头位在LASIK手术中控制散光的作用  

Therapeutic effect of controlling head position on astigmatic myopia during excimer laser in situ keratomileusis

作　　者：黄建忠[1] 刘伟民[1] 蓝方方[1] 沈降[1] 罗武强[1] 李旭松 

机构地区：[1]广西壮族自治区人民医院视光中心,南宁市530021

出　　处：《广西医学》2008年第3期326-328,共3页Guangxi Medical Journal

摘　　要：目的探讨LASIK术中散光控制的方法。方法对接受LASIK手术的184例368眼随机分为A组(88例176眼)和B组(96例192眼),A组采用切瓣后移动电动床对焦瞳孔中心的方法(只重视眼位),B组在确定头位正位后再采用虹膜扩张器对焦固定病人眼位的方法(重视头位+眼位)。两组患者均进行术前、术后1 d、7 d、1个月、3个月、6个月裸眼视力、球镜屈光度、柱镜屈光度检查对比。结果两组病例之间术前和术后1 d、7 d、1个月、3个月、6个月的裸眼视力、球镜屈光度比较差异均无统计学意义(P>0.05);两组病例之间术前柱镜屈光度比较差异均无统计学意义(t=-1.032,P>0.05),但术后1 d、7 d、1个月、3个月和6个月两组间的柱镜屈光度均存在差异有统计学意义(P<0.05)。结论LASIK术中固定病人头位对控制术后散光有至关重要的作用。Objective To evaluate the therapeutic effect of controlling head position on astigmatic myopia during excimer laser in situ keratomileusis （LASIK）. Methods One hundred and eighty four patients （368 eyes） were enrolled, and randomly assigned into two groups. Group A,88 patients （ 176 eyes） ,move operation table to focus laser beam on the patient＇s pupil ,while group B,96 patients （ 192 eyes） ,use iris dilator to focus laser beam on the patient＇s pupil after controlling patient＇s head position. All patients were examined for uncorrected visual acuity and refractive errors, including spherical and cylindrical errors, at pre-LASIK, and post-1 day, 1 week, 1 month ,3 months and 6 months after LASIK. Changes in uncorrected visual acuity, spherical and cylindrical powers were analyzed before and after LASIK. Results There were no significant difference in uncorrected visual acuity and spherical errors between group A and group B before and at different times after LASIK （ P 〉 0.05 ）, and there was no significant difference in cylindrical errors between group A and group B at the time of pre-LASIK （ P 〉 0.05 ）. But significant difference were found in cylindrical errors between two groups at post-1 day, 1 week, 1 month ,3 months and 6 months after LASIK （P 〈 0.05 ）. Conclusion It is important to control head position during the procedure of LASIK to correct the power of astigmatism for astigmatic myopia.

关 键 词：散光 准分子激光原位角膜磨镶术 虹膜扩张器 头位 

分 类 号：R779.63[医药卫生—眼科]