圆锥角膜的角膜前后表面形态及厚度检测

目的　了解圆锥角膜的角膜地形图改变。方法　应用Orbscan角膜地形图系统检测 35例 (47只眼 )圆锥角膜患者的角膜 ,对其角膜中心点、锥顶、角膜后表面最高点、角膜屈光度最大点和角膜最薄点的位置、角膜前表面高度、角膜屈光度及角膜厚度 ,以及角膜屈光度和角膜前表面高度的关系进行分析。结果　圆锥角膜锥顶的高度平均为 (0 10 2± 0 0 4 4 )mm ,距角膜中心点的距离为(0 6 86± 0 376 )mm。圆锥角膜锥顶、角膜后表面最高点和角膜屈光度最大点的位置分布以颞下最多 ,其他依次为鼻下、颞上、鼻上 ,最薄点以鼻下方为多 ,其次为颞下。圆锥角膜的角膜曲率为 (6 0 9± 10 4 / 5 3 4± 8 7)D ,角膜中央直径 3mm、5mm内平均屈光度数分别为 (5 7 1± 8 0 )D、(5 0 7± 5 4 )D。圆锥角膜锥顶的高度与此点的屈光度数呈明显的正相关 (r=0 6 97,P <0 0 1) ,与此点的角膜厚度呈负相关 (r=- 0 5 6 3,P <0 0 1)。结论　Orbscan角膜地形图系统可为早期诊断圆锥角膜并提供形态学依据。

Corneal topography and thickness in keratoconus

OBJECTIVE: To evaluate the corneal topography and pachymetry in keratoconus. METHODS: Thirty-five patients (47 eyes) with keratoconus were evaluated by Orbscan corneal topography system. The location, anterior and posterior surface elevation, curvature and pachymetry were analyzed with special reference to the central point of cornea, the apex, the highest point of posterior surface, the point with greatest curvature and the thinnest point. The correlation between the point of greatest curvature and the apex was also analyzed. RESULTS: The mean elevation of the apex was (0.102 +/- 0.044) mm, the mean distance between the apex and the central point of cornea was (0.686 +/- 0.376) mm. Most of the apexes, the points with the highest posterior surface, the points with the greatest curvature were located in the inferior temporal quadrant, followed by inferior nasal, superior temporal and superior nasal quadrant. The SimK of keratocunus was (60.9 +/- 10.4/53.4 +/- 8.7) D and the mean powers within 3 mm and 5 mm were (57.1 +/- 8.0) D and (50.7 +/- 5.4) D respectively. High correlation between apex elevation and the apex curvature was found (r = 0.697, P < 0.01), and there was also negative relationship between apex elevation and corneal thickness (r = -0.563, P < 0.01). CONCLUSIONS: The Orbscan system can provide accurate and subtle information about the shape and thickness of keratoconus, which can help us to learn this disorder deeply, especially in the early diagnosis of this disease.