目的:评价实时虹膜识别技术应用在波前引导准分子激光原位角膜磨镶术（laser in situkeratomileusis, LASIK）治疗中高度近视性散光中的准确性、稳定性。方法:采用随机对照研究,接受实时虹膜识别联合波前引导LASIK手术的近视性散光患者57例104眼作为试验组,接受常规波前引导LASIK手术的近视性散光患者58例107眼作为对照组,对两组患者术后1,3,6mo的裸眼视力、最佳矫正视力、散光度、散光轴向、波前像差等进行比较。结果:静态虹膜识别检测出眼球旋转偏移角度为2.61°±2.08°,动态虹膜识别检测眼球旋转变化范围为0°～5°。术后6mo时,试验组裸眼视力≥术前最佳矫正视力的患者（96眼,92.3%）多于对照组（78眼,72.9%）,差异有统计学意义(P＜0.01)；试验组的平均散光（-0.28±0.26D）低于对照组(-0.44±0.35D),差异有统计学意义(P＜0.05)。术后6mo,试验组无散光眼（49眼,47.1%）多于对照组（31眼,29.0%）, 差异有统计学意义(P＜0.01)。当瞳孔直径为6mm时,试验组彗差的增加少于对照组,差异有统计学意义(P＜0.01)。结论:实时虹膜识别技术能够有效校正LASIK术前和术中的眼球旋转偏差及瞳孔中心移位,使散光度数和轴向的治疗更加精确,同时提高视觉质量。

AIM:To assess efficacy, stability, and change in cylindrical degree and axis after real-time iris recognition combined with wavefront guided laser in situkeratomileusis (LASIK) for the correction of moderate or high myopic astigmatism.METHODS:In this prospective contrast study, 115 patients (211 eyes) with moderate or high myopic astigmatism were randomly divided into two groups:the experimental group (57 cases, 104 eyes) received real-time iris recognition combined with wavefront guided LASIK, and the control group (58 cases, 107 eyes) received conventional wavefront guided LASIK. The naked visual acuity, best-corrected visual acuity(BCVA), the degree and axis of astigmatism, wavefront aberration were compared between two groups at postoperative 1 month, 3 months and 6 months.RESULTS:In experimental group, static iris recognition detected that eye cyclotorsional misalignment was 2.61°±2.08°, dynamic iris recognition detected that the intraoperative cyclotorsional misalignment range was 0°-5°. Six months after operation, the naked vision of 96 eyes(92.3%) in experimental group and 78 eyes (72.9%) surpassed the preoperative BCVA of each group(P＜0.01); the degree of astigmatism in experimental group(-0.28±0.26D) was significantly lower than that in the control group (-0.44±0.35D) (P＜0.05). In experimental group, 49 eyes became non-astigmatism 6 months after operation and in control group 31 eyes. At 6mm pupil size, there was significant different in third order coma aberration between experimental group and control group(P＜0.01).CONCLUSION:Real-time iris recognition can compensate deviation from eye cyclotorsion and pupil centroid shift, more precise treatment for the degree and axis of astigmatism, and increase visual quality in LASIK.