[1]孙玺皓,王保君,杨华,等.经上皮准分子激光角膜表面切削术（TransPRK）对角膜光密度与角膜高阶像差的影响[J].眼科新进展,2019,39(11):1071-1075.[doi:10.13389/j.cnki.rao.2019.0246]
　SUN Xi-Hao,WANG Bao-Jun,YANG Hua,et al.Changes and correlation of corneal optical density and corneal higher-order aberrations after transepithelial photorefractive keratectomy[J].Recent Advances in Ophthalmology,2019,39(11):1071-1075.[doi:10.13389/j.cnki.rao.2019.0246]
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经上皮准分子激光角膜表面切削术（TransPRK）对角膜光密度与角膜高阶像差的影响/HTML
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
39卷
期数:
2019年11期
页码:
1071-1075
栏目:
应用研究
出版日期:
2019-11-05

文章信息/Info

Title:
Changes and correlation of corneal optical density and corneal higher-order aberrations after transepithelial photorefractive keratectomy
作者:
孙玺皓; 王保君; 杨华; 李新民; 代志强; 袁小艾
453100　河南省卫辉市，新乡医学院第一附属医院眼科
Author(s):
SUN Xi-Hao; WANG Bao-Jun; YANG Hua; LI Xin-Min; DAI Zhi-Qiang; YUAN Xiao-Ai
Department of Ophthalmology，the First Affiliated Hospital of Xinxiang Medical University，Weihui 453100，Henan Province，China
关键词:
经上皮准分子激光角膜表面切削术; 角膜光密度; 高阶像差
Keywords:
transepithelial photorefractive keratectomy; corneal optical density; high-order aberrations
分类号:
R778
DOI:
10.13389/j.cnki.rao.2019.0246
文献标志码:
A
摘要:
目的　观察经上皮准分子激光角膜表面切削术（transepithelial photorefractive keratectomy，TransPRK）对角膜光密度与角膜高阶像差的影响，并分析二者的相关性。方法　选取于2017年3月至7月在新乡医学院第一附属医院眼科行TransPRK治疗近视及近视散光的患者80例，均选取右眼纳入研究。对比患眼术前与术后1个月、3个月、6个月角膜光密度与高阶像差的变化情况。术前与术后不同时间点差异的比较采用LSD-t检验，角膜光密度和高阶像差之间的相关性应用Pearson相关分析。结果　在TransPRK术后1个月、3个月、6个月以角膜顶点为中心≤2 mm、＞2~6 mm和＞6~10 mm区域内角膜光密度均较术前明显增高，差异均有统计学意义（均为P＜0.05）。术后1个月、3个月、6个月，总高阶像差、彗差、球差均较术前明显升高，差异均有统计学意义（均为P＜0.05）；三叶草像差在术后1个月、3个月与术前相比差异均有统计学意义（均为P＜0.05）；二级散光差在术后1个月与术前相比差异有统计学意义（P＜0.05）。术后3个月以角膜顶点为中心≤2 mm区域内角膜光密度的变化值与球差的变化值存在负相关性（r=-0.252，P=0.024）。以角膜顶点为中心＞2 ~6 mm区域内角膜光密度变化值与总高阶像差、彗差的变化值均存在正相关性（r=0.403、0.567，均为P=0.000）；与球差的变化值存在负相关性（r=-0.607，P=0.000）。术后6个月时以角膜顶点为中心≤2 mm区域内角膜光密度的变化值与球差的变化值存在负相关性（r=-0.257，P=0.021）；以角膜顶点为中心＞2 ~6 mm区域内角膜光密度变化值与彗差的变化值存在正相关性（r=0.244，P=0.029），与球差的变化值存在负相关性（r=-0.374，P=0.001）。结论　角膜光密度可以作为评判角膜健康情况的定量客观指标，其可以评估TransPRK术后患者角膜的恢复情况，并且预测或者提示术后高阶像差的变化。
Abstract:
Objective　To observe the changes in corneal optical density and higher order aberrations (HOAs) after transepithelial photorefractive keratectomy (TransPRK) and to analyze the correlation between the corneal optical density and HOAs.Methods　Totally 80 patients (80 right eyes) of myopia and astigmatism were selected from the First Affiliated Hospital of Xinxiang Medical University from March to July 2017.The change of HOAs and the corneal optical density of patients were compared before and after TransPRK at 1 day，1 month,3 months and 6 months.LSD-t test was used to compare the change between pre-operative and different time points of post-operative data.Pearson correlation analysis was applied to analyze the correlation between corneal optical density and HOAs.Results　After TransPRK,the corneal optical density from the area of corneal vertex to 2 mm,>2 mm to 6 mm,>6 mm to 10 mm significantly increased when compared with before operation during the entire follow-up period (all P<0.05).The postoperative values of corneal HOAs root mean square (HO-RSM),coma and spherical aberration were significantly increased at 1 month,3 months and 6 months (all P<0.05).There were significant differences between pre-operative and post-operative trefoil at 1 month and 3 months (all P<0.05).There were statistical differences between pre-operative secondary astigmatism and post-operative data at 1 month (P<0.05).At 3 months after operation,there was a negative correlation between the change of corneal optical density from the area of corneal vertex to 2 mm and the spherical aberration (r=-0.252,P=0.024),while the variation of corneal optical density in the area from 2mm to 6 mm and HO-RMS as well as coma had a positive correlation r=0.403,0.567,both P=0.000).In addition,there was a negative correlation between the change of corneal optical density in the area from 2 mm to 6 mm and the spherical aberration r=-0.607,P=0.000).After TransPRK,there was a negative correlation between the change of corneal optical density that the area from corneal vertex to 2 mm and the spherical aberration at 6 months r=-0.257,P=0.021).Finally,6 months after TransPRK,there was a positive relevant between the change of corneal optical density that the area from 2 mm to 6 mm and the coma r=0.244,P=0.029);on the contrary,there was a negative relationship with spherical aberration r=-0.374,P=0.001).Conclusion　Corneal optical density,as a quantitative and objective index,can evaluate corneal health and the recovery of refractive surgery patients,predict the changes of HOAS after TransPRK.

参考文献/References:

［1］　ARBA M S，AWWAD S T.Theoretical analyses of the refractive implications of transepithelial PRK ablations［J］.Br J Ophthalmol，2013，97（7）：905-911.
［2］　IMAMOGLU S，KAYA V，ORAL D，PERENTE I，BASARIR B，YILMA Z.Corneal wavefront-guided customized laser in situ keratomileusis after penetrating keratoplasty［J］.J Cataract Refract Surg，2014，40（5）：785-792.
［3］　HOSSEINI S H R J，ABTAHI S M B，KHALILI M R.Comparison of higher order aberrations after wavefront-guided LASIK and PRK：One year follow-up results［J］.J Ophthalmic Vis Res，2016，11（4）：350-357.
［4］　KERATOLOGY GROUP，OPHTHALMOLOGICAL SOCIETY OF CHINESE MEDICAL ASSOCIATION.Expert consensus on clinical diagnosis and treatment of laser corneal refractive surgery（2015）［J］.Chin J Ophthalmol，2015，51（4）：249-254.
中华医学会眼科学分会角膜病学组.激光角膜屈光手术临床诊疗专家共识（2015年）［J］.中华眼科杂志，2015，51（4）：249-254.
［5］　LORENTE-VELZQUE A，MADRID-COSTA D，NIETO-BONA A，GONZLEZ-MESA A，CARBALL O.Recovery evaluation of induced changes in higher order aberrations from the anterior surface of the cornea for different pupil sizes after cessation of corneal refractive therapy［J］.Cornea，2013，32（4）：16-20.
［6］　N D S，ROZEMA J J，JONGENELEN S，RUIZ H I，ZAKARIA N，TASSIGNON M J.Normative values for corneal densitometry analysis by scheimpflug optical assessment［J］.Invest Ophthalmol Vis Sci，2014，55（1）：162-168.
［7］　OTRI A M，FAREE U，AL-AQABA M A，DUA H S.Corneal densitometry as an indicator of corneal health［J］.Ophthalmology，2012，119（3）：501-508.
［8］　YANG D，GU T P，LI Y，LIN W P，LI N，WEI R H.Analysis of densitometry of keratoconus［J］.Rec Adv Ophthalmol，2017，37（5）：450-454.
杨丹，谷天瀑，李颖，林伟平，厉娜，魏瑞华.圆锥角膜的光密度分析［J］.眼科新进展，2017，37（5）：450-454.
［9］　TAKACS A I，MIHALTZ K，NAGY Z Z.Corneal density with the Pentacam after photorefractive keratectomy［J］.J Refract Surg，2011，27（4）：269-277.
［10］　BOULZEPANKERT M，DARIEL R，HOFFART L.Corneal scheimpflug densitometry following photorefractive keratectomy in myopic eyes［J］.J Refract Surg，2016，32（11）：788-796.
［11］　ABDELKADER A.Effect of fibrin glue on corneal lamellar healing and how it correlates to biomechanical properties：biomechanical wavefront analysis and confocal study［J］.Eye Vis（Lond），2016，3（1）：15-28.
［12］　ABDELKADER A.Corneal biomechanical properties and their correlates with healing process after Descemetic versus pre-Descemetic lamellar keratoplasty［J］.Eur J Ophthalmol，2013，23（5）：652-657.
［13］　SAFAK K，KAMIL B，SABAHATTIN S，AHMET H.A clinical and confocal microscopic comparison of transepithelial PRK and LASEK for myopia［J］.J Ophthalmol，2014，4（3）：185-199.
［14］　GANDHI S，JAIN S.The anatomy and physiology of cornea［M］//Keratoprostheses and artificial corneas.Berlin：Springer Berlin Heidelberg，2015：223-237.
［15］　GIBSON D J，TULI S S，SCHULTZ G S.The progression of haze formation in rabbit corneas following phototherapeutic keratectomy［J］.Invest Ophthalmol Vis Sci，2013，54（7）：4776-4781.
［16］　WANG Y，ZHAO K X.High-order aberration and visual quality after corneal refractive surgery［J］.Chin J Ophthalmol，2011，47（7）：664-668.
王雁，赵堪兴.角膜屈光手术后的高阶像差与视觉质量［J］.中华眼科杂志，2011，47（7）：664-668.
［17］　YANG X，WANG Y，ZHAO K，FANG L.Comparison of higher-order aberration and optical quality after Epi-LASIK and LASIK for myopia［J］.Graefes Arch Clin Exp Ophthalmol，2011，249（10）：1559-1560.
［18］　KATSANEVAKI V J，KALYVIANAKI M I.One-year clinical results after epi-LASIK for myopia［J］.Ophthalmology，2007，114（6）：1111-1117.
［19］　KALUZNY B J，SZKULMOWSKI M，BUKOWSKA D M，WOJTKOWSKI M.Spectral OCT with speckle contrast reduction for evaluation of the healing process after PRK and transepithelial PRK［J］.Biom Optics Express，2014，5（4）：1089-1098.
［20］　XU R，BRADLEY A，THIBOS L N.Impact of primary spherical aberration，spatial frequency and stiles crawford apodization on wavefront determined refractive error：A computational study［J］.Ophthalmic Physiolog Optics，2013，33（4）：444-455.
［21］　IVARSEN A，FLEDELIUS W J H.Three-year changes in epithelial and stromal thickness after PRK or LASIK for high myopia［J］.Invest Ophthalmol Vis Sci，2009，50（5）：2061-2066.

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备注/Memo:
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更新日期/Last Update: 2019-11-18