目的:探讨虹膜定位联合波前像差引导LASIK矫正重度近视性散光(柱镜>-2.00D)的临床疗效。方法:接受虹膜定位联合波前像差引导LASIK手术的重度散光患者39例73眼作为试验组,同期行常规LASIK手术重度近视性散光患者37例70眼作为对照组,对两组的术后3mo疗效进行比较。结果:试验组71眼(97%)术后裸眼视力≥术前最佳矫正视力(best-corrected visual acuity,BCVA),对照组57眼(81%),术后视力恢复试验组明显优于对照组(P<0.01)。试验组和对照组术后视力较术前BCVA提高≥1行分别为49眼(67%)和27眼(39%),试验组明显优于对照组(P<0.01)。术后残余散光度≤±0.50D试验组47眼(64%),对照组23眼(33%),试验组明显小于对照组(P<0.01)。术后3mo采用与术前瞳孔直径基本一致时测量数据,试验组和对照组总高阶像差(root mean square of high order aberration,RMSh)值分别为0.512±0.117和0.635±0.213,试验组RMSh值小于对照组(P<0.05)。两组RMSh较术前均有不同程度增加,平均增高幅度分别为30.9%和65.7%,试验组明显小于对照组(P<0.01)。试验组和对照组患者对术后视觉质量表示"满意"或"基本满意"分别占71眼(97%)和64眼(91%),试验组术后满意度优于对照组(P<0.05)。结论:对于重度散光,虹膜定位联合波前像差引导LASIK疗效优于常规LASIK手术,术后视力提高理想,残余散光较少、高阶像差增幅减小及满意度较高。

AIM:To evaluate the clinical effects of iris location combined wave-front aberration guided laser in situ kerat-omileusis (LASIK) in the treatment of higher astigmatism.METHODS:Iris location combined wave-front aberration guided LASIK was performed in 39 patients 73 eyes as the experimental group,and traditional LASIK was performed in 37 patients 70 eyes as the control group.The therapeutic effects were compared between two groups.RESULTS:Three months postoperatively,the postoperative naked vision of 71 eyes (97%) in experimental group and 57 eyes (81%)in control group surpassed the preoperative best-corrected visual acuity of each group.The experimental group was obviously better than control group(P<0.01).The postoperative naked vision of 49 eyes (67%) in experimental group and 27 eyes (39%)in control group were higher at least one line than the preoperative best-corrected visual acuity.The experimental group was obviously better than control group(P<0.01).The remainder astigmatism postoperatively of 47 eyes (64%) in experimental group and 23 eyes (33%)in control group were within ±0.5D.The experimental group was obviously better than control group(P<0.01).The root mean square of higher order aberration value were 0.512±0.117μm in experimental group and 0.635±0.213μm in control group.The root mean square of higher order aberration value in experimental group was smaller than that in control group 3 months postoperatively (P<0.05).Total higher order aberration value of experimental group increased by 30.9% and control group increased by 65.7%.The increase of total higher order aberration in experimental group was smaller than that in control group (P<0.01).There were 71 eyes (97%)in experimental group and 64 eyes (91%)in control group feeling comfortable with visual quality 3 months postoperatively (P<0.05).CONCLUSION:The visual quality of wave-front aberration guided LASIK is better than that of traditional LASIK.Good therapeutic effects can be achieved in iris location combined wave-front aberration guided LASIK in the treatment of higher astigmatism.

R779.63

中国2008年西安市科技攻关资助项目(No.SF08010)~~