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目的探讨LASIK手术中发生眼球旋转和瞳孔中心移位的影响因素。设计回顾性临床病例系列。研究对象近视患者131例262眼。方法对接受双眼LASIK手术的近视患者,应用Custom Vue~(TM)软件测量术中眼球旋转及瞳孔中心移位,并探讨其影响因素;按照年龄、性别、眼别、角膜瓣制作方法、等效球镜、术前瞳孔直径、术中瞳孔直径、瞳孔直径差值等因素进行分组,对不同分组的眼球旋转和瞳孔中心移位的结果进行比较。主要指标术中眼球旋转度数及瞳孔中心移位距离。结果LASIK手术中平均眼球旋转度数(3.07°±2.07°)(0°～8.6°)。平均瞳孔中心移位为(0.33±0.14)mm(0.04～0.51mm)。旋转度数与术前瞳孔直径、术前术中瞳孔差值、术前等效球镜度数具有相关性(r=0.188,0.156,0.130,P均<0.05)。术前瞳孔>7.0mm组眼球旋转度数为(3.35°±2.17°),明显高于术前瞳孔≤7.0 mm组(2.71°±1.89°,P=0.014)。右眼瞳孔中心移位(0.39±0.12)mm,明显高于左眼(0.28±0.13)mm(P=0.000)。结论Custom Vue~(TM)系统可以测量LASIK术中发生的眼球旋转和瞳孔中心移位。术前瞳孔直径和手术中瞳孔直径变化值可影响眼球旋转度数。右眼的瞳孔中心移位高于左眼。
Objective To investigate the influencing factors of eyeball rotation and pupil center shift in LASIK. Design retrospective clinical case series. 131 cases of 262 myopic patients were studied. Methods Myopic eyes underwent LASIK in both eyes were measured with Custom Vue ™ software. The intraocular rotation and pupil center displacement were measured and the influencing factors were analyzed. The effects of age, sex, eyes and corneal flap production were evaluated Spherical, preoperative pupil diameter, intraoperative pupil diameter, pupil diameter difference and other factors were grouped, the different groups of eye rotation and pupil center shift results were compared. The main indicators of intraoperative eye rotation degree and pupil center shift distance. Results The mean rotational degree of eyeball during LASIK was 3.07 ° ± 2.07 ° (0 ° ~ 8.6 °). The average pupil center shift was (0.33 ± 0.14) mm (0.04 ~ 0.51mm). The degree of rotation was correlated with preoperative pupil diameter, preoperative pupil difference and preoperative spherical equivalent (r = 0.188,0.156,0.130, P <0.05). Preoperative pupil> 7.0mm group eye rotation degree (3.35 ° ± 2.17 °), significantly higher than the preoperative pupil ≤ 7.0 mm group (2.71 ° ± 1.89 °, P = 0.014). Right pupil center shift (0.39 ± 0.12) mm, significantly higher than the left eye (0.28 ± 0.13) mm (P = 0.000). Conclusion The Custom Vue ™ system can measure eye rotation and pupil center shift in LASIK. Preoperative pupil diameter and intraoperative pupil diameter changes can affect the degree of eye rotation. The right eye pupil center shift higher than the left eye.