角膜波前像差引导的个性化LASIK和常规LASIK治疗近视的临床研究  

A clinical study between laser in situ keratomileusis and corneal wavefront aberrations guided laser in situ keratomileusis on correcting myopir

作　　者：李颖[1] 彭绍民[1] 赵耀[1] 原慧萍[1] 于志红[1] 

机构地区：[1]哈尔滨医科大学附属第二医院眼科,哈尔滨150086

出　　处：《中国实用眼科杂志》2006年第12期1326-1329,共4页Chinese Journal of Practical Ophthalmology

基　　金：黑龙江省自然科学基金(编号:GC05C410)

摘　　要：目的比较常规准分子激光原位角膜磨镶术(LaserinsituKeratomileusis,LASIK)和角膜波前像差引导的个性化准分子激光原位角膜磨镶术(cornealwavefrontaberrationsguidedLASIK,CW-GLASIK)治疗近视眼术后患者视觉质量的变化,探讨角膜波前像差引导的个性化准分子激光原位角膜磨镶术对对比敏感度和眩光以及角膜波前像差的影响,评价其手术的有效性。方法选取拟做LASIK手术的近视眼患者(近视球镜≤-10.00D,散光≤-2.5D)随机分成两组,一组行常规LASIK手术,另一组行角膜波前像差引导的个性化LASIK手术,手术均采用德国Schwind公司EsirisT准分子激光治疗系统,微角膜刀采用MoriaLSK-ONE气动平推刀,对比敏感度检查采用VectorVisionCSV-1000HGT,角膜波前像差分析采用德国OPTIKON2000KeratronScout分析仪。手术光学区直径为(6.0-7.0)mm,波前像差分析为6mm瞳孔直径。术前、术后检查裸眼视力、屈光度、对比敏感度及角膜地形图并进行波前像差分析。结果术后两组的裸眼视力均达到术前矫正视力,无显著性差异(p>0.05)。两组术后1m时对比敏感度及眩光和术前比较均明显下降,差异有显著性(p<0.05),术后3m时各空间频率对比敏感度和眩光均有所恢复,但均未达到术前水平,角膜波前像差引导的个性化LASIK组在各空间频率的对比敏感度和眩光同术前比较,无显著性差异,LASIK组在各空间频率的对比敏感度和眩光和术前比较差异有显著性(p<0.05),角膜波前像差引导的个性化LASIK组在中(6c/d)、高(12c/d、18c/d)空间频率的对比敏感度和眩光明显好于常规LASIK组,有显著性差异(p<0.05)。两组术后1m、3m角膜彗差、球差均比术前增大,但角膜波前像差引导的个性化LASIK组较常规LASIK组增大幅度小,差异有统计学意义(p<0.05)。结论角膜波前像差引导的LASIK手术能有效地矫正近视,改善近视眼患者术后对比敏感度,降低术后彗差和球差,手术效果�Objective To evaluate the visual quality after corneal wavefront aberrations guided laser in situ keratomileusis （CW-G LASIK） on correcting myopia. To present the changes on contrast sensitivity （CS）, glare sensitivity （GS） and root mean square （RMS） of coma and spherical after CW-G LASIK. Methods Two different cases were presented- 1） LASIK; 2）corneal wavefront aberrations guided LASIK. All procedures were performed with the Esiris T excimer laser system and Moria LSK-ONE microkeratome. The OPTIKON 2000 Keratron Scout device was used for topographies and corneal wavefront measurements. VectorVion CSV- 1000 HGT was used to evaluate the CS and GS. The optical zone was 6.0-7.00mm. Wavefront aberrations were analyzed for 6.0mm pupil zone. Pre- and postoperative CS, GS and corneal wavefront aberrations were analyzed. Results The recovery of postoperative UCVA after corneal wavefront aberrations guided LASIK and LASIK returned to the preoperative level. The postoperative CS and GS of each space frequency decreased after CW-G LASIK and LASIK, but the CS and Gs were better than LASIK, especially at 6, 12, 18c/d space frequency. The postoperative RMS of coma and spherical increased after both surgeries, especially after LASIK. Conclusions CW-G LASIK is effective on correcting myopia. It can improve the CS and GS, decrease the RMS after surgery. It is stable and safe.

关 键 词：近视 准分子激光原位角膜磨镶术 角膜波前像差 个性化切削 对比敏感度 

分 类 号：R778.11[医药卫生—眼科]