近视患者角膜生物力学参数与像差的相关性分析

苏哲; 卢艳; 袁青; 潘雪; 刘鹏飞

doi:10.7619/jcmp.20234001

近视患者角膜生物力学参数与像差的相关性分析

苏哲¹,
卢艳^1, ,,
袁青¹,
潘雪¹,
刘鹏飞²

1.
首都医科大学附属北京世纪坛医院眼科, 北京, 100038
2.
首都医科大学附属北京世纪坛医院麻醉科, 北京, 100038

基金项目:

中华少年儿童慈善救助基金会益缘公益项目 2022-B03

详细信息

通讯作者:
卢艳, E-mail: Louiselu1964@163.com

中图分类号: R778;R775;R319
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- 文章访问数: 169
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- PDF下载量: 16
出版历程
- 收稿日期: 2023-12-10
- 修回日期: 2024-02-26
- 网络出版日期: 2024-04-01
- 刊出日期: 2024-03-27

Correlation between corneal biomechanical parameters and aberrations in patients with myopia

1.
Department of Ophthalmology, Beijing Millennium Temple Hospital Affiliated to Capital Medical University, Beijing, 100038
2.
Department of Anesthesiology, Beijing Millennium Temple Hospital Affiliated to Capital Medical University, Beijing, 100038

摘要

摘要:
目的
探讨近视患者角膜生物力学参数与全眼像差、角膜前表面像差的相关性。
方法
选取95例(190眼)近视患者作为研究对象, 测量全眼像差、角膜前表面像差，记录总像差均方根(RMS)、总高阶像差均方根(RMSh)，测量角膜生物力学参数[中央角膜厚度(CCT)、眼内压(IOP)、校正Goldman眼压(IOPg)、角膜补偿眼压(IOPcc)、角膜黏滞阻力(CH)、角膜阻力因子(CRF)]。比较不同近视程度患者的角膜生物力学参数和总RMS、总RMSh, 采用Pearson相关分析法分析角膜生物力学参数与全眼、角膜前表面高阶像差(彗差、球差)的相关性。
结果
95例患者左眼、右眼的角膜前表面像差(总RMS、总RMSh)均大于全眼像差，差异有统计学意义(P < 0.05); 高度近视患者全眼、角膜前表面的总RMS均高于中度、低度近视患者，且中度近视患者高于低度近视患者，差异有统计学意义(P < 0.05)。相关性分析结果显示, IOP与低度、中度近视患者的全眼和角膜前表面球差均呈强正相关(P < 0.01), 与高度近视患者的全眼球差呈强正相关(P < 0.01); IOPg与低度、中度、高度近视患者的全眼球差均呈强正相关(P < 0.01), 与中度近视患者的角膜前表面球差呈强正相关(P < 0.01); IOPcc与低度、中度近视患者的全眼球差呈正相关(P < 0.05); CRF、CH均分别与低度、中度近视患者的全眼和角膜前表面球差呈正相关(P < 0.05), 与高度近视患者的全眼球差呈正相关(P < 0.05)。
结论
近视患者的全眼像差通常小于角膜前表面像差, IOP、IOPg、IOPcc均与全眼球差存在相关性，且低度近视患者角膜生物力学参数与高阶像差的相关性强于中度、高度近视患者。
- 近视 /
- 角膜生物力学 /
- 像差 /
- 眼压 /
- 球差
Abstract:
Objective
To investigate the correlation of corneal biomechanical parameters with ocular aberrations as well as corneal anterior surface aberrations in patients with myopia.
Methods
A total of 95 patients (190 eyes) with myopia were selected as study subjects. Ocular aberrations and corneal anterior surface aberrations were measured, and the total root mean square (RMS) and root mean square of high order aberration(RMSh) were recorded. Corneal biomechanical parameters, including central corneal thickness (CCT), intraocular pressure (IOP), Goldmann-correlated IOP (IOPg), corneal-compensated intraocular pressure (IOPcc), corneal hysteresis (CH), and corneal resistance factor (CRF) were also measured. The corneal biomechanical parameters, total RMS, and total RMSh were compared among patients with different degrees of myopia. Pearson correlation analysis was used to assess the correlations of corneal biomechanical parameters with ocular and corneal anterior surface high-order aberrations (coma and spherical aberration).
Results
The corneal anterior surface aberrations (total RMS and total RMSh) in both left and right eyes of the 95 patients were greater than the ocular aberrations(P < 0.05). The total RMS of both the ocular and corneal anterior surfaces was higher in patients with high myopia compared to those with moderate and low myopia, and was also higher in patients with moderate myopia compared to those with low myopia (P < 0.05). Correlation analysis revealed there were strong positive correlations of IOP with the spherical aberration of both the ocular and corneal anterior surfaces in patients with low and moderate myopia (P < 0.01), as well as a strong positive correlation between IOP and the ocular aberrations in patients with high myopia(P < 0.01). IOPg showed strong positive correlations with the ocular aberrations in patients with low, moderate, and high myopia (P < 0.01), as well as a strong positive correlation with the corneal anterior surface spherical aberration in patients with moderate myopia (P < 0.01). IOPcc was positively correlated with the ocular aberrations in patients with low and moderate myopia (P < 0.05). CRF and CH were positively separately correlated with the spherical aberration of both the ocular and corneal anterior surfaces in patients with low and moderate myopia (P < 0.05), and positively correlated with the ocular aberrations in patients with high myopia (P < 0.05).
Conclusion
The ocular aberrations in patients with myopia are typically smaller than the corneal anterior surface aberrations. IOP, IOPg, and IOPcc are all correlated with ocular aberrations, and the correlation between corneal biomechanical parameters and high-order aberrations is stronger in patients with low myopia compared to those with moderate and high myopia.
- myopia /
- corneal biomechanics /
- aberrations /
- intraocular pressure /
- spherical aberration

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表 1 95例患者左眼和右眼的全眼像差、角膜前表面像差比较(x±s) μm

项目	左眼(n=95)		右眼(n=95)
项目	总RMS	总RMSh	总RMS	总RMSh
全眼像差	0.82±0.22	0.30±0.08	0.78±0.19	0.32±0.09
角膜前表面像差	1.34±0.32^*	0.57±0.13^*	1.31±0.30^*	0.59±0.15^*
RMS: 像差均方根; RMSh: 高阶像差均方根。与全眼像差比较, * P < 0.05。

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表 2 不同近视程度患者右眼全眼、角膜前表面像差比较(x±s) μm

患者类别	n	全眼		角膜前表面
患者类别	n	总RMS	总RMSh	总RMS	总RMSh
低度近视患者	16	0.54±0.15	0.32±0.07	0.98±0.25	0.56±0.11
中度近视患者	47	0.66±0.18^*	0.31±0.05	1.27±0.33^*	0.58±0.09
高度近视患者	32	0.93±0.21^*#	0.29±0.04	1.56±0.38^*#	0.62±0.12
F		30.060	2.313	16.815	2.202
P		< 0.001	0.105	< 0.001	0.116
与低度近视患者比较, * P < 0.05; 与中度近视患者比较, #P < 0.05。

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表 3 不同近视程度患者右眼CCT、IOPg、IOPcc、CH、CRF比较(x±s)

患者类别	n	CCT/μm	IOP/mmHg	IOPg/mmHg	IOPcc/mmHg	CH	CRF
低度近视患者	16	545.87±28.94	15.92±3.63	15.72±3.52	15.78±3.26	10.80±1.83	10.83±1.94
中度近视患者	47	541.17±26.53	15.51±3.24	15.25±3.19	15.11±3.08	10.73±1.77	10.58±1.67
高度近视患者	32	542.55±30.02	15.46±3.30	16.03±3.01	15.78±3.15	10.26±1.59	10.33±1.55
F		0.167	0.113	0.585	0.543	0.862	0.502
P		0.847	0.893	0.559	0.583	0.426	0.607
CCT: 中央角膜厚度; IOP: 眼内压; IOPg: 校正Goldman眼压; IOPcc: 角膜补偿眼压; CH: 角膜黏滞阻力; CRF: 角膜阻力因子。

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表 4 不同近视程度患者右眼角膜生物力学参数与高阶像差(彗差、球差)的相关性分析

角膜生物力学参数	低度近视患者(n=16)				中度近视患者(n=47)				高度近视患者(n=32)
角膜生物力学参数	A_彗差	A_球差	C_彗差	C_球差	A_彗差	A_球差	C_彗差	C_球差	A_彗差	A_球差	C_彗差	C_球差
CCT	0.102	0.064	0.135	-0.015	0.141	0.182	0.037	0.080	0.089	-0.028	0.114	-0.041
IOP	0.071	0.637^**	0.142	0.497^**	0.050	0.349^**	-0.008	0.365^**	0.104	0.375^**	0.029	-0.038
IOPg	-0.166	0.587^**	-0.094	0.142	0.098	0.443^**	0.115	0.320^**	-0.022	0.396^**	0.094	0.067
IOPcc	-0.071	0.390^*	-0.163	0.116	0.105	0.321^*	0.073	0.187	0.144	0.102	-0.102	-0.048
CRF	0.344	0.493^*	0.218	0.492^*	0.088	0.445^*	0.117	0.281^*	0.170	0.334^*	0.120	0.139
CH	0.259	0.458^*	0.168	0.416^*	0.123	0.386^*	-0.031	0.233^*	0.127	0.295^*	0.108	0.149
A: 全眼; C: 角膜前表面。表中所列数据为相关性系数(r), * P < 0.05, * * P < 0.01。

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