查看更多>>摘要：目的： 探讨角膜中央与周边的厚度差异对角膜生物力学特性的影响。 方法： 回顾性系列病例研究。收集2006年10月至2007年10月在邯郸眼科医院测量的健康人群336例（336眼），来自邯郸眼科研究。运用Orbscan-II测量角膜中央厚度（CCT）、角膜最薄点（TCP）以及3、4、5、6、7 mm处颞侧、上方、鼻侧及下方的角膜厚度；通过计算3、4、5、6、7 mm区域角膜厚度与中央厚度的比值，得到反映角膜中央与周边厚度差异的角膜厚度指数（CTI）。通过眼反应分析仪（ORA）测量角膜迟滞系数（CH）、角膜阻力因子（CRF）；采用Pearson相关和Spearman相关分析CH、CRF与角膜厚度及年龄之间的相关性；采用独立样本t检验分析7 mm CTI总体分布中两端的最大5%与最小5%两组之间CH和CRF的差异。 结果： 研究对象4、5、6、7 mm角膜厚度与年龄均呈负相关（r=-0.15，P=0.003；r=-0.23，P<0.001；r=-0.33，P<0.001；r=-0.41，P<0.001），且随直径增大相关性逐渐增加；角膜最薄点、CCT及3 mm区域角膜厚度与年龄无相关性。5、6、7 mm CTI与年龄呈负相关（r=-0.18，P=0.001；r=-0.27，P<0.001；r=-0.27，P<0.001），3、4 mm CTI与年龄无相关性。CH与年龄无明显相关性，CRF与年龄呈负相关（r=-0.15，P=0.006）。CH与3、4、5、6 mm CTI呈负相关（r=-0.13，P=0.023；r=-0.14，P=0.010；r=-0.15，P=0.008；r=-0.13，P=0.019），CRF与3、4、5、6 mm CTI也呈负相关（r=-0.21，P<0.001；r=-0.24，P<0.001；r=-0.26，P<0.001；r=-0.16，P=0.005）。7 mm CTI位于总体分布中两端的最大5%与最小5%两组之间比较，CH和CRF差异有统计学意义（t=2.93，P=0.006；t=2.78，P=0.009）。 结论： 随年龄增加，健康人群CCT变化不大而周边厚度明显下降。CCT与周边厚度差异较大的角膜可能存在抵抗眼内压及外力作用能力下降的风险。 Objective: To investigate the effect of the thickness difference between central and peripheral cornea on the biomechanical properties of cornea. Methods: In this retrospective case series study, population data measured in Handan Eye Hospital in Handan Eye Study from October 2006 to October 2007 were reviewed, 336 eyes were included. Orbscan II was used to measure the central corneal thickness (CCT), the thinnest point of cornea (TCP) and the corneal thickness of temporal, upper, nasal and lower parts at 3, 4, 5, 6, 7 mm the corneal thickness index (CTI), which reflects the difference between the central and peripheral thicknesses of the cornea, was obtained by calculating the ratio of the corneal thickness to the central thickness in the average 3, 4, 5, 6, 7 mm area. Corneal hysteresis (CH) and corneal resistance factor (CRF) were measured by ocular response analyzer (ORA) Pearson or Spearman correlation were used to analyze the correlation between CH、CRF and corneal thickness and age. Independent sample t-test was used to determine the difference of CH and CRF between the two groups of which the 7 mm CTI is located at the maximum 5% and minimum 5% at both ends of the overall distribution. Results: There was a negative correlation between 4, 5, 6, 7 mm corneal thickness and age (r=-0.15, P=0.003 r=-0.23, P<0.001 r=-0.33, P<0.001 r=-0.41, P<0.001) and the correlation increases gradually the thinnest point, central corneal thickness and corneal thickness at 3 mm were not correlated with age. Five, 6, 7 mm CTI was negatively correlated with age (r=-0.18, P=0.001 r=-0.27, P<0.001 r=-0.27, P<0.001) There was no correlation between 3, 4 mm CTI and age. There was no significant correlation between CH and age and CRF was negatively correlated with age (r=-0.15, P=0.006). CH was negatively correlated with 3, 4, 5, 6 mm CTI (r=-0.13, P=0.023 r=-0.14, P=0.010 r=-0.15, P=0.008 r=-0.13, P=0.019), CRF was negatively correlated with 3, 4, 5, 6 mm CTI (r=-0.21, P<0.001 r=-0.24, P<0.001 r=-0.26, P<0.001 r=-0.16, P=0.005). There was significant difference in CH and CRF between the two groups of which the 7 mm CTI was located at the maximum 5% and minimum 5% at both ends of the overall distribution (t=2.93, P=0.006 t=2.78, P=0.009). Conclusion: With the increase of age, the central corneal thickness remains unchanged while the peripheral corneal thickness decreases significantly in healthy people. The cornea with great difference between central and peripheral thickness may have the risk of the decreased ability to resist intraocular pressure and external force.
万方数据