【摘要】 目的 观察预行飞秒激光原位角磨镶术(FS-LASIK)的近视患者在不同光照条件下Kappa角的特征及其变化规律。方法 采用自身前后对照试验。选取2021年6月至8月在江西省人民医院近视矫正中心预行FS-LASIK的近视患者104例(208眼)。用Sirius三维角膜地形图分别测量患者双眼在明视、黄昏视和暗视条件下的瞳孔直径和瞳孔中心偏移量。并将瞳孔中心偏移量在直角坐标系中转换为Kappa角水平分量和Kappa角垂直分量，并分析其变化规律。分析患者双眼瞳孔直径和Kappa角之间的关系。结果 患者右眼Kappa水平分量在明视、黄昏视和暗视条件下分别为(0.00±0.13)mm、(-0.06±0.13)mm、(-0.12±0.13)mm,差异有统计学意义(P<0.05);患者左眼Kappa角水平分量在明视、黄昏视和暗视条件下分别为(-0.04±0.14)mm、(0.02±0.13)mm、(0.08±0.13)mm,差异有统计学意义(P<0.001)。患者双眼瞳孔直径在不同光照条件下差异均有统计学意义(均为P<0.001)。两两比较结果显示，患者双眼瞳孔直径和Kappa角水平分量在明视与黄昏视，明视与暗视，黄昏视与暗视条件下比较差异均有统计学意义(均为P<0.05)。患者双眼Kappa角垂直分量在不同光照条件下差异均无统计学意义(均为P>0.05)。当光照条件从明视到黄昏视再到暗视转变时，Kappa角的分布从鼻侧移向颞侧。且右眼在明视条件下Kappa角水平分量最小，而左眼在黄昏视条件下Kappa角水平分量最小。患者右眼不同光照条件下Kappa角水平分量与瞳孔直径呈负相关(P<0.05)。患者左眼不同光照条件下Kappa角水平分量与瞳孔直径呈正相关(P<0.05)。结论 随着光线从明视到黄昏视再到暗视的转变，Kappa角由鼻侧移向颞侧，且在黄昏视和明视状态下，Kappa角较小。在日后行调整Kappa角的个性化手术时，可通过将术中光线调亮来降低Kappa角对手术的影响。更多还原

【Abstract】 Objective To observe the features and changing rules of angle Kappa in myopic people before femtosecond laser-assisted in situ keratomileusis(FS-LASIK) under varying illuminations. Methods A before-after study in the same patient was employed. Totally 208 eyes from 104 myopic patients who were preparing for FS-LASIK at the Myopia Correction Center of Jiangxi Provincial People’s Hospital from June to August 2021 were included. Pupil diameters and pupil center offset were measured by Sirius 3 D corneal topography under photopic, mesopic and scotopic conditions. The pupil center offset was converted to the horizontal component and vertical component of angle Kappa in the rectangular coordinate system, and the changing rules were analyzed. The relationship between pupil diameters and angle Kappa in both eyes was analyzed. Results The horizontal components of angle Kappa in the right eyes of patients under the photopic, mesopic and scotopic conditions were(0.00±0.13) mm,(-0.06±0.13) mm,(-0.12±0.13) mm, respectively, and the difference was statistically significant(P<0.05). The horizontal components of angle Kappa in the left eyes of patients under the photopic, mesopic and scotopic conditions were(-0.04±0.14) mm,(0.02±0.13) mm,(0.08±0.13) mm, respectively, and the difference was also statistically significant(P<0.001). There were statistically significant differences in the pupil diameters of both eyes under varying illuminations(all P<0.001). The pairwise comparison results showed that there were statistically significant differences between pupil diameter and the horizontal component of angle Kappa in both eyes between photopic and mesopic conditions, photopic and scotopic conditions, and mesopic and scotopic conditions(all P<0.05). There was no statistically significant difference in the vertical components of angle Kappa in both eyes under varying illuminations(all P>0.05). When the condition changed from photopic to mesopic to scotopic, the distribution of angle Kappa moved from the nasal to the temporal side. The horizontal component of the angle Kappa was at its lowest under photopic conditions for the right eye and under mesopic conditions for the left eye. The horizontal component of angle Kappa in the right eye was negatively correlated with pupil diameter under varying illuminations(P<0.05). The horizontal component of angle Kappa in the left eye was positively correlated with pupil diameter under varying illuminations(P<0.05). Conclusion When the condition changes from photopic to mesopic to scotopic, the distribution of angle Kappa moves from the nasal to the temporal side, and angle Kappa is smaller under the photopic and mesopic conditions. The influence of angle Kappa on the operation can be reduced by brightening intraoperative light in future personalized surgery.更多还原