波前像差引导联合非球面LASIK治疗近视散光术后疗效观察

Outcomes of combined wavefront-guided and aspheric LASIK for myopia and myopic astigmatism

摘要:

目的：观察波前像差引导联合非球面LASIK治疗近视散光眼的临床疗效。

方法：前瞻性研究。选取拟行LASIK手术治疗的近视散光眼患者45例62眼，随机分为两组，分别接受波前像差引导联合非球面LASIK与波前像差引导LASIK。观察术后6mo两组安全性、有效性、预测性、全眼高阶像差及暗光下对比敏感度的差异。

结果：两种切削模式的安全性、有效性及预测性相似。术后6mo，两组各高阶像差均较术前增大，差异有统计学意义(P<0.01)，波前像差引导联合非球面组总高阶像差及球差的增幅小于波前像差引导组，差异有统计学意义(P<0.05)，两组术后彗差的增幅无统计学差异(P=0.657)。波前像差引导联合非球面组术后6mo暗光下对比敏感度在各个空间频率均恢复至术前水平， 差异无统计学意义(P>0.05)； 波前像差引导组除低空间频率外，其余空间频率恢复至术前水平，差异无统计学意义(P>0.05)。

结论：波前像差引导联合非球面LASIK较波前像差引导LASIK可更好地减少术后高阶像差的增加，改善暗光下对比敏感度。

Abstract:

AIM: To evaluate the clinical outcomes of combined wavefront-guided and aspheric laser in situ keratomileusis(LASIK)to correct myopia and myopic astigmatism.

METHODS: Prospective study. Forty-five patients(62 eyes)with myopia and myopic astigmatism were randomly dividied into two groups: the wavefront-guided and aspheric LASIK group and the wavefront-guided LASIK group. Safety, efficacy, predictability, ocular higher order aberrations(HOAs), and contrast sensitivity under mesopic condition were compared at 6mo postoperatively.

RESULTS: Both platforms had equal safety, efficacy and predictability. At 6mo after operation, total HOAs, spherical aberration and coma increased in both groups(P<0.01). The changes of total HOAs and spherical aberration in wavefront-guided and aspheric group were significantly less than those in wavefront-guided group(P<0.05), while the change of coma between two groups was not statistically significant(P=0.657).Contrast sensitivity in the wavefront-guided and aspheric group recovered to preoperative levels under mesopic conditions at all spatial frequencies(P>0.05), while contrast sensitivity in the wavefront-guided group recovered to preoperative levels at all spatial frequencies(P>0.05).

CONCLUSION: Wavefront-guided and aspheric LASIK induced less HOAs and associated with better mesopic contrast sensitivity compared with wavefront-guided LASIK.