目的:探讨角膜屈光手术术前筛查时不同角膜直径对角膜形态和生物力学结果的影响。
方法:回顾性分析300例眼科和耳鼻喉科医院接受角膜屈光手术的患者,复旦大学,2023年10月至2023年12月。所有患者均无圆锥角膜或角膜手术史。根据角膜地形图测量将患者分为两组:(1)正常角膜直径组(n=159),角膜直径在11.5mm至12.0mm之间;(2)角膜直径异常组(n=141),角膜直径小于10.0毫米或大于12.5毫米。角膜厚度,形态学数据,使用Pentacam角膜地形图测量生物力学数据。进行相关分析,探讨角膜直径与各种角膜地形图和生物力学数据之间的关系。
结果:在包括BFSf(F=43.21)在内的角膜地形图数据中观察到显着差异,BFSb(F=30.24),Df(F=15.32),Dp(F=32.36),Da(F=9.66),D(F=58.36),PPIavg(F=32.64),各组间ARTmax(F=12.06)(P<0.05)。此外,BFSf,BFSb,Db,Dp,D,PPIavg和PPIavg在任何两组之间均具有统计学意义(P<0.05)。在Df中也发现了显著差异,Da,和ARTmax在小角膜和大角膜之间,以及正常大小和大角膜之间(P<0.05)。相关分析显示角膜直径与A1V呈负相关(r=-0.12),HCdArcLength(r=-0.17),CBI(r=-0.27),bIOP(r=-0.13),Df(r=-0.025),PPIavg(r=-0.028),和TBI(r=-0.27)。相反,BFSf(r=0.009),BFSb(r=0.001),PD(r=0.15),ARTH(r=0.37)与角膜直径呈正相关。
结论:角膜直径显著影响角膜屈光手术的术前筛查。较小的角膜直径对角膜地形图BAD分析系统表现出更大的影响。
OBJECTIVE: To investigate the impact of different corneal diameters on corneal morphology and biomechanical outcome during preoperative screening for corneal refractive surgery.
METHODS: A retrospective analysis was conducted on 300 patients who underwent corneal refractive surgery at Eye and ENT Hospital, Fudan University between October 2023 and December 2023. All patients had no history of keratoconus or previous corneal surgery. Patients were categorized into two groups based on corneal topography measurements: (1) normal corneal diameter group (n=159), those with corneal diameter ranging from 11.5 mm to 12.0 mm; (2) abnormal corneal diameter group (n=141), those with corneal diameter smaller than 10.0 mm or larger than 12.5 mm. Corneal thickness, morphologic data, and biomechanical data were measured using Pentacam corneal topography. Correlation analysis was conducted to explore the relationship between corneal diameter and various corneal topography and biomechanical data.
RESULTS: Significant differences were observed in corneal topography data including BFSf (F=43.21), BFSb (F=30.24), Df (F=15.32), Dp (F=32.36), Da (F=9.66), D (F=58.36), PPIavg (F=32.64), and ARTmax (F=12.06) between the groups (P<0.05). Additionally, BFSf, BFSb, Db, Dp, D, and PPIavg exhibited statistically significant differences between any two groups (P<0.05). Significant differences were also found in Df, Da, and ARTmax between small and large corneas, as well as between normal-sized and large corneas (P<0.05). Correlation analysis indicated negative correlations between corneal diameter and A1V (r=-0.12), HCdArcLength (r=-0.17), CBI (r=-0.27), bIOP (r=-0.13), Df (r=-0.025), PPIavg (r=-0.028), and TBI (r=-0.27). Conversely, BFSf (r=0.009), BFSb (r=0.001), PD (r=0.15), and ARTH (r=0.37) displayed positive correlations with corneal diameter.
CONCLUSIONS: Corneal diameter significantly affects preoperative screening for corneal refractive surgery. Smaller corneal diameters exhibit a greater influence on the corneal topography BAD analysis system.