方法：该回顾性分析共纳入416眼，分为3组，低度近视组159眼，等值球镜-3.68±1.33D； 近视散光组161眼，等值球镜-5.99±2.24D，柱镜度2.41±1.07D； 高度近视组96眼，等值球镜-7.41±0.80D. 制瓣后，进行波前像差为基础的准分子激光削切术。在术后10d，2，6和12mo后评估其安全性，有效性，可预测性和稳定性。

结果：术后12mo，低度近视组等值球镜-0.36±0.31D，近视散光组0.15±0.41D，高度近视组0.58±0.68D。低度近视组中，裸眼视力为20/20的患者占90.60%，近视散光组78.90%，高度近视组67%。疗效指标在三组中分别为0.98， 1.04和0.92. 安全性指标分别为1.00， 1.07 和1.05。低度近视组有5眼(3.1%)最佳矫正视力提升1行，近视散光组有44眼(27.3%)提升1～3行，高度近视组18眼(19.2%)提升1～2行。低度近视组只有2例产生角膜雾状混浊。在疗效和安全性方面三组比较均无统计学差异。

结论：波前像差引导的激光上皮瓣下角膜磨镶术是治疗低度近视，近视散光和高度近视的一种有效安全的方法，而在治疗近视散光时其可预测性、有效性和安全性更佳。

METHODS: A retrospective analysis of 416 eyes were assigned to 3 groups: 159 eyes with low myopia(LM)and mean refractive spherical equivalent(MRSE)of -3.68±1.33 dioptre(D); 161 eyes with myopic astigmatism(MA)and MRSE of -5.99±2.24D and mean cylinder of 2.41±1.07D; and 96 eyes with high myopia(HM)and MRSE of -7.41±0.80D. After an epithelial flap creation, a wavefront-based excimer laser ablation was performed. Safety, efficacy, predictability and stability were evaluated at day 10, 2, 6 and 12mo postoperatively.

RESULTS:At 12mo, the MRSE was -0.36±0.31D in LM group, 0.15±0.41D in MA group and 0.58±0.68D in HM group. The uncorrected visual acuity(UCVA)was 20/20 in 90.60% of patients in LM group, 78.90% in MA group and 67% in HM group. Efficacy indices were 0.98, 1.04 and 0.92 in LM, MA and HM groups, respectively. Safety indices were 1.00, 1.07 and 1.05 in LM, MA and HM respectively. Five eyes(3.1%)in the LM group gained 1 line. Forty-four eyes(27.3%)in MA gained 1-3 lines and eighteen eyes(19.2%)of HM group gained 1-2 lines of BSCVA. Only 2 eyes in LM group developed corneal haze. There were not statistically significant differences in efficacy and safety indices amongst three groups.

CONCLUSION: Wavefront-guided LASEK is an effective and safe procedure for the treatment of LM, MA, and HM.although in myopic astigmatism the predictability, efficacy and safety indices had been better.