Q值引导LASIK术后角膜非球面性和眼球面像差的变化  

Change of corneal asphericity and spherical aberration after Q-value customized LASIK

作　　者：周李 邓应平[1] 

机构地区：[1]四川大学华西临床医学院第一附属医院眼科,四川省成都市610041 [2]川北医学院第二临床学院眼科

出　　处：《眼科新进展》2010年第3期250-253,258,共5页Recent Advances in Ophthalmology

摘　　要：目的探讨Q值引导的LASIK对角膜Q值、眼球面像差的修正效果。方法选择27例(54眼)接受近视手术治疗的患者做LASIK。等效球镜度数在-2.75～-9.00D以内,散光度小于-2.00D,屈光参差度数在-1.00D以内,每例患者随机选择一眼行Q值引导LASIK(F-CAT组),另一眼行常规LASIK(对照组)。目标Q值取自身术前Q20-0.50。术后随访1个月,比较F-CAT组和对照组术后角膜Q值、眼球面像差以及总高阶像差的差异。结果术后1个月时,F-CAT组和对照组术后最佳矫正视力达到1.0者分别有26眼和27眼,2组比较差异无统计学意义(P>0.05)。术前F-CAT组和对照组Q20均值分别为-0.18±0.10和-0.17±0.09(Z=-1.01,P=0.31)。术后1个月F-CAT组Q20均值为0.68±0.67,对照组为0.84±0.64(Z=-2.27,P=0.02)。术前F-CAT组和对照组的C12均值分别为(0.026±0.076)μm和(0.025±0.091)μm(Z=-0.94,P=0.35)。术后1个月C12均值分别为(0.107±0.091)μm和(0.128±0.074)μm(Z=-2.32,P=0.02)。术后2组总高阶像差均方根均增加,术前、术后2组间总高阶像差均方根差异均无统计学意义(均为P>0.05)。结论在目标Q值取自身术前Q20-0.50治疗-9.00D内近视时,Q值引导LASIK在保持术前角膜前表面形态和减小术后球面像差方面比常规LASIK有优势,但它仍不能阻止高阶像差增加的趋势。Objective To discuss the effect of Q-value customized LASIK on adjusting corneal Q-value and spherical aberration.Methods LASIK was taken in 27 myopic patients（54 eyes） whose sphericial equivalent degree was from-2.75 D to-9.00 D,astigmatism was less than-2.00 D and anisometropia less than-1.00 D,one eye of each patient was treated with fine-customized aspheric treatment（F-CAT group） randomly and contralateral eye was treated with conventional LASIK（control group）.The target Q-value was-0.50 plus self-Q20.The differences of corneal Q-value,spherical aberration and higher-order aberrations were compared between two groups at 1 month after operation.SPSS 13.0 software was used for statistical analysis.Results The best corrected visual acuity achieving 1.0 in F-CAT group and control group were 26 eyes and 27 eyes respectively,there was no statistical difference（P〉0.05）.The mean value of Q20 in F-CAT group and control group was-0.18±0.10 and-0.17±0.09 respectively before operation（Z=-1.01,P=0.31）,and which was 0.68±0.67 and 0.84±0.64 respectively at 1 month after operation（Z=-2.27,P=0.02）.The mean value of C12 in F-CAT group and control group was （0.026±0.076）μm and （0.025±0.091）μm before operation（Z=-0.94,P=0.35）,which was （0.107±0.091）μm and （0.128±0.074）μm at 1 month after operation（Z=-2.32,P=0.02）.The root mean square value of higher-order aberrations in both groups increased after operation,there was no statistical difference in root mean square value of higher-order aberrations between before and after operation in two groups（all P〉0.05）.Conclusions When treating the myopia with equivalent spherical degree lower than-9.00 D and target Q-value at-0.50 plus self-Q20,the Q-value customized LASIK is superior to the conventional LASIK in maintaining the anterior corneal shape before operation and reducing spherical aberration after operation,but it still can not prevent the trend of higher-order aberrations increase.

关 键 词：准分子激光原位角膜磨镶术 非球面系数 球面像差 

分 类 号：R779.63[医药卫生—眼科]