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目的 评价角膜地形图分析在圆锥角膜早期诊断中的重要作用。方法 对矫正视力较为理想 ,裂隙灯显微镜及角膜曲率计检查均无阳性发现的 2 0例 (36只眼 )患者 ,利用计算机辅助角膜地形检测仪 (eyesys2 0 0 0 ,美国产 )对角膜影像的参数进行分析 ,并分别于 3个月、6个月、1年进行随访检测明确诊断。结果 早期圆锥角膜患者的 SRI、SAI、角膜中央的屈光力、I- S值、单眼病例两眼角膜中央屈光力的差值、Sim K值及 Sim K的差值、角膜屈光力的变化范围等均增高 ,有助于诊断早期圆锥角膜 ,特别是角膜最大屈光力的位置、角膜屈光力的变化范围对诊断早期圆锥角膜非常敏感。根据文献及笔者临床实践认为以下四个指标更有利于圆锥角膜患者的早期诊断。(1)角膜中央屈光力 >4 6 .0 0 D;(2 )同一病例两眼角膜中央屈光力的差值 >1.0 0 D;(3) I- S值 >2 .0 0 D;(4)最大一环与最小一环屈光力的差值≥ 4 .5 0 D。其中有两项或两项以上发现异常 ,应定期随访 ,如有进行性发展即可确诊圆锥角膜。结论 提示角膜地形图检测是圆锥角膜早期诊断中具有高度敏感性的、可靠的定量分析方法 ,证实了角膜地形图检测在圆锥角膜早期诊断中具有重要的作用 ,是目前最有效的早期诊断方法
Objective To evaluate the important role of corneal topography in the early diagnosis of keratoconus. Methods Twenty patients (36 eyes) without positive findings of slit lamp and corneal curvature were examined with a computer-assisted corneal topography (eyesys 2000) Parameters were analyzed and respectively at 3 months, 6 months, 1 year follow-up test to confirm the diagnosis. Results The SRI, SAI, central corneal refractive power and I-S value of the early keratoconus patients, the differences of the central corneal refractive power, the differences of Sim K value and Sim K, the changes of the corneal refractive power and so on, Helps to diagnose early keratoconus, especially the corneal maximum refractive power position, corneal refractive power of the range of changes in the diagnosis of early keratoconus is very sensitive. According to the literature and the author’s clinical practice that the following four indicators are more conducive to the early diagnosis of keratoconus patients. (1) central corneal refractive power> 46.0 0 D; (2) the same case the difference between the central corneal refractive power of both eyes> 1.0 0 D; (3) I-S value> 2. 0 D; The difference between a ring and the minimum ring refractive power ≥ 4. Two or more of them were found to be abnormal and should be followed up regularly. If there is progressive development, the keratoconus can be confirmed. Conclusions Corneal topography is a highly sensitive and reliable quantitative method for early diagnosis of keratoconus, confirming that corneal topography plays an important role in the early diagnosis of keratoconus and is the most effective method for early diagnosis