[关键词]
[摘要]
目的：基于角膜基质床厚度/术前角膜厚度(residual corneal stroma thickness /corneal thickness，RCST/CT)的不同，比较飞秒激光辅助LASIK和角膜板层刀辅助LASIK术后早期角膜生物力学的变化。
方法：选取190例379眼，其中飞秒激光辅助LASIK组94例187眼，角膜板层刀辅助LASIK组96例192眼。根据术后剩余RCST/CT的不同，将飞秒激光辅助LASIK组(FS-IK组)和角膜板层刀辅助LASIK组(M-IK组)各分为三组，IK-Ⅰ组(RCST/CT<55%)、IK-Ⅱ组(55%≤RCST/CT<60%)和IK-Ⅲ组(RCST/CT≥60%)。分别于术前、术后1mo和3mo应用眼反应分析仪(reichert ocular response analyzer，ORA)检测角膜滞后量(corneal hysteresis，CH)和角膜阻力因子(corneal resistance factor，CRF)。
结果：不同手术方式(FS-IK与M-IK)比较，CH和CRF均无统计学差异(F=0.44，F=2.56，P=0.51，P=0.11)。不同的RCST/CT比较，CH和CRF均有统计学差异(F=103.03，128.48，P均<0.05)。Ⅰ组CH和CRF较Ⅱ组明显减小(P<0.05)，Ⅱ组CH和CRF较Ⅲ组明显减小(P<0.05)，Ⅰ组CH和CRF较Ⅲ组明显减小(P<0.05)。术前及术后不同时间比较，CH和CRF均有统计学差异(F=576.99， 1162.06，P均<0.05)。术后1mo和3mo，CH和CRF均较术前明显减小(P<0.05)，术后1mo和术后3mo比较，CH和CRF差异无统计学意义(P>0.05)。
结论：无论是飞秒激光辅助LASIK还是角膜板层刀辅助LASIK在术后早期角膜生物力学参数均下降，但两种手术方式对角膜生物力学的影响无差异。LASIK术后保留角膜基质床比例越小对角膜生物力学的影响越大。
[Key word]
[Abstract]
AIM: To compare the corneal biomechanical changes at early stage after femtosecond laser assisted
in situ keratomi(LASIK)and microkeratome LASIK according to different residual corneal stroma thickness/cornea thickness(RCST/CT).
METHODS: Ninety-four patients(187 eyes)with femtosecond LASIK(FS-IK)and 96 patients(192 eyes)with microkeratome LASIK(M-IK)were included in this study. LASIK group was divided into three groups according to the ratio of RCST/CT, which were IK-I group(RCST/CT<55%), IK-Ⅱ group(55%≤RCST/CT<60%)and IK-Ⅲ group(RCST/CT≥60%). Corneal hysteresis(CH)and corneal resistance factor(CRF)were measured by reichert ocular response analyzer(ORA)at pre-operation, postoperative 1and 3mo.
RESULTS: Compared with FS-IK and M-IK,there were no statistical difference in CH and CRF(F=0.44, F=2.56, P=0.51, P=0.11). Based on different RCST/CT, there were statistical differences in CH and CRF between group Ⅰ and group Ⅱ(F=103.03, 128.48,P<0.05), group Ⅱ and group Ⅲ(P<0.05), group Ⅰ and group Ⅲ(P<0.05). There were statistical differences in CH and CRF between pre-operation and different postoperative times(F=576.99, 1162.06, P<0.05). CH and CRF of postoperative 1mo and 3mo were significantly smaller than pre-operation(P<0.05), but there was no statistical difference between postoperative 1and 3mo(P>0.05).
CONCLUSION: The biomechanical parameters decreased at early stage after femtosecond LASIK and microkeratome LASIK, but there is no statistical difference between femtosecond LASIK and microkeratome LASIK. The less the ratio of RCST/CT, the more effect on biomechanics.
[中图分类号]
[基金项目]
黑龙江省哈尔滨市科技创新人才研究专项资金项目(No.2010RFLXS010); 黑龙江省教育厅科学技术专项资金项目(No.12521263); 黑龙江省人事厅留学回国人员科技项目择优资助资金项目(No.2012-134)
