准分子激光皮下角膜磨镶术后雾状混浊形成的影响因素

目的:通过准分子激光上皮下角膜磨镶术(LASEK)术后角膜上皮下雾状混浊(haze)形成等级的分析,探讨haze形成的主要影响因素。方法:于2005年10月至2006年6月接受LASEK手术的92例(179只眼)连续病例中,选取随访超过3个月的病例83例(162眼,占总眼数的90.50%),其中男性23例(45只眼),女性60例(117只眼);年龄为18-48岁,平均(26.81±7.23)岁;术前屈光度(等效球镜度数)为-15.75--4.00D,平均(-9.24±2.48)D;术前角膜中央厚度为440-533μm,平均(489.83±18.00)μm。应用SPSS12.0软件中的Spearman等级相关分析方法和逻辑回归分析方法,分析术后角膜上皮下雾状混浊(haze)与手术前后各项检测指标,包括患者年龄、术前屈光度、术前角膜中央厚度、术中角膜切削深度、术中角膜切削率(术中角膜切削深度/术前角膜中央厚度)、术后角膜上皮愈合时间等因素的关系。结果:83例患者术中角膜切削深度为67.90-143.30μm,平均(117.60±14.55)μm;术中角膜切削率为0.135-0.295,平均(0.240±0.028);角膜上皮愈合时间,3 d为127眼(78.40%),4 d为27眼(16.67%),5 d为6眼(3.70%),6 d为2眼(1.23%);术后最后一次复查时的角膜haze,0级为130眼(80.25%),0.5级为13眼(8.02%),1级为11眼(6.79%),2级为5眼(3.09%),3级为3眼(1.85%)。等级相关分析显示,haze与年龄呈负相关(r=-0.173,P<0.05),与术中角膜切削深度呈正相关(r=0.155,P<0.05),逻辑回归分析显示,年龄与术中角膜切削深度不能预测haze的发生。结论:LASEK术后haze形成等级与术中角膜切削深度呈正相关,与患者年龄呈负相关,但相关性较小,主要的影响因素尚待进一步研究。

Analysis of Factors that Contribute to Corneal Haze After Laser-assisted Subepithelial Keratomileusis

Objective: To analyze the factors that contribute to corneal haze after LASEK and to investigate their clinical significance.Methods: 162 eyes of 83 patients who had LASEK were examined.The age of 83 patients was 18-48(26.81±7.23) years,the spherical equivalent refraction ranged from-15.75 to-4.00(-9.24±2.48)D,and the corneal thickness was 440-533(489.83±18.00)μm.The grades of corneal haze after surgery and the indices obtained were adopted to undergo a Spearman correlation analysis by SPSS 12.0 software. Results: The depth of ablation was 67.90-143.30(117.60±14.55) μm,the ablation ratio was 0.135-0.295(0.240±0.028),the corneal haze was 0-3 grade,with 130 eyes(80.25%)in grade 0,13 eyes(8.02%) in grade 0.5,11 eyes(6.79%) in grade 1,5 eyes(3.09%) in grade 2 and 3 eyes(1.85%) in grade 3.The factors that contribute to corneal haze were age(r=-0.173,P<0.05) and the depth of ablation(r=0.155,P<0.05).Conclusion: There was a positive correlation between corneal haze and the depth of ablation and a negative correlation between corneal haze and the patients' age.