Pentacam前节分析系统测量角膜厚度、地形图及屈光手术后角膜后表面的研究

山东大学耳鼻喉眼学报 ›› 2011, Vol. 25 ›› Issue (5): 82-.

Pentacam前节分析系统测量角膜厚度、地形图及屈光手术后角膜后表面的研究

李莹，李悦，罗岩，金玉梅

中国医学科学院北京协和医院眼科，北京 100730

收稿日期:2011-07-29 修回日期:2011-08-05 出版日期:2011-10-16 发布日期:2011-10-16
作者简介:李莹，医学博士，眼科学博士后，主任医师，教授，博士生导师。

Determination of corneal thickness, topography, and the posterior corneal surface changes using the Pentacam rotationg scheimpflug camera

LI Ying, LI Yue, LUO Yan, JIN Yu-mei

Peking Union Medical College Hospital, Beijing 100730

Received:2011-07-29 Revised:2011-08-05 Online:2011-10-16 Published:2011-10-16

摘要/Abstract

摘要：

目的验证Pentacam眼前节成像系统与超声测厚仪和传统角膜地形图所测量结果的一致性，并分析准分子激光手术后角膜后表面的变化特点，评价手术方式、切削深度、切削比、残留基质厚度以及眼内压对角膜后表面变化的影响。方法入选2010年1月至2010年6月在我院行准分子激光屈光手术患者，按照各组要求分别选取若干例近视眼患者进行分析。术前应用Pentacam、超声测厚仪以及传统角膜地形图仪测量每眼，并完善眼压等其余术前常规检查。按手术方式将患者分为LASIK组和LASEK组，纪录患者术中的切削深度、残留基质厚度，计算切削比，屈光手术后8~12周复查Pentacam。结果 ① Pentacam与超声测厚仪测量角膜中央厚度结果相符率达97.62%，Poisson相关系数为0.96；② Pentacam与传统角膜地形图仪测量角膜前表面平均曲率值相符率达100%，Poisson相关系数为0.98；③ LASIK组平均角膜后表面前移2.46μm，LASEK组平均角膜后表面前移0.6μm，两组中后表面前移量均随AD和AD/CT增大而增大，随RBT增大而减小，与IOP没有明显相关性。结论 ① Pentacam系统测量中心角膜厚度与A超仪测量结果较为符合。作为一项新型的、安全无创的眼科检查仪器，Pentacam系统测量结果准确，可在准分子激光屈光手术前使用；② 对与无特殊眼疾者，Pentacam检查可以替代传统Placido盘系统的角膜地形检查，且能获得全角膜厚度、角膜后表面地形、晶状体等更多、更全面的数据；③ LASEK和LASIK手术后角膜后表面均存在微小前移，其中接受LASEK手术的患者前移量较小；④ 屈光手术后角膜后表面前移量与切削深度、切削比和剩余基质床厚度有关。角膜组织消融得越多，保留的角膜厚度越少，对角膜原有的结构破坏越大，则对角膜后表面形态影响愈大，前移量越大。眼压高低不对角膜后表面前移产生影响。

关键词: Pentacam，前房成像系统；超声检查；角膜

Abstract:

Objective To verify the consistency between the results of Pentacam and ultrasonic pachymetry, and between that of Pentacam and traditional corneal topography; to evaluate the influence of surgery type, AD, AD/CT, RBT and IOP on the changes of posterior cornear after excimer laser photorefractive keratectomy by Pentacam. Methods Choose myopic patients who underwent excimer laser refractive surgery during January 2010 to June 2010 in our hospital. Certain amount was included for each group of analysis. Pentacam, ultrasonic pachymetry, traditional corneal topography and other tests necessary for the surgery like IOP were taken. Patients were divided into the LASIK and LASEK groups according to the type of surgery. For every patient during the surgery, AD and RBT were documented and AD/CT was calculated. 8~12 weeks after the surgery, Pentacam was redone. Results ① Consistence rate of Pentacam and ultrasonic pachymetry for CCT was 97.62%，and poisson correlation coefficient was 0.96；② Consistence rate of Pentacam and traditional corneal topography for AverK was 100%，and poisson correlation coefficient 0.98； ③ Mean value of posteror cornea elevation for patients underwent LASIK surgery was 2.46μm，while that of patients underwent LASEK was 0.6μm. In both groups forward shift rised with the increase of AD and AD/CT, declined with the increase of RBT, and showed no correlation with IOP. Conclusions ① Pentacam is consistent with ultrasonic pachymetry for measuring CCT. As a noninvasive novel inventure, Pentacam is suitable for pre-operative tests for excimer laser photorefractive keratectomy. ② For healthy patients, Pentacam could replace traditional corneal topography. More results of the anterior segment of the eye could be got other than K vales by using Pentacam. ③ Minor posteror cornea elevation exists after both LASEK and LASIK. And the former is more subtle. ④ The degree of posteror cornea elevation is in positive relation with AD and AD/CT, negative with RBT, and no relation with IOP.

Key words: Pentacam rotationg scheimpflug camera; Ultrasonography; Cornea

中图分类号:

R770.42

李莹，李悦，罗岩，金玉梅. Pentacam前节分析系统测量角膜厚度、地形图及屈光手术后角膜后表面的研究[J]. 山东大学耳鼻喉眼学报, 2011, 25(5): 82-.

LI Ying, LI Yue, LUO Yan, JIN Yu-mei. Determination of corneal thickness, topography, and the posterior corneal surface changes using the Pentacam rotationg scheimpflug camera[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2011, 25(5): 82-.

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