摘要目的 分析飞秒激光制瓣LASIK术后眼前节各参数(前房深度、前房角宽度、4 mm范围角膜后表面最高值、瞳孔中心与角膜顶点距离)的变化.方法 前瞻性临床研究.接受飞秒制瓣LASIK手术的患者25例(50眼),记录并分析术前和术后6个月以上中央角膜内皮细胞计数、前房深度、前房角宽度、4 mm范围角膜后表面最高值、瞳孔中心与角膜顶点距离、明瞳孔大小、暗瞳孔大小,比较术前术后各参数的变化.瞳孔中心与角膜顶点距离因考虑到其方向性的正负数值会导致较大的统计偏差,故取绝对值进行分析.手术前后数据的比较采用配对t检验.结果 中央角膜内皮细胞计数术前和术后分别为(2 829.7±227.2)个/mm2和(2716.4±255.2)个/mm2,术后较术前减少(t=3.077,P＜0.01).前房深度术前和术后分别为(3.18±0.19)mm和(3.08±0.21)mm,术后变浅(t=11.079,P＜0.01).前房角术前和术后分别为39.39°±3.90°和37.92°±3.76°,术后变窄(t=5.241,P＜0.01).4 mm范围角膜后表面最高值、明环境瞳孔、暗环境瞳孔手术前后差异无统计学意义.X轴瞳孔中心与角膜顶点之间的距离术前和术后分别为(0.11±0.10)mm和(0.14±0.12)mm,术后较术前增加(t=-3.318,P＜0.01);Y轴瞳孔中心与角膜顶点之间的距离术前和术后分别为(0.11±0.08)mm和(0.15±0.11)mm,术后较术前增加(t=-4.157,P＜0.01).结论 飞秒制瓣LASIK术后中央角膜内皮细胞计数、前房深度、前房角宽度、瞳孔中心与角膜顶点距离明显改变.其中瞳孔中心与角膜顶点距离的变化,对指导二次手术确定切削中心具有较大意义.

abstractsObjective To analyze the changes of the parameters of anterior segment of eyes after femtosecond laser LASIK.Methods In this prospective clinic study,50 eyes of 25 patients who underwent femtosecond laser laser in situ keratomileusis (LASIK) were included.The corneal endothelium density,anterior chamber depth,anterior chamber angle width,posterior corneal surface height (4 mm diameter),distance between pupil center and corneal vertex,pupil diameter under light and dark environment were compared before and 6 months or more after surgery.Distance between pupil center and corneal vertex using absolute value.Data were analyzed using paired t test.Results After surgery,comeal endothelium density (2 829.7±227.2 cells/mm2 vs.2 716.4±255.2 cells/mm2),anterior chamber depth(3.18±0.19 mm vs.3.08±0.21 mm),anterior chamber angle width (39.39°±3.90°,37.92° ±3.76°) decreased (t=3.077,11.079,5.241,P＜0.01).The differences of posterior corneal surface height (4 mm diameter),pupil diameter under light and dark environment before and after surgery were insignificant.The distance between pupil center and corneal vertex on X axis increased (0.11±0.10 mm vs.0.14±0.12 mm,t=-3.318,P＜0.01).The distance between pupil center and corneal vertex on Y axis increase (0.11±0.08 mm vs.0.15±0.11 mm,t=-4.157,P＜0.01).Conclusion The parameters of anterior segment of eyes after femtosecond laser LASIK changed obviously,especially for the distance between pupil center and corneal vertex.Maybe this change is important in guiding the following surgery.