病例报告

电弧光致双眼角膜烧伤1例

A case report of corneal burn caused by arc light

:244-249
 
报告1例因电路短路产生电弧光烧伤患者双眼角膜的病例。专科检查:双眼角膜缘颞侧球结膜缺血区小于1/3,角膜上皮呈白色混浊,上皮部分脱落。入院给予清除角膜表面白色坏死组织、抗炎、扩瞳对症治疗,2周后角膜恢复透明,随访3个月患者晶状体及眼底未见明显异常;探讨电弧光在眼球不同部位的致病机制。
A case of corneal burn caused by arc light due to electrical short is reported. Specialist examination: ischemic areas of the temporal limbus bulbar conjunctiva in both eyes were less than 1/3, the corneal epithelium was white and cloudy, and the epithelium was partially peeled. The corneas became transparent after 2 weeks’ treatment of removing the white necrotic tissue, anti-inflammatory and dilating pupil. During the follow-up within 3 months, the patient’s lens and fundus showed no obvious abnormalities. The injury mechanism of arc light caused by electrical short to the eyeball is discussed.
综述

角膜后表面散光对散光型人工晶状体计算的重要性

Importance of calculation of posterior corneal astigmatism on Toric intraocular lens power

:167-175
 
随着白内障手术由复明性向屈光性转变,对角膜的散光矫正显得越来越重要。而角膜散光不仅仅应该关注角膜前表面的散光数据,更应该考虑角膜后表面的散光,否则对散光人工晶状体植入矫正角膜散光可能出现不同程度的术后屈光误差。角膜后表面散光均值约为0.37 D,且多数情况下会产生逆规散光的效果,因此在进行散光型人工晶状体计算时应考虑到这一特点,进一步防止术后欠矫或过矫的发生。
With the cataract surgery evolving from visual restoration surgery to refractive surgery, surgical correction of corneal astigmatism becomes more and more important. For Toric intraocular lens implantation, the surgeon should not only pay attention to the values in surface of anterior corneal astigmatism but also that in posterior corneal astigmatism. Otherwise,unwanted postoperative refractive errors may occur. The mean value of posterior corneal astigmatism was around 0.37 D.In most cases, the posterior corneal astigmatism produces against-the-rule effect. Therefore, the above-mentioned feature of posterior corneal astigmatism should be noticed to prevent the under-correction or over-correction effect of toric lens.
论著

全视场光学相干层析技术的角膜高分辨率成像

High-resolution corneal imaging with full-field optical coherence tomography

:17-22
 
目的:针对活体共聚焦显微镜(in vivo confocal microscopy,IVCM)和传统光学相干层析技术(optical coherence tomography,OCT)在人眼角膜成像各自存在成像视野小或无法细胞成像的限制,开发具有高分辨率的非接触全视场光学相干层析系统(full-field optical coherence tomography,FFOCT),实现活体人眼角膜细胞结构FFOCT成像。方法:FFOCT系统采用高数值孔径干燥显微物镜及高速面阵相机,使用双相位调制图像处理方法,实现系统高速高分辨率非接触成像。利用系统对健康人眼进行角膜各深度层的活体FFOCT成像验证其可行性。结果:本研究团队研发了FFOCT的新型活体人眼角膜高分辨率成像系统,实现理论平面成像分辨率1.7 μm,成像视野1.26 mm×1.26 mm,成像速率达275帧/s。利用该系统对正常活体人眼角膜成像实验,在非接触情况下获取了角膜各主要结构层的高分辨率结构影像。结论:FFOCT高分辨率活体人眼角膜成像系统兼具了传统OCT的非接触、大成像视野及IVCM的细胞级别平面分辨率的优势,将为角膜疾病的研究及临床诊疗提供全新的成像分析技术。
Objective: Due to the limitations of small imaging field of view of in vivo confocal microscopy (IVCM) or the incapability of cellular imaging of traditional optical coherence tomography (OCT) in human corneal imaging, this study was designed to develop a novel high-resolution in vivo human corneal imaging system based on full-field OCT (FFOCT). Methods: The FFOCT system utilized a high numerical aperture air immersion microscope objective and a high-speed area array CMOS camera with two-phase modulation image processing algorithm to achieve high-speed high-resolution non-contact imaging of human cornea. To verify its feasibility, in vivo cornea imaging at different depth was performed on a healthy human subject. Results: The FFOCT system achieved a theoretical lateral imaging resolution of 1.7 μm, an imaging field of view of 1.26 mm×1.26 mm, and an imaging rate of 275 Hz/s. High-resolution FFOCT images of the main structural layers of cornea were achieved by imaging a healthy human cornea in vivo with this system in a non-contact way. Conclusion: The FFOCT human corneal imaging system combines the advantages of the non-contractness and the large imaging field of view of traditional OCT with the cellular lateral resolution of IVCM, potentially providing a new imaging system for the research and clinical diagnosis and treatment of corneal diseases.
技术交流

影响角膜异物剔除术预后的因素分析

Analysis of influencing factors of prognosis of corneal foreign body removal

:348-352
 
角膜异物是眼科急诊中常见病之一,不及时处置或处置不当会导致角膜不同程度的损伤,严重者可引起角膜感染、角膜穿孔等并发症,严重损害视功能。因此安全、高效地剔除角膜异物至关重要。本文从角膜异物的特点、伤后首诊时间、角膜合并感染以及角膜异物的剔除方法等方面对角膜异物剔除术预后的影响进行回顾总结,旨在为医护人员行角膜异物剔除时提供有用参考。
Corneal foreign body is one of common diseases in ophthalmic emergency. Improper handling can cause different degree of corneal injuries, even corneal infection, perforation and endophthalmitis. Therefore, it is essential to eliminate corneal foreign bodies safely and effectively. This article mainly summarizes the influence of the characteristics of the corneal foreign bodies, the first diagnosis time after injury, corneal co-infection and the methods of weeding out the corneal foreign bodies upon the clinical prognosis of corneal foreign body removal, aiming to provide useful reference for medical practitioners in removing corneal foreign bodies.
综述

真菌性角膜炎行角膜移植后真菌复发的临床研究

Clinical study of fungal recurrence after corneal transplantation for fungal keratitis

:955-961
 
真菌性角膜炎是我国导致角膜盲的重要原因之一。由于部分患者在感染早期缺乏合理治疗,导致病情迁延难治,最终行角膜移植是主要的治疗手段。然而真菌感染十分顽固,术后仍有一定概率复发。因此,了解真菌性角膜炎的最新研究进展以及不同类型抗真菌药物和角膜移植手术的优劣,根据适应证选择合理的治疗方案,才能最大程度控制感染,降低真菌复发率,挽救患者视力。与此同时,对角膜移植后真菌复发的相关文献进行研究,总结其复发规律、影响因素和临床特征以及治疗手段和预后。为制订合理的、符合国情的治疗策略提供参考依据。
Fungal keratitis is one of the important causes of corneal blindness in China. Due to the lack of reasonable treatment for some patients in the early stage of infection, the disease is protracted and refractory, and eventually, corneal transplantation is the main treatment. However, Fungal keratitis infection is very stubborn, and there is still a certain probability of recurrence after surgery. Therefore, understanding the latest research advances in fungal keratitis as well as the advantages and disadvantages of different types of antifungal drugs and corneal transplantation, and choosing a reasonable treatment plan according to the indications can maximize the control of the infection, reduce the recurrence rate of the fungus and save the vision of patients. In addition, the relevant literature on fungal recurrence after corneal transplantation was studied to summarize its recurrence pattern, influencing factors and clinical features, as well as treatment means and prognosis. The purpose of this study is to provide a reference basis for formulating a reasonable treatment strategy in line with China’s national conditions.
论著

角膜绷带镜对独眼白内障患者焦虑情绪及生活质量的影响

Effect of corneal bandage lens on anxiety and quality of life in patients with one-eyed cataract

:558-562
 
目的:探讨角膜绷带镜对独眼白内障患者焦虑情绪及生活质量的影响。方法:选取中山大学中山眼科中心白内障科2020年12月至2021年7月收治的120例独眼白内障患者作为试验对象,采用便利抽样法分为实验组(佩戴角膜绷带镜)与对照组(未佩戴角膜绷带镜)。运用焦虑自评量表、视功能的生存质量量表来评估比较2组患者的焦虑程度、术后生存质量。结果:入院前2组患者的焦虑评分、生存质量评分差异无统计学意义(P>0.05),术后第1天实验组患者的焦虑评分明显低于对照组、生存质量评分明显高于对照组,差异有统计学意义(P<0.05)。实验组患者的焦虑评分由入院前的55.35±7.09降低至43.77±5.56,焦虑程度比入院前减轻20%;对照组患者焦虑评分由入院前的54.27±5.93降低至47.92±7.02,焦虑程度较入院前减轻12%;实验组患者生存质量评分由入院前的55.32±25.57增至术后第1天的81.01±13.74,增长了46%;对照组患者生存质量评分由入院前的56.38±14.43降低至术后第1天的36.15±17.97,降低了35%。结论:角膜绷带镜可以减轻独眼白内障患者的焦虑情绪,提高术后生活质量。

Objective: To investigate the effect of corneal bandage lens on anxiety and quality of life in patients with monocular cataract. Methods: A total of 120 patients with monocular cataract treated in our department from December 2020 to July 2021 were selected as the subjects. They were divided into an experimental group (wearing corneal bandage lens) and a control group (without corneal bandage lens) by convenient sampling method. Self-rating Anxiety Scale and Visual Function Quality of Life Scale were used to evaluate and compare the degree of anxiety and postoperative quality of life between the 2 groups. Results: There was no significant difference in anxiety score and quality of life score between the 2 groups before admission (P>0.05). On the first day after operation, the anxiety score of the experimental group was significantly lower than that of the control group, and the quality of life score was significantly higher than that of the control group (P<0.05). The anxiety score of patients in the experimental group decreased from 55.35±7.09 to 43.77±5.56, and the degree of anxiety decreased by 20% compared with that before admission. The anxiety score of patients in the control group decreased from 54.27±5.93 to 47.92±7.02, and the degree of anxiety decreased by 12% compared with that before admission. The score of quality of life in the experimental group increased from 55.32±25.57 before admission to 81.01±13.74 on the first day after operation, an increase of 46%. The quality of life score of patients in the control group decreased from 56.38±14.43 before admission to 36.15±17.97 on the first day after operation, a decrease of 35%.Conclusion: Corneal bandage lens can reduce the anxiety of patients with monocular cataract and improve the quality of life after operation.
“眼科再生医学”专题

干细胞治疗在角膜重建中的研究进展

Research progress of stem cell therapy in corneal reconstruction

:544-549
 
外伤、感染、先天性疾病等均可能破坏角膜的组织结构和细胞稳态,同时造成角膜干细胞缺损,进而导致组织无法正常愈合,引起角膜盲,是世界范围内致盲的重要原因之一。目前已有多种干细胞相关的技术方法应用于重建功能性角膜组织,取得了瞩目的治疗效果。本综述以角膜缘干细胞缺乏症为主,旨在介绍多种来源的干细胞在角膜重建中的研究现状和最新进展,同时对不同干细胞的特异性标志物的研究进展进行阐述。
Trauma, infection and congenital diseases may disrupt the tissue structure and cellular homeostasis of the cornea, while causing impaired function of corneal stem cell defects, which in turn may even lead to corneal blindness caused by the inability of the tissue to heal properly. Corneal blindness is one of the major causes of blindness worldwide. Several stem cell-related techniques have been applied to reconstruct functional corneal tissue with impressive therapeutic results. This review focuses on corneal limbal stem cell deficiency and aims to present the current status and recent progress of research on stem cells from multiple sources in corneal reconstruction, as well as to describe specific markers of corneal stem cells.
论著

连续锁边缝合联合角膜绷带镜在翼状胬肉手术中的应用

Application of continuous locking suture combined with corneal bandage contact lens in pterygium operation

:137-142
 
目的:探讨连续锁边缝合联合角膜绷带镜在翼状胬肉手术中应用的效果。方法:采用前瞻性随机对照临床研究。选取2018年1月到2021年6月期间在我院行翼状胬肉切除联合自体角膜缘结膜瓣移植术的患者132例180眼,按结膜瓣固定方式随机分为A、B两组,其中A组患者(64例90眼)行间断缝合固定法,B组患者(68例90眼)行连续锁边缝合法,术毕两组患者均给与配戴角膜绷带镜。比较两组患者的术后眼部疼痛程度评分、术后效果及并发症。结果:术后1、3 d,B组疼痛评分明显低于A组,差异有统计学意义(P<0.01);术后1、3、7 d两组间角膜染色评分差异无统计学意义(P>0.05);术前、术后3个月两组间泪膜破裂时间(breakup time of tear film,BUT)差异无统计学意义(P>0.05),但术后3个月组内的BUT较手术前有明显改善(P<0.05)。术前、术后2周两组间视力差异均无统计学意义(P>0.05),术后2周两组组内视力较手术前均有明显改善(P<0.05)。随访3个月,两组患者主要术后并发症包括胬肉撕除后浅层基质损伤延迟愈合、线结处结膜增生、结膜植片松脱等,并发症发生率两组相当。结论:采用连续锁边缝合联合配戴角膜绷带镜治疗翼状胬肉可以促进角膜创面的修复,减轻患者的术后刺激症状,提高患者术后舒适度;连续锁边缝合时需要适当增加缝线跨度,可减少术后结膜植片的松脱。
Objective: To investigate the effect of continuous locking suture combined with corneal bandage lens in the operation of pterygium. Methods: A prospective randomized controlled clinical trial was conducted. From January 2018 to June 2021, 132 patients (180 eyes) who underwent pterygium excision combined with autologous limbal conjunctival flap transplantation were randomly divided into group A and group B according to the fixation of conjunctival fla. The patients in group A (64 cases, 90 eyes) were treated with intermittent suture and fixation, and the patients in group B (68 cases, 90 eyes) were treated with continuous locking suture. Both groups were given corneal bandage lenses at the end of the operation. The postoperative ocular pain score, postoperative effect and complications were compared between the two groups. Results: The pain score in group B was significantly lower than that in group A at 1 and 3 d after operation (P<0.01), and there was no significant difference in corneal staining score between the two groups at 1, 3 and 7 d after operation (P>0.05). There was no significant difference in breakup time of tear film (BUT) between the two groups before and 3 months after operation (P>0.05), but the BUT at 3 months after operation in the group was significantly better than that before operation (P<0.05). There was no significant difference in visual acuity between the two groups before and 2 weeks after operation (P>0.05). The visual acuity of the two groups was significantly improved 2 weeks after operation (P<0.05). During the follow-up of 3 months, the main postoperative complications of the two groups included delayed healing of superficial matrix injury after pterygium avulsion, conjunctival hyperplasia, conjunctival graft loosening and so on. Conclusion: Continuous locking suture combined with corneal bandage lens in the treatment of pterygium can promote the repair of corneal wound, reduce the postoperative irritation symptoms and improve the postoperative comfort of patients. It is necessary to increase the suture span during continuous locking suture, which can reduce the loosening of conjunctival graft after operation.
论著

Corvis ST角膜生物力学分析仪测量近视眼角膜厚度

Measurement of corneal thickness in myopia with Corvis ST corneal biomechanical analyzer

:117-124
 
目的:比较角膜生物力学分析仪(Corvis ST)、A型超声测厚仪(A超)、Lenstar LS 900(Lenstar)在测量近视眼角膜厚度的差异,为屈光术前筛查提供参考。方法:纳入2020年3至12月佛山市第二人民医院收治的屈光术前近视患者244例(244只右眼),并按中央角膜厚度(central corneal thickness,CCT)将患者分为3组:薄角膜组(CCT≤520 μm)、正常角膜组(520 μm570 μm),分别采用Corvis ST、A超、Lenstar三种仪器测量3组患者的中央角膜厚度,并纳入对比指标。结果:Corvis ST与A超、Lenstar在薄角膜组、正常角膜组、厚角膜组的测量值对比差异均有统计学意义(均P<0.05);在相关性方面,Corvis ST与A超、Lenstar在薄角膜组、正常角膜组、厚角膜组呈正相关(r=0.841,P<0.001 vs r=0.832,P<0.001;r=0.866,P<0.001 vs r=0.918,P<0.001;r=0.497,P<0.001 vs r=0.801,P<0.001);在一致性方面,Corvis ST与A超、Lenstar在薄角膜组、正常角膜组、厚角膜组上一致性系数ICC及95%置信区间分别为0.602(0.091,0.857),0.758(0.221,0.901)、0.741(0.207,0.890),0.845(0.396,0.938)、0.417(0.005,0.679),0.667(0.172,0.851),95%一致性区间范围分别是(-2.2~24.2 μm,-6.7~19.5 μm;-8.4~24.6 μm,-6.8~19.4 μm;-8.7~23.8 μm,-7.0~18.3 μm)。结论:通过对3组数据统计分析得出,Corvis ST与A超、Lenstar的测量值相比,差异均有统计学意义,且Corvis ST的测量值均高于后两种仪器;Corvis ST与后两者均有着较高的相关性,且在正常角膜厚度测量上相关性最高;在一致性方面,从ICC点估计及95%置信区间数值分析,一致性较差;从Bland-Altman角度分析,Corvis ST与后两者的绝对值最大差值超过10 μm,一致性较差,但在与Lenstar的绝对值最大差值均在20 μm内。因此,在测量精度要求较高的屈光手术筛查方面,Corvis ST与A超、Lenstar之间不能相互替代,而对于大规模临床筛查,其角膜厚度测量值对眼压的影响有一定的临床参考意义。
Objective: To compare the differences of corneal thickness measured by corneal biomechanical analyzer (Corvis ST), A-mode ultrasonic thickness meter (A-ultrasound) and Lenstar LS 900 (Lenstar) in myopia, so as to provide reference for preoperative screening of refractive surgery. Methods: A total of 244 patients (244 right eyes) with myopia before refractive surgery in Foshan Second People’s Hospital from March to December 2020 were included in the study, and the patients were divided into three groups according to the central corneal thickness (CCT): the thin cornea group (CCT≤520 μm), the normal cornea group (520 μm570 μm). The central corneal thickness (CCT) of the three groups was measured by Corvis ST, A-type ultrasonic thickness gauge and Lenstar LS 900, respectively, and included in the comparison index. Results: The measured values of Corvis ST, A-ultrasound and Lenstar in the thin cornea group, the normal cornea group and the thick cornea group were statistically significant (all P<0.05). Corvis ST was positively correlated with A-ultrasound and Lenstar in the thin cornea group, the normal cornea group and the thick cornea group (r=0.841, P<0.001 vs r=0.832, P<0.001; r=0.866, P<0.001 vs r=0.918, P<0.001; r=0.497, P<0.001 vs r=0.801, P<0.001). In terms of consistency, the consistency coefficients ICC of Corvis ST, A-ultrasound and Lenstar in the thin cornea group, the normal cornea group and the thick cornea group were 0.602 (0.091, 0.857), 0.758 (0.221, 0.901); 0.741 (0.207, 0.890), 0.845 (0.396, 0.938); 0.417 (0.005, 0.679), 0.667 (0.172, 0.851), and the range of 95% consistency interval were -2.2–24.2 μm, -6.7–19.5 μm; -8.4–24.6 μm, -6.8–19.4 μm; -8.7–23.8 μm, -7.0–18.3 μm. Conclusion: Through the statistical analysis of the data from the three groups, it is concluded that the measured values of Corvis ST are statistically significant compared with those of A-ultrasound and Lenstar, and the measured values of Corvis ST are higher than those of the latter two instruments. Corvis ST has a high correlation with the latter two, and the correlation is the highest in the measurement of normal corneal thickness. In terms of consistency, from the ICC point estimation and 95% confidence interval numerical analysis, the consistency was poor. From the perspective of Bland Altman, the maximum absolute value difference between Corvis ST and Lenstar was more than 10 μm, indicating poor consistency, but the maximum absolute value difference between Corvis ST and Lenstar was within 20 μm. Therefore, in refractive surgery screening with high measurement accuracy, Corvis ST, A-ultrasound and Lenstar cannot replace each other. However, in large-scale clinical screening, the measured value of corneal thickness has a certain clinical reference significance on the impact of intraocular pressure.
论著

SMILE术后角膜体积的变化及其与角膜生物力学特性的相关性

Correlation of the changes in corneal volume with the corneal biomechanical parameters after small incision lenticule extraction

:609-619
 
目的:基于新一代Corvis® ST分析成人近视患者经飞秒激光小切口角膜透镜取出术(small incision corneal lens extraction,SMILE)后角膜体(corneal volumn,CV)的变化与角膜生物力学变化的相关性,进一步证明C V对于评估SMILE术后角膜生物力学特性以及预测屈光手术结果的价值。方法:采用前瞻性病例观察研究方法,纳入2021年1月至8月在佛山市第二人民医院拟行SMILE的成人近视患者72例(72眼)。为避免双眼相关性,纳入患者的一个合适眼(右眼或者左眼),根据术前中央角膜厚度,将厚度470~<530 μm分为低角膜厚度组,530~<560 μm为中角膜厚度组 , ≥560μm为高角膜厚度组。应用新一代 Corvis® ST 于术前和术后3个月测量非接触生物力学校正眼压(biomechanical intraocular pressure,bIOP)、2 mm处变形幅度的比值[DA ratiomax(2 mm),DA2ratio]、综合半径(integrated inverse concave radius,IR)、水平方向Ambr?sio相关厚度,最薄点厚度/厚度变化率(Ambrósio’s relational thickness,ARTh)、第1次压平时角膜硬度参数(stiffness parameter applanation 1,SP-A1)、Corvis生物力学指数(Corvis biomechanical index,CBI)和应力和应变参数(stress-strain index,SSI)7项角膜生物力学参数。应用Pentacam眼前节分析系统测量中央角膜厚度(central corneal thickness,CCT)和不同区域的CV(CV3mm、CV5mm、CV7mm和CV10mm)。对比SMILE术前与术后3个月的CV、角膜生物力学参数的变化,并分析角膜生物力学参数与CV的相关性。数据采用配对、独立样本t检验分析差异性;单因素方差分析不同角膜厚度组的差异性;Spearman相关性分析和偏最小二乘回归(partial least squares linear regression,PLSLR)分析相关性。结果:SMILE术后3个月,CV3mm、CV5mm、CV7mm和CV10mm均较术前显著下降(均P<0.001);bIOP、ARTh、SP-A1和SSI较术前明显下降(P<0.05);DA2ratio、IR和CBI较术前明显升高(P<0.05)。术前和术后3个月不同角膜厚度组的ARTh、SP-A1DA2ratio、IR和CBI差异均有统计学意义(均P<0.05),低中角膜厚度组SSI术前后变化不大(P>0.05)。术前DA2ratio与CV3mm、CV5mm呈负相关,与CV10mm呈正相关;ARTh与CV3mm、CV5mm呈正相关,与CV10mm呈负相关;bIOP与CV10mm呈正相关;IR与CV3mm、CV5mm呈负相关,与CV10mm呈正相关;SP-A1与CV3mm、CV5mm呈正相关,与CV10mm呈负相关;CBI与CV3mm、CV5mm和CV10mm呈负相关,SSI与CV3mm呈正相关,与CV10mm呈负相关。SMILE术后3个月,ARTh与CV3mm、CV5mm呈正相关,与CV10mm呈负相关;CBI与CV3mm负相关、CV10mm呈正相关(均P<0.05)。SMILE术后3个月变化量中,ARTh与CV3mm、CV5mm呈正相关,与CV10mm负相关;CBI与CV3mm呈负相关,与CV10mm呈正相关(均P<0.05)。结论:成人SMILE术后3个月CV3mm、CV5mm、CV7mm、CV10mm、眼压和CCT较术前均显著降低;越往周边区域CV减少量越多。SMILE术后3个月的新一代Corvis® ST角膜生物力学新型参数较术前有显著变化;不同区域CV与角膜生物力学参数存在一定的相关性,预期SMILE术后不同区域的CV可以表征术后部分角膜生物力学特性的改变,CV可能成为表征预测角膜扩张发展的参数因素。
Objective: To evaluate the changes in corneal volume (CV) and the correlation of corneal biomechanics in adult myopic patients after small incision corneal lens extraction (SMILE) based on the new generation of Corvis® ST.This paper further demonstrates the value of CV in evaluating corneal biomechanical properties after SMILE and predicting the outcome of refractive surgery. Methods: A total of 72 cases (72 eyes) of adult myopia who were scheduled for SMILE in The Second People’s Hospital of Foshan from January to August 2021 were included in this prospective observational case study. To avoid binocular correlation, a suitable eye for each person was selected for inclusion. Based on the preoperative central corneal thickness (CCT), the cases were divided into a low corneal thickness group (470–<530 μm), a medium corneal thickness group (530–<560 μm), and a high corneal thickness group (≥560 μm). The biomechanical intraocular pressure (bIOP), DA ratiomax (2 mm) (DA2ratio), integrated inverse concave radius (IR), Ambrósio’s relational thickness (ARTh), stiffness parameter applanation 1 (SP-A1),corvis biomechanical index (CBI) and stress-strain index (SSI) were measured by Corvis® ST. The Pentacam anterior segment analysis system was used to measure partial CV and total CV with a diameter of 3, 5, and 7 mm from the top of the cornea, with an assumed diameter of 10 mm. The changes in corneal biomechanical parameters and CV before SMILE and 3 months after SMILE were compared. The correlation between corneal biomechanical parameters and CV was studied. Data were analyzed by paired and independent sample t-tests. One-way analysis of variance (ANOVA) was used to assess the differences between the corneal thickness groups. Spearman correlation analysis and partial least squares linear regression (PLSLR) were used for correlation analyses. Results: Three months after SMILE, the CV in different areas (CV3mm, CV5mm, CV7mm, and CV10mm) were significantly lower than those before SMILE, and the differences were statistically significant (all P<0.001). The corneal biomechanical parameters bIOP, ARTh, SP-A1, and SSI were significantly decreased compared with those before the operation (P<0.05). In contrast, the DA2 ratio, IR, and CBI were significantly higher than those before the operation (P<0.05). A comparison of the corneal biomechanical parameters ARTh, SP-A1, DA2 ratio, IR, and CBI in the different corneal thickness groups before and after SMILE showed overall differences among the groups (P<0.05).However, there was no significant change in the SSI between the low and medium corneal thickness groups. The correlation of the preoperative baseline DA2ratio was negatively correlated with CV3mm and CV5mm, and positively correlated with CV10mm; Conversely, ARTh was positively correlated with CV3mm and CV5mm, and negatively correlated with CV10mm; BIOP was positively correlated with CV10mm; IR was negatively correlated with CV3mm and CV5mm, and positively correlated with CV10mm; SP-A1 was positively correlated with CV3mm and CV5mm, and negatively correlated with CV10mm; CBI was negatively correlated with CV3mm, CV5mm, and CV10mm, while SSI was positively correlated with CV3mm and negatively correlated with CV10mm (all P<0.05). At 3 months after SMILE, ARTh was positively correlated with CV3mm and CV5mm, and negatively correlated with CV10mm; CBI was negatively correlated with CV3mm, and positively correlated with CV10mm (all P<0.05). Conclusion: This study demonstrated that at 3 months after SMILE, CV3mm, CV5mm, CV7mm, CV10mm, intraocular pressure, and CCT in the central and peripheral areas decreased significantly compared with to those before the operation, and the more peripheral the area, the more the CV decreased. Three months after SMILE, the new corneal biomechanical parameters of the new generation Corvis® ST changed significantly compared to those before the operation, and there was a certain correlation between CV in different regions and corneal biomechanical parameters. It is expected that CV in different regions after SMILE can characterize some changes in corneal biomechanical properties after SMILE, and CV may become a parameter factor for characterizing and predicting the development of corneal dilatation.
其他期刊
  • 眼科学报

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
    浏览
  • Eye Science

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
    浏览
推荐阅读
出版者信息