析因设计在LASIK残留角膜基质床厚度影响因素探究中应用.docVIP

析因设计在LASIK残留角膜基质床厚度影响因素探究中应用[摘要] 目的 采用析因设计法探索LASIK残留角膜基质床厚度的主要影响因素的关联及其该设计方法的实用性。方法 从近三年来医院眼科接受LASIK患者中抽取病例，以术前眼压、屈光度数、术后残留角膜基质床厚度为主要研究因素进行析因设计（factorial design）试验。结果 术前屈光度间、术前眼压与术前屈光度间差异无意义（p＞0.05）；其余均有统计学差异（p＜0.05或P＜0.01）；术前眼压、屈光度、术后角膜基质床厚度间存在交互影响（P＜0.01），说明此三因素对手术成功与否有直接关系。结论 在术前眼压低于21mmHg、术前屈光度中度、术后残留角膜基质床厚度保留300μm及以上最安全，析因设计方法同样适用于眼科专业中多因素多水平的研究。 [关键词] 析因设计； 角膜基质； 准分子激光原位角膜磨镶术； 影响因素 [中图分类号] R772.2[文献标识码] A[文章编号] 1005-0515（2011）-03-009-02 Application of factorial design in study about influence factors of thickness of residual corneal stroma bed After LASIK GAO Wei，Ding Ya-Mei，Man-Jun （Department of Ophthalmology, The Dongfang Hospital of The First people Hospital， Lianyungang of Jiangsu ，Lianyungang 222042，China） [Abstract] Objective To apply factorial design to ascertain the thickness of residual corneal stroma bed after the laser in situ keratomileusis (LASIK) and the relevance with the main influence factors and at function. Methods Cases were randomly selected from patients treated with LASIK in ophthalmic hospital recent three years. Do factorial design experiments with the main study factors such as preoperative intraocular pressure, degrees of refraction and thickness of postoperative residual corneal stroma bed. Results The differences between Preoperative dioptres are meaningless, the differences between Preoperative dioptre and preoperative intraocular pressure are meaningless too (p0.05), and there are statistical differences in others. There are interaction among preoperative intraocular pressure, preoperative dioptre and thickness of postoperative residual corneal stroma bed (p-6.00D）；C1表示残留角膜基质床厚度小（300μm）。将要研究的三因素和各水平组合设计方案列于表1。 表1中第一行第一列A1B1C1 表示术前眼压＜21mmHg、术前屈光度 1.3 研究方法与仪器设备 LASIK术前用超生角膜测厚仪检查中央角膜厚度，采用美国SCMD微型角膜刀和Visx20/20准分子激光机进行，术时根据检查角膜厚度、眼压、屈光度等参数选取角膜瓣厚度和切削区直径，残留角膜基质床厚度≥200μm。采用美国Orbtek公司生产的OrbscanⅡ角膜地形图系统，于术前、术后5-7天首次测角膜厚度，以后不同时间测。因为LASIK术后半年至一年患者的角膜基本处于稳定，本次研究采用术后6个月测量的角膜后表面曲率值进行分析。 2 结果 术后半年测量的角