3种角膜光密度评估近视Trans-PRK术后haze的比较

doi:10.3760/cma.j.cn115909-20220915-00359

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摘要目的：分析经上皮准分子激光角膜表面切削术（Trans-PRK）矫正近视术后角膜顶点最大光密度、角膜中央前层平均光密度及角膜中央全层平均光密度与角膜上皮下混浊（haze）的相关性，并进一步探究haze的最佳评价指标。方法：系列病例研究。连续性收集2020年10月至2022年3月在郑州大学第二附属医院眼科行Trans-PRK并在术后定期复查的近视患者48例（94眼），记录术后1、3、6个月的 haze程度并使用Pentacam三维眼前节分析仪测量角膜光密度。采用Spearman秩相关分析患者术后1个月haze、角膜顶点最大光密度、角膜中央前层平均光密度、角膜中央全层平均光密度间的相关性，并选定术后1个月haze≥1级为阳性，对角膜顶点最大光密度、角膜中央前层平均光密度及角膜中央全层平均光密度绘制接受者操作特性曲线（ROC曲线），计算ROC曲线下面积（AUC）。结果：Trans- PRK术后1个月haze与角膜顶点最大光密度、角膜中央前层平均光密度及角膜中央全层平均光密度均呈正相关（r=0.35、0.61、0.48，均P<0.01）。ROC曲线显示角膜顶点最大光密度、角膜中央前层平度AUC最大，其95%置信区间为0.92~1.00（P<0.001），最佳临界值为21.15，灵敏度为76.2%，特异性为97.3%。结论：相较角膜顶点最大光密度、角膜中央全层平均光密度，角膜中央前层平均光密度评估近视Trans-PRK术后haze更为理想。

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	李佳佳
	李帅飞

Abstract：Objective: To analyze the correlation of the maximum corneal densitometry of corneal apex, the average corneal densitometry of central anterior layer, and the average corneal densitometry of central total layer with haze after the correction of myopia using transepithelial photorefractive keratectomy (Trans-PRK), and further explore the best evaluation index of haze. Methods: This was a case series study. Atotal of 94 eyes of 48 myopic patients who underwent Trans-PRK with regular review in the Second Affiliated Hospital of Zhengzhou University from October 2020 to March 2022 were collected in this study. The haze degree and corneal densitometry measured by Pentacam were recorded at 1, 3, and 6 months after operation. Spearman rank correlation test was used to analyze the correlation of the maximum corneal densitometry of corneal apex, the average corneal densitometry of central anterior layer and the average corneal densitometry of central total layer with haze at 1 month after operation. haze≥1 grade at 1 month after operation was considered as positive. Receiver operating characteristic (ROC) curves were drawn for the maximum corneal densitometry of corneal apex, the average corneal densitometry of central anterior layer, and the average corneal densitometry of central total layer. Then area under curve (AUC) was calculated. Results: haze was positively correlated with the maximum corneal densitometry of corneal apex, the average corneal densitometry of central anterior layer, and the average corneal densitometry of central total layer at 1 month after Trans-PRK (r=0.35, 0.61, 0.48, respectively, all P<0.01). The ROC curve showed that the AUCs of the maximum corneal densitometry of corneal apex, the average corneal densitometry of central anterior layer, and the average corneal densitometry of central total layer were 0.820, 0.957, and 0.826, respectively. The AUC of the average corneal densitometry of central anterior layer was the largest one among the three kinds of corneal densitometry, with a 95% confdence interval of 0.92-1.00 (P<0.001). The optimal critical value was 21.15, along with the sensitivity 76.2% and the specificity 97.3%. Conclusion: Compared with the maximum corneal densitometry of corneal apex and the average corneal densitometry of central total layer, the average corneal densitometry of central anterior layer was better in the evaluation of haze after trans-PRK for myopia.

收稿日期: 2022-09-15

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通讯作者: 李佳佳（ORCID：0000-0001-6474-2685），Email：897671365@qq.com

引用本文:

李佳佳, 李帅飞. 3种角膜光密度评估近视Trans-PRK术后haze的比较[J]. 中华眼视光学与视觉科学杂志, 2023, 25(5): 361-365. Jiajia Li1, Shuaifei Li2. Comparison of Three Kinds of Corneal Densitometry in Evaluation of haze after Trans-PRK for Myopia. Chinese Journal of Optometry Ophthalmology and Visual science, 2023, 25(5): 361-365. DOI: 10.3760/cma.j.cn115909-20220915-00359

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https://www.cjoovs.com/CN/ 10.3760/cma.j.cn115909-20220915-00359 或 https://www.cjoovs.com/CN/Y2023/V25/I5/361