摘要
目的探讨圆锥角膜的屈光状态和角膜地形图形态分布。方法147例(262只眼)圆锥角膜,使用电脑验光和角膜曲率仪与计算机辅助的角膜地形图仪测量眼部屈光度、角膜曲率、角膜散光度、角膜表面规则指数(SRI)、表面非对称指数(SAI)及进行角膜形态学描述。结果将圆锥角膜患者分为可疑、轻度、中度及重度。病灶形态分为蝶形和非蝶形。蝶形又分为对称和不对称;非蝶形又分为乳头状、卵圆形、球形及不规则形。蝶形病变,以对称蝶形多见,常见于可疑和轻度病例。乳头状和卵圆形,多见于轻、中度病例,多位于角膜中央或中央偏下方;球形多见于中、重度病例,多位于角膜中央;不规则形见于重度病例。多数患者双眼病灶间存在对称性。病变直径与角膜顶点屈光度间无相关性(r=0.208,P=0.092),病变顶点距中心距离与顶点屈光度间呈负相关(r=-0.400,P=0.001)。结论利用角膜地形图,可筛查和早期诊断圆锥角膜,有助于采取及时适当的治疗,避免对圆锥角膜患者进行准分子激光角膜屈光手术;同时了解病变在角膜上的分布规律,可指导硬性角膜接触镜的验配。(中华眼科杂志,2006,42:231-235)
Objective To investigate the refraction and videokeratographic characteristics of keratoconus. Methods 262 eyes of 147 patients with keratoconus were examined using autorefractor and computerized corneal topography, which generated the quantitative descriptors including refraction, keratometry, corneal astigmatism, the surface regularity index （SRI） , the surface asymmetry index （SAI） , and morphologic description. Results All patients were classified into four groups： suspect, mild, moderate and advanced group. The topographical configurations of the lesions were divided into bow-tie pattern subdivided into symmetric and asymmetric pattern, and non-bow-tie pattern including nipple, oval, global and anomalistic pattern. The bow-tie pattern mostly appeared symmetrical and occurred in suspect and mild cases. The nipple and oval pattern mostly occurred in mild and moderate ones located in the central or inferior paracentral cornea. The global pattern mostly occurred in moderate and advanced ones located in the central cornea. The anomalistic pattern occurred in advanced ones. Bilateral topography showed symmetrical in majority of patients with bilateral keratoconus. There was no correlation between the diameter of lesion and the refraction power of corneal apex （ r = 0. 208, P = 0. 092 ）. There was negative correlation between the distance from corneal center to the apex of lesion and the refraction power of corneal apex （ r = - 0. 400, P = 0. 001 ）. Condusions Corneal topography is a sensitive method to detect the keratoconus earlier,which helps eye doctors to take appropriate measures to improve patients vision and avoid patients from undergoing excimer laser keratorefractive surgery. In addition, it can show the configuration of the lesion, which guide the fitting of hard contact lens.
出处
《中华眼科杂志》
CAS
CSCD
北大核心
2006年第3期231-235,共5页
Chinese Journal of Ophthalmology
关键词
角膜地形图
圆锥角膜
接触镜
屈光
眼
Corneal topography
Keratoconus
Contact lenses
Refraction,ocular
