| 『摘要』
目的：探讨周期性眼外负压吸引对角膜地形的影响及可能原因
方法：随机选取40例患者（40只眼，眼别随机），以球外负压100mmHg /3s速度（1mmHg＝0.133Kpa）升高至300±20mmHg（Tonopen眼压计测定即时眼内压约为45mmHg）维持5秒后释放负压至0，间隔1分钟重复10个循环。试验后即时（约30~60sec）、5min、15min检测患者角膜地形图、视力、眼压、眼表状况、自觉症状等。以受试眼自身前后对照、受试眼与对侧眼对照参考，采用多变量因素分析CIM(角膜表面规则指数)、 SF（形状系数）、AST(角膜散光度)等角膜地形指标，P值小于0.05为有统计学意义。
结果：1）周期性眼外负压吸引后随时间的变化，角膜散光值、CIM变化有明显差异。（F值分别为5.99、0.431，P值分别为0.003、0.001均<0.05）即时结果明显超出吸引前，5min到15min迅速恢复，至15min检测时回复至检测前水平。SF的改变未见有统计学差异。（F＝0.058，P＝0.635>0.05）。性别、眼别、及瞳孔大小未见对该检测结果有统计意义干扰。(P值均大于0.05)
2）吸引结束后，轻度眼部不适4例（4/40），结膜轻度充血15例（15/40），都可耐受，1例（1/40）患者角膜上皮有轻度点状脱失，2例(2/40)患者主诉有轻度视物模糊（视力未见下降），休息5min及缓解紧张情绪后自觉明显好转。检测患者视力均无下降。受试结束后患者眼内压值（15±5mmHg）处正常范围。
结论：周期性眼外负压吸引对角膜表面形状有一定影响，随着时间的推移该影响力迅速减少，至15min时角膜形状基本恢复。其原因可能是多方面的，同时未发现患者的视觉质量受到干扰。
关键词：负压吸引， 角膜地形， CIM， SF， 角膜散光
Effect of Periodical Vacuum-suction on Corneal Topography
Li Shanshan Dai Jinhui
ABSTRACT
Objective：to evaluate the effect of periodical vacuum-suction on corneal topography.
Method: 40 patients (40 eyes) were involved in the study randomized. With the speed of 100mmHg/3sec（1mmHg＝0.133Kpa）, the suction pressure reached at 300±20mmHg ( IOP was 45mmHg measured by Tonopen) for about 5sec， then the pressure was released to zero. That circle was repeated for 10 times after 1min’s interval. We observed the topography at once (within 1 min) 、5min、15min post-suction respectively. And also the patients’ complaints、visual acuity、IOP were detected. Using Multivariate Tests we analyzed the data of CIM(corneal irregularity measurement)、SF(shape factor)、 astigmatism. P<0.05 was considered the data had significant difference.
Result: There was significant difference in CIM and astigmatism according to the time after suction. (F=5.99 and 0.413, P=0.003and 0.001<0.05) The immediate influence was the most and it decreased quickly. At 15min no difference was detected. No significant difference was seen in SF. (F=0.058, P=0.635>0.05) 4 (4/40) people complained of mild discomfort in eyes and 2(2/40) said they had blurred vision (but their eyesights didn’t drop)which resumed after relaxing. We found 15(15/40) with slightly conjunctival congestion and one person with dotted epithelium missing. No one had decreased visual acuity in the study. All the IOP after suction were within normal arrange. No obvious disturbance was found in sex and eye distinction and pupil size to our results. (P>0.05)
Conclusions: Periodical vacuum-suction has some influence on people’s corneal topography, which can be caused by many reasons. But the influence doesn’t disturb the eyesights. It decreases rapidly and the corneal shape recovers at 15min.
Key words: vacuum-suction, corneal topography, CIM, SF, corneal astigmatism
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