LASIK术后角膜地形图变化与治疗效果的关系分析

目的应用计算机辅助的角膜地形图仪对飞点扫描LASIK手术前后角膜形态进行分析,评估LASIK术后角膜形态改变情况与临床效果的关系。方法对29例（58眼）高度近视 （-6.00~-10.00ＤS）患者行LASIK手术，观察术前和术后1个月、3个月及6个月的裸眼及最佳矫正视力、屈光度、角膜地形图形态、模拟角膜曲率计度数（Simk）的改变。结果术后1个月、3个月、6个月角膜地形图平滑型分别占82.76%、89.66%、93.10%，且相对稳定,其他形较少，无中央岛形成，切削形态随时间延长逐渐变规则。术后1个月、3个月、6个月裸眼视力≥1.0的百分比构成分别为100%、96.55%、96.55%。屈光度较术前明显改善并且在术后6个月基本稳定,术后模拟角膜计度数（Simk等效值）及Simk差值较术前明显降低，并随时间延长有逐渐增加的趋势,术后3~6个月基本稳定。结论角膜地形图的检查和分析能清楚地显示LASIK术角膜表面形态变化,有利于个体化实施准分子激光原位角膜磨镶术获得更完美的视功能。

Analysis of Relationslip between Corneal Topography and Clinical Result After Excimer Laser Assisted In-situ Keratomileusis

ObjectiveTo study the corneal topography changes and morphologic changes to analyze their contribution in operation and clinical effects after excimer laser assisted in-situ keratomileusis (LASIK) for high myopia correction.Methods58 eyes of 29 cases with high myopia undergone LASIK was examined with uncorrected visual acuty(UCVA) , best corrected visual acuty(BCVA) ,diopter and corneal topography preoperatively and 1,3 and 6 months postoperatively. ResultsThe percentage of corneal topographic pattern after 1,3months including smooth pattern was 82.76%,89.66%,93.10% respectively which was relatively stable, and the other pattern was seldom.No central islet was found. Artherectomy shape became regulating gradually.The percentage of UCVA exceeding and being equal to 1.0 at 1,3,6month after LASIK was 100%,96.56%,96.55% respectively.The dioptor after LASIK was amendment evidently and turned to be stable at 3 month after LASIK.Simulated keratometer value (Simk) either isoeffect or the phase contrast one decreased conspicuously after surgery.They tended to increasing gradually slowly with the time going and was stable at 3 to 6 month later. ConclusionExamination and analysis on the corneal topography before and after LASIK can clearly display the morphological changes of the corneal surface morphology,which helps carry out LASIK individually and then achieve perfect refractive correction.