国人近视人群角膜前表面散光与眼球散光的定量分析.doc

　　国人近视人群角膜前表面散光与眼球散光的定量分析 ：胡正再,欧阳红专,李琳,张思文,周智玲,张琼芳,王孟林 【摘要】 目的：研究国人近视人群角膜前表面散光与眼球散光的关系，为眼屈光手术设计提供 参考 。方法：连续性资料358眼。采用日本TOMEY公司的TMS4角膜地形图仪进行角膜前表面地形图检查，获取角膜前表面散光度数及轴向;用日本TOPCON公司的RM8000自动电脑验光仪进行散瞳验光，获取眼球散光度数和轴向。结果：眼球散光与角膜前表面散光的比值为0.811±0.665;眼球散光lt;0.50D者150眼，散光度数差异、散光轴向差异均有统计学意义;散光度数、散光轴向均正相关;0.50D≤眼球散光lt;1.00D者122眼，散光度数差异有统计学意义;轴向差异无统计学意义;散光度数无相关性，散光轴向正相关;眼球散光≥1.00D者86眼，散光度数差异无统计学意义;散光轴向差异有统计学意义;散光度数、散光轴向均正相关。结论：角膜后表面及晶状体对角膜前表面散光有一定的补偿作用;角膜前表面散光与眼球散光正相关，散光度数越高，相关程度越高;角膜屈光手术根据眼球散光进行手术设计可能较好，屈光性晶状体置换术及白内障手术可根据角膜前表面散光确定手术切口位置。 【关键词】 近视;角膜前表面;散光 　　AbstractAIM: To research the relationship betatism of anterior corneal surface and overall astigmatism, and provide the reference for the refractive surgery design.METHODS: Totally 358 eyes atic degree and axis of anterior corneal surface ination atism cycloplegic refraction by an automatic refractor (RM8 000, TOPCON pany, Japan).RESULTS: The ratio of the overall astigmatism and the astigmatism of anterior corneal surface atism less than 0.50D, the differences of astigmatic degree and axis betatisms atic degree and axis. In 122 eyes atism betatic degree but not in axis betatisms. There atic degree and positive correlation in astigmatic axis. 86 eyes atism more than 1.00D，significant difference atic axis but not in degree; There atic degree and axis.CONCLUSION:The posterior corneal surface and crystalline pensate for the astigmatim of anterior corneal surface. The astigmatism of anterior corneal surface is positively correlated atism. The higher the astigmatic degree, the higher the correlation. Corneal refractive surgery may be designed better according to the overall astigmatism. The incision location in refractive lens exchange and cataract surgery is determined by the astigmatism of anterior corneal surface. 　　KEYyopia; anterior corneal surface; astig　matism 　　 0引言 　　在眼屈光手术设计时，角膜前表面散光度数与轴向是非常重要的参考。准分子激光角膜屈光手术时，常需要根据它对手术量进行调整;在屈光性角膜切开术中，根据它来决定手术切口的位置;在屈光性晶状体手术甚至白内障手术时，也要根据它来决定角膜切口位置。因此，了解角膜散光在眼球散光中的贡献并对手术设计进行调整很有必