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目的探讨高度近视[准分子激光原位角膜磨镶术(laserinsitukeratomileusis,LASIK)后远期的屈光回退的相关因素,并对其进行角膜共聚焦显微镜(confocalmicroscopethroughfocusing,CMTF)的观察和分析。方法对发生屈光回退的35名高度近视患者的66[,进行了随访观察及回顾分析。结果屈光回退的度数与角膜曲率的变化值呈负相关(P<0.05);屈光回退的度数与角膜中央厚度变化值呈负相关(P<0.05);角膜共聚焦显微镜观察发现,回退患者的基质层厚度为(403.14±22.30)μm,与对照组(347.58±42.64)μm相比,统计学差异有显著性。回退患者的最前层基质细胞的数目为(704.50±35.9)个/mm2与对照组(1087.0±67.0)个/mm2相比,统计学差异具有显著性。结论LASIK术后远期的屈光回退与手术前后角膜曲率的变化有关,回退患者基质层的增厚可能引起角膜曲率的变化,从而产生屈光回退。前基质细胞的减少或许参与了此过程。
Objective To investigate the related factors of long-term refractive regression after laser in situ keratomileusis (LASIK) in high myopia, and to observe and analyze the confocal microscopic penetration focusing (CMTF). Methods Thirty-five patients with high myopia who had refractive regression were followed up and retrospectively analyzed. Results There was a negative correlation between the degree of refractive regression and the change of corneal curvature (P <0.05). The degree of refractive regression was negatively correlated with the change of central corneal thickness (P <0.05). Corneal confocal microscopy showed that, The thickness of stromal layer in patients with regression was (403.14 ± 22.30) μm, which was significantly higher than that in control group (347.58 ± 42.64) μm. There was significant difference in the number of stromal cells in the front of patients who got back (704.50 ± 35.9) / mm2 compared with the control group (1087.0 ± 67.0) / mm2. Conclusion The long-term refractive retroreflection after LASIK is related to the change of corneal curvature before and after surgery. The thickening of the stroma may lead to the change of corneal curvature, resulting in refractive regression. Pre-stromal cell reduction may be involved in this process.