结果 1. Pentacam与超声测厚仪测量角膜中央厚度结果相符率达97.62%,Poisson相关系数0.96; 2. Pentacam与传统角膜地形图仪测量角膜前表面平均屈光度相符率达100%,Poisson相关系数0.98； 3. LASIK组平均角膜后表面前移2.46m, LASEK组平均角膜后表面前移0.6μm,两组中后表面前移量均随AD和AD/CT增大而增大,随RBT增大而减小,与IOP没有明显相关。结论 1. Pentacam系统测量中心角膜厚度与A超仪测量结果较为符合。作为一项新型的、安全无创的眼科检查仪器,Pentacam系统测量结果准确,可在准分子激光屈光手术前使用。 2.对与无特殊眼疾的病人,Pentacam检查可以替代传统Placido盘系统的角膜地形检查,且能获得全角膜厚度、角膜后表面地形、晶状体等更多更全面的数据。 3. LASEK和LASIK手术后角膜后表面均存在微小前移,其中接受LASEK手术的患者前移量较小。 4.屈光手术后角膜后表面前移量与切削深度、切削比和剩余基质床厚度有关。角膜组织消融得越多,保留的角膜厚度越少,对角膜原有的结构破坏越大.则对角膜后表面形态影响愈大,前移量越大。眼压高低不对角膜后表面前移产生影响。
[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.
【学位授予单位】：北京协和医学院
【学位级别】：博士
【学位授予年份】：2010
【分类号】：R772.2

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