非球面因子Q引导准分子激光原位角膜磨镶术治疗近视眼的临床研究  

Clinical studies on Q-factor guided LASIK for the correction of myopic astigmatism

作　　者：黄国富[1] 杨斌[1] 王铮[1] 张晓晓[1] 邱平[1] 周胜[1] 

机构地区：[1]中山大学中山眼科中心,广州510060

出　　处：《中华眼科杂志》2008年第9期820-824,共5页Chinese Journal of Ophthalmology

基　　金：教育部优秀青年教师基金资助项目（教人司[2002]350号）;广东省教育厅“千百十工程”人才基金资助项目（Q02025）

摘　　要：目的对比研究非球面因子Q引导准分子激光原位角膜磨镶术（LASIK）治疗近视散光的疗效。方法随机对照临床研究。接受Q值引导LASIK患者43例（43只眼）作为试验组，同期接受常规LASIK患者41例（41只眼）作为对照组，均取右眼进行分析，对两组疗效进行比较。随访时间为术前、术后1周、术后1个月、术后3个月。检查项目包括：视力、屈光度、角膜地形图、眼压、波阵面像差、超声角膜厚度、对比敏感度等。应用SPSS13．0软件包，对手术前后Q值、瞳孔直径、像差、对比敏感度、切削深度等数据采用配对t检验，对有效光区和术前预期矫正的有效球镜度、K值、Q值、切削深度进行相关性分析。结果术后3个月，试验组裸眼视力≥1．0占97．67％，对照组裸眼视力≥1．0占97．56％；试验组和对照组最佳球镜度均在-0．50～＋0．50D，试验组平均为（-0．19±0．20）D，对照组平均为（-0．17±0．17）D；试验组Q值平均为（0．50±0．28），对照组平均为（0．82±0．40），两者差异有统计学意义（t=4．274，P=0．033）；试验组球差平均为（-0．265±0．156）μm，对照组平均为（-0．487±0．159）μm，差异有统计学意义（t=4．572，P=0．011）；试验组对比敏感度术后1个月恢复术前水平，对照组术后3个月恢复术前水平；术后3个月试验组有效光区平均（5．74±0．22）mm，对照组平均（5．34±0．29）mm，差异有统计学意义（t=7．352，P=0．013）。结论Q值引导LASIK安全、有效、具有良好的预测性；和常规LASIK相比，Q值引导LASIK矫正球差具有优势，术后视觉质量更好。Objective To compare the results of the Q-factor guided LASIK with the conventional LASIK for the correction of myopic astigmatism. Methods Forty-three eyes underwent Q-factor guided LASIK and 41 eyes were received conventional LASIK. The patients were followed up for more than 3 months . Examinations included refraction, distance and near vision, noncontact tonometer, topography （ provide Q value）, aberrometer, ultrasonic pachymetry, contrast sensitivity function. Results At 3 months, 97.67% of Q-factor guided LASIK eyes attained UNCVA 1.0 or better and 97.56% eyes in the control group. The mean postoperative SE for Q-factor guided LASIK group was （ -0. 19 ± 0. 20） diopters （D） at 3 months and （ -0. 17 ± 0. 17） diopters （D） in conventional LASIK group. The postoperative Q value of Q-factor guided LASIK was （0. 50 ±0. 28） and （0. 82 ±0. 40） in the conventional LASIK group,significant difference was noted between two groups. Both Q-factor guided LASIK and conventional LASIK significantly increased spherical aberration , the mean RMS of postoperative spherical aberration were （ - 0. 265 ± 0. 156） μm, （ -0. 487 ±0. 159）μm respectively, significant difference were noted between two groups at 3 months . Contrast sensitivity was reduced at 1 week and restored at 1 month postoperatively in Q-factor guided LASIK, while in conventional LASIK it was reduced at 1 week, 1 month and restored at 3 months. Corneal topography revealed in Q-factor guided LASIK the diameter of effective optical zone （EOZ） was （5.74 ± 0. 22） mm. However postoperative EOZ of conventional LASIK was （5.34 ± 0. 29 ） mm in control group. Conclusions Q-factor guided LASIK is effective, safe and predictable for correction of myopic astigmatism. The postoperative visual quality of Q-factor guided LASIK is better than that of conventional LASIK due to its superiority for correction of spherical aberration. （ Chin J Ophthalmol, 2008, 44：820-824）

关 键 词：近视 散光 角膜磨镶术 激光原位 

分 类 号：R686[医药卫生—骨科学]