非球面切削LASEK治疗薄角膜高度近视的临床疗效研究  

Clinical Curative effect on aspheric keratectomy excimer laser subepithelial keratomileusis （LASEK） for high myopic of thin corneal

作　　者：朱云喜[1] 金敏[1] 王小园[1] 杨为中[1] 高宗银[1] 朱运军[1] 张柳[1] 

机构地区：[1]广州医学院附属广州市第一人民医院眼科,广州510180

出　　处：《中国实用眼科杂志》2009年第12期1361-1363,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的探讨角膜波前像差引导联合Q值优化的最优个性化角膜屈光矫正程序（ORK—CAM）引导的非球面切削准分子激光上皮下角膜磨镶术（LASEK）治疗角膜薄的高度近视临床疗效。方法运用角膜波前像差引导联合Q值优化的ORK—CAM及小光斑高速飞点激光扫描系统对49例76只眼角膜薄的高度近视患者行LASEK。术后2周，1月，3及6月检查裸眼视力、验光、Haze等级。术后半年时复查角膜地形图、波前像差、视觉对比敏感度并进行满意度调查。结果术前平均最佳眼镜矫正视力（BSCVA）为1．10＋0．12，术后6月BucVA（BucVA）为1．12＋0．17。术后平均模拟角膜记读数（SimK）等效值、慧差、球差、总体像差分别增加了一13．5％、93．87％、172．22％、23．81％、43．28％，较术前差异有统计学意义。角膜地形图形态有92．11％为同心圆型，视觉质量满意度为95．92％。结论角膜波前像差引导的LASEK治疗角膜薄的高度近视，术后3个月以后平均视力稳定，且好于术前BCVA。术后6月时平均总波前像差增加百分比较小，球差增加较少，较好的保持了角膜的的非球面性。术后患者出现眩光、夜视力差的机率较低，具有较好的临床疗效。Objeetive To discuss the clinical curative effect of corneal wavefront-guided combining Q- value guided aspheric keratectomy excimer laser subepithelial keratomileusis （LASEK） of ORK-CAM （Optimized Refi＇active Keratectomy Customized Ablation Manager, ORK-CAM） in treatment for high my- opia with thin cornea. Methods Corneal wavefront-guided combining Q- value guided aspheric keratectomy excimer laser subepithelial keratomileusis （LASEK）of ORK-CAM were used in 76 eyes of 49 patients who were high myopia with thin cornea. UCVA （uncorrected visual acuity, UCVA）, optometry, level of haze were observed at 2, 4 weeks, 3, 6 months post-operation. Topography, wave^ont aberration, Visual contrast sensitivity and investigation of Satisfaction were reviewed 6 months post-operation. Results BSCVA （best spectacle-corrected visual acuity, BSCVA）was 1.10＋0.12 preoperative, and UCVA was 1.12＋0.17 at 6 months after operation. Simk （sinulated keratometry, SimK） of equivalent value, Coma-like, spherical-like, RMSg （root of mean square of general aberration） increased -13.5%, 93.87%, 172.22%, 23.81%, 43.28% postoperative respectively. Compared with preoperation, these data all had statistical significance. 92.11% eyes of postoperative topography were central uniform type. 43.87% patients were satisfied with the quality of vi- sion. Conclusions Corneal wavefront-guided combining Q- value guided aspheric keratectomy excimerlaser subepithelial keratomileusis （LASEK）of ORK-CAM for high myopia have a stable vision after 3 months of surgery, and better than preoperative UCVA. The RMSg, Sqrab increased a little 6 months after operation. The rate of Glare, Bad night vision was low. Corneal wavef^ont aberration-guided aspheric keratectomy excimer, ORK-CAM have a good clinical curative effect.

关 键 词：高度近视 角膜波前像差 非球面切削 高阶像差 LASEK 

分 类 号：R778.11[医药卫生—眼科] R778.110.5[医药卫生—临床医学]