CK和LASIK治疗老视的临床效果对比研究  

Comparison study of the clinical effects between CK and LASIK on correcting presbyopia

作　　者：王华[1] 罗栋强[1] 何书喜[1] 陈蛟[1] 

机构地区：[1]湖南省人民医院眼科,中国湖南省长沙市410005

出　　处：《国际眼科杂志》2008年第7期1401-1404,共4页International Eye Science

基　　金：中国湖南省卫生厅科技计划处资助项目(No.B2007132)~~

摘　　要：目的:比较分析传导性角膜成形术(conductive keratoplas-ty,CK)和准分子激光原位角膜磨镶术(laser in situ kera-tomileusis,LASIK)应用单眼视治疗老视的临床效果和视觉质量。方法:21例(26眼)及24例(41眼)老视患者分别接受CK和LASIK治疗,术前患者屈光度球镜+0.75^+2.0D,散光≤+0.75D,术后预期目标屈光度主导眼矫正为0^-0.5D,非主导眼矫正为-1.5^-2.5D近视状态且近视力≥0.5(J3),术后随访1a。结果:术后1aCK组和LASIK组双眼裸眼视力≥0.8且近视力≥J3者分别为52.4%、66.7%,近视力≥0.33(J4)者分别为81.0%、87.5%,两组与术前相比均有显著性差异(P<0.01),两组间相比较无显著性差异(P>0.05);术眼等效球镜屈光度与预期目标相差±0.5D以内者分别为42.3%、70.7%,两组相比较差异有显著性(P<0.05);术眼散光度在±0.75D以内者分别为57.7%、92.7%,两组相比较差异有显著性(P<0.05);术眼角膜光学视功能区CK组和LASIK组相比较无显著性差异;两组患者术眼对比敏感度较术前均无明显下降;术后1a患者术眼有干眼症状者CK组为3眼(11.5%),LASIK组为8眼(19.5%),两组相比较无显著性差异(P>0.05)。结论:应用单眼视原理采用CK和LASIK治疗老视均取得了较满意的疗效,两种手术方式的远期疗效和稳定性有待进一步观察。AIM： To compare and analyze the clinical effects and visual quality between conductive keratoplasty （CK） and laser in situ keratomileusis （LASlK） with monovision for presbyopia. METHODS. CK and LASlK were performed in 21 patients （26 eyes） and 24 patients （41 eyes） with presbyopia, respectively and the follow-up was one year, The preoperative sphere was ＋ 0.75 - ＋ 2.0D and cylinder was 0- ＋ 0. 75D. For distance vision correction, the target refraction was 0 - -0.5D in the dominant eye. And for near vision, the target refraction was - 1.5 - - 2.5D in the non- dominant eye. RESULTS： At 1 year after surgery, 52.4% of group CK and 66.7% of group LASlK had binocular distance UCVA of 20/25 or better along with J3 or better near, and along with J4 or better near was 81.0% and 87.5%. There was significant difference of binocular UCVA between preoperative and postoperative in two groups （ P 〈 0.01 ）. Whereas binocular UCVA was no statistically significant between group CK and group LASlK（P〉0.05）. At 1 year, 42.3% of CK eyes and 70.7% of LASlK eyes had a manifest refractive spherical equivalent （ MRSE ） within ± 0. 5D of intended correction, respectively. Postoperative cylinder within ±0.75D was 57.7% in group CK and 92. 7% in group LASlK. Postoperative contrast sensitivity function was not significant decrease than that of preoperative. There was 11.5% （3 eyes） of CK eyes and 19.5% （8 eyes）of LASIK eyes had dry eye syndrome. The between-group differences in MRSE and postoperative cylinder were statistically significant （ P〈 0.05）. Optic function zone and dry eye syndrome was not statistically significant between two groups （P〉0.05）. CONCLUSION. CK and LASlK with monovision are effective treated eyes with presbyopia. Furthermore, their long-term results and stability are needed more time to be observed.

关 键 词：老视 传导性角膜成形术 准分子激光原位角膜磨镶术 单眼视 

分 类 号：R779.63[医药卫生—眼科] R169.42[医药卫生—临床医学]