【摘要】 目的 探讨准分子激光原位角膜磨镶术（LASIK）后角膜后表面曲率改变及相关因素。方法 采用OrbscanⅡ眼前节分析系统对80例156眼近视眼LASIK手术前和手术后3个月进行检测，分别记录角膜前、后表面曲率，角膜厚度，并进行统计学分析。结果 LASIK手术后角膜后表面曲率与术前比较差异有显著性（P<0.001），术后比术前平均增加（0.76±0.71）D;术后角膜后表面曲率增加值与术前角膜前、后表面曲率大小及屈光度高低无相关性（r=0.100，P>0.1;r=-0.099，P>0.1;r=-0.140，P>0.1）;与手术切削量呈高度正相关（r=0.337，P<0.001）;与术后角膜厚度呈显著负相关（r=-0.218，P<0.05）;与角膜基质层残留角膜厚度值无显著相关性（r=-0.162，0.05<P<0.1）。结论 LASIK术后角膜后表面曲率较术前明显增加，角膜厚度变薄可能是导致手术后角膜后表面曲率增加的主要因素。

　　关键词 准分子激光原位角膜磨镶术 角膜地形图 近视 角膜后曲率

　　A correlative analysis about posterior corneal surface topographical

　　changes after laser in situ keratomileusis   Wang Hua，He Shuxi，Chen Jiao

　　Department of Ophthalmology，The People’s Hospital，Hunan410005

　　【Abstract】 Objective To evaluate posterior corneal surface topographical changes after laser in situ keratomileusis（LASIK）and its correlative factors.Methods We retrospectively studied the curvature of the anterior and posterior corneal surface，cornea thickness in156eyes of80patients preoeratively and3-month after LASIK with the OrbscanⅡsystem.Results The curvature of the posterior corneal surface significantly increased after LASIK comparingwith preopration（P<0.001），averagly increased（0.76±0.71）D.The increase degree of the curvature of the posterior corneal surface was not statistically related with degree of the curvature of the anterior and posterior corneal surface，diopter preoperatively（r=0.100，P>0.1;r=-0.099，P>0.1;r=-0.140，P>0.1）.It had significantly positive correlation with the ablation quantity（r=0.337，P<0.001）;and had significantly negative correlation with the corneal thickness after LASIK（r=-0.218，P<0.05）;whereas it had no significantly correlation with residual corneal bed thickness（r=-0.162，0.05<P<0.1）.Conclusion The curvature of the posterior corneal Surface significantly increased after LASIK.The change of the thickness of corneal might be the main factor which results in the increase of the curvature after operation.

　　Key words Laser in Situ Keratomileusis topography myopia posterior corneal surface topography 

　　随着准分子激光原位角膜磨镶术（Laser in Situ Keratomileusis，LASIK）的广泛开展，有关LASIK术后角膜后表面曲率的改变越来越受到重视，它不仅影响手术疗效，而且与手术安全性直接相关。本文通过采用裂隙扫描角膜地形图对80例156眼LASIK手术前后角膜后表面曲率进行比较，旨在研究影响术后角膜后表面曲率改变的相关因素，现将
结果报告如下。

　　1 资料与方法

    1.1 一般资料 收集2003年6月～2004年6月在我院行LASIK的近视患者80例（156眼），其中男34 例，女46例，年龄18～40岁，平均（28±5.6）岁;术前球镜-2.00～-14.00D，平均（-6.64±2.84）D;术前柱镜0～-3.5D，平均（-0.75±0.71）D。术前排除圆锥角膜、可疑圆锥角膜及角膜后表面明显前凸的病例。