飞秒激光小切口角膜基质透镜取出术后非接触眼压变化的相关因素分析及公式验证

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Abstract Objective: To analyze the relative factors of changes of intraocular pressure (IOP) measured by noncontact tonometer (NCT) before and after small incision lenticule extraction (SMILE) and evaluate regression equations for predicting ΔNCT. The efficacy of regression equations was validated. Methods: This study included 154 patients (304 eyes) with myopia and myopic astigmatism receiving SMILE in Eye Hospital Wenzhou Medical University from June 2016 to August 2017. These eyes were randomly divided into group 1 (150 eyes) and group 2 (154 eyes). The spherical equivalent (SE), central corneal thickness (CCT), ablation depth (AD), ablation rate (AR), residual stromal bed thickness (RSBT), preoperative NCT (NCTpre), NCT at 3 months after operation (NCT3mo), average keratometry (Ave K), steep keratometry (Steep K) and flat keratometry (Flat K) were obtained. Two multivariate linear regression equations were established by analyzing ΔNCT and relative factors for group 1 after Spearman correlation analysis. Data of group 2 were used for validation. Results: There was significant difference in NCT before (15.72±2.86) mmHg and after SMILE (9.94±2.32) mmHg (P<0.05). The NCT had a decline of (5.78±2.59) mmHg. SE was highly correlated with AD and AR (r=-0.956, -0.949, P<0.001). NCTpre was moderately correlated with NCT3mo (r=0.559, P<0.01). The Spearman correlation analysis was performed to evaluate the relationship between relative factors and ΔNCT and the following multivariate linear regression equations were established: Equation A: ΔNCT=NCTpre×0.502–SE×0.385–3.951 (Adjusted R2=0.489, F=72.329, P<0.001); Equation B: ΔNCT=NCTpre×0.509+AR×0.179–5.545 (Adjusted R2=0.489, F=72.423, P<0.001). There was no significant difference between the predicted ΔNCT and measured values through equations A, B and equation Schallhorn (Simplified) for group 2 (P>0.05). A higher correlation was shown between the predicted ΔNCT and measured values obtained by equations B (r=0.650, P<0.001) and A (r=0.638, P<0.001) than equation Schallhorn (Simplified) (r=0.637, P<0.001). Conclusion: NCTpre and AR were closely correlated with changes of NCT before and after SMILE. The regression equation of ΔNCT might be clinically applied to acquire the real postoperative NCT.

Key words： small incision lenticule extraction noncontact tonometry linear regression

Received: 22 December 2017

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	CUI Lele
	ZHOU Weihe
	LI Ming
	YU Ye.

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https://xb.wmu.edu.cn/EN/ OR https://xb.wmu.edu.cn/EN/Y2018/V48/I6/413

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