| 直视下睫状体离断复位术对角膜地形图的影响 |
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| 引用本文： | 莫宾,史翔宇,李松峰,刘毅.直视下睫状体离断复位术对角膜地形图的影响[J].眼科新进展,2021,0(9):865-869. |
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| 作者姓名： | 莫宾 史翔宇 李松峰 刘毅 |
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| 作者单位： | 100730 北京市，首都医科大学附属北京同仁医院 北京同仁医院眼科中心；北京市眼科学与视觉科学重点实验室 |
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| 摘 要： | 目的 探讨传统直视下睫状体离断复位手术前后角膜地形图的变化。方法 收集我院2018年1月至2020年12月因睫状体离断行直视下睫状体离断复位术患者17例（17眼）。所有入选患者术前及术后均行超声生物显微镜(UBM)检查确认睫状体离断及术后复位情况，术前及术后均行Pentacam角膜地形图检查，分析入选患者术前术后角膜地形图相关参数的变化情况。所有入选患者均由同一术者操作下完成直视下睫状体离断复位术。结果 所有患者直视下睫状体离断复位术后UBM检查证实睫状体离断复位；所有术眼术前角膜前表面散光度为（1.24±0.66）D，术后1周为（2.02±1.03）D，差异有统计学意义（P=0.012）。术眼术前角膜前表面变异指数（ISV）为16.29±6.05，术后为27.00±4.69；术眼术前角膜前表面垂直非对称性指数（IVA）为0.12±0.04，术后为0.18±0.05，术眼术前及术后ISV、IVA比较，差异均有统计学意义（均为P<0.001）。角膜前表面7 mm和9 mm环域间的平均曲率术前为（7.97±0.27）mm，术后为（8.05±0.29）mm，差异有统计学意义（P=0.001）。睫状体离断复位手术缝合范围按中位数记录，Pearson相关分析结果显示，睫状体离断复位手术缝合范围中位数与术后散光轴位之间具有显著相关性（r=0.634,P=0.006）。术后1个月，9例患者行Pentacam角膜地形图复查，ISV为17.33±5.74，IVA为0.12±0.05，角膜前表面散光度为（1.02±0.46）D，与术前相比，差异均无统计学意义（均为P>0.05）。结论 经典的直视下睫状体离断复位术可以有效地使睫状体离断复位，但可造成术后早期散光。Pentacam角膜地形图用以评估手术前后患者角膜状态，可为更客观地评估手术效果提供参考。
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| 关 键 词： | 睫状体离断复位术 Pentacam角膜地形图 散光 |
Effect of ciliary body reduction under the direct observation on corneal topography |
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| MO Bin,SHI Xiangyu,LI Songfeng,LIU Yi.Effect of ciliary body reduction under the direct observation on corneal topography[J].Recent Advances in Ophthalmology,2021,0(9):865-869. |
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| Authors: | MO Bin SHI Xiangyu LI Songfeng LIU Yi |
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| Affiliation: | Beijing Tongren Eye Center,Beijing Tongren Hospital,Capital Medical University,Beijing Ophthalmology & Visual Sciences Key Laboratory,Beijing 100730,China |
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| Abstract: | Objective To observe the changes of corneal topography before and after ciliary body detachment and reduction under the direct observation.Methods A total of 17 patients (17 eyes) with cyclodialysis surgically treated with ciliary body detachment and reduction under the direct observation by the same surgeon in Beijing Tongren Eye Center during January 2018 to December 2020 were recruited. All patients were examined by ultrasound biomicroscopy (UBM) before and after operation to confirm the cyclodialysis and postoperative reduction. Pentacam was performed preoperatively and postoperatively to analyze the changes of corneal topography parameters.Results Closure of the cyclodialysis was achieved in all 17 eyes using UBM. There was a significant difference in the astigmatism of anterior corneal surface before operation and 1 week after operation ［(1.24±0.66） D vs. （2.02±1.03） D, P=0.012］. The preoperative and postoperative index of surface variance was 16.29±6.05 and 27.00±4.69, respectively. The preoperative and postoperative index of vertical asymmetry was 0.12±0.04 and 0.18±0.05, respectively. Significant differences in index of surface variance and index of vertical asymmetry were obtained before and after operation (both P<0.001). The preoperative and postoperative Rper was (7.97±0.27) mm and (8.05±0.29) mm respectively, which was statistically significant (P<0.001). The suture range of cyclodialysis was recorded by median, and postoperative astigmatism axis was associated with the median suture range (r=0.634, P=0.006). One month after operation, Pentacam examination was performed in 9 cases. It is shown that postoperative index of surface variance, index of vertical asymmetry and astigmatism at 1 month was 17.33±5.74, 0.12±0.05 and (1.02±0.46) D, respectively, although no significant differences in them were found between preoperative levels and those at 1 month after operation (all P>0.05).Conclusion Classic ciliary body detachment and reduction under the direct observation can effectively achieve the reduction of the ciliary body, but it can also cause early postoperative astigmatism changes. Pentacam corneal topography can well evaluate the corneal state, which provides a reference for more objective evaluation of surgical effect. |
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| Keywords: | ciliary body detachment and reduction Pentacam corneal topography astigmatism |
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