ORK引导的非球面个性化切削与传统准分子激光原位角膜磨镶术术前后角膜像差分析  

Corneal aberrations before and after ORK-guided aspheric excimer laser versus conventional LASIK surgery

作　　者：匡丽晖[1] 金敏[1] 丁小珍[1] 王小园[1] 高宗银[1] 周传清[2] 

机构地区：[1]广州医学院附属广州市第一人民医院眼科,510180 [2]上海交通大学激光与光子生物医学研究所

出　　处：《中华生物医学工程杂志》2010年第5期492-494,共3页Chinese Journal of Biomedical Engineering

摘　　要：目的 研究ORK引导的非球面个性化切削手术前后的角膜像差变化特点,并与传统的准分子激光原位角膜磨镶术（LASIK）进行比较.方法 选取2008至2009年在广州市第一人民医院激光中心就诊的平均等效球镜度、散光、角膜像差没有明显差异的近视患者400例（800眼）,随机分为2组：A组200例（400眼）接受ORK引导的非球面个性化切削手术,B组200例（400眼）接受传统LASIK手术.进行2组患者术前和术后6个月裸眼视力、等效球镜、散光和角膜像差的比较.结果 术后6个月,2组患者裸眼视力差异无统计学意义（P＞0.05）.术后6个月,瞳孔直径6 mm时,2组患者术后等效球镜度和散光度均减少,但2组间比较及变化值组间比较差异无统计学意义（均P＞0.05） 术后6个月2组患者角膜总高阶像差均方根值（RMS）、三阶像差均方根值（RMS3）、四阶像差均方根值（RMS4）、球差和慧差均增加,但A组的增幅小于B组[RMS：（0.17±0.14）μm比（0.27±0.12）μm RMS3：（0.03±0.12）μm比（0.10±0.16）μm RMS4：（0.21±0.12）μm比（0.26±0.18）μm 球差：（0.17±0.13）μm比（0.27±0.19）μm 慧差：（0.01±0.12）μm比（0.11±0.17）μm,均P＜0.05].结论 ORK引导的非球面个性化切削手术能相对减少术后角膜高阶像差的增加,尤其是球差的增幅相对较小.Objective To investigate the changes in corneal aberration before and after ORK-guided aspheric customized excimer laser versus conventional laser-assisted in situ keratomileusis （LASIK）surgery. Methods Four hundred patients （800 eyes） registered to the Laser Center of The First Municipal People＇s Hospital of Guangzhou between 2008 and 2009 and comparable in mean spherical equivalent,astigmatism and corneal aberration, were randomly assigned to two groups to receive the ORK-guided aspheric customized excimer laser surgery （group A, 200 patients, 400 eyes） or conventional LASIK surgery （group B, 200 patients, 400 eyes）. Naked-eye vision, spherical equivalent, astigmatism and corneal aberration were measured and compared between the two groups before and 6 months after the surgery.Results Six months after surgery, there were no statistical differences in naked- eye vision （P〉0.05）between two groups. Group A and B had lowered spherical equivalent and astigmatism with pupils 6 mm in diameter, but these parameters were comparable between two groups in both absolute value and reduction from baseline （all P〉0.05）. While RMS, RMS3, RMS4, SphA and Coma increased in both groups. Group A had less increase in these parameters than group B [RMS： （0.17±0.14） μm vs （0.27±0.12） μm RMS3：（0.03±0.12） μm vs （0.10±0.16） μm RMS4： （0.21±0.12） μm vs （0.26±0.18） μm SphA： （0.17±0.13） μmvs （0.27±0.19） μm Coma： （0.01±0.12） μm vs （0.11±0.17） μm,all P〈0.05]. Conclusion Compared with the conventional spheric surgery, ORK-guided aspheric customized excimer laser surgery may be associated with less increase in high-order corneal aberration, especially in spherical aberration.

关 键 词：角膜磨镶术 激光原位 角膜外科手术 激光 屈光性角膜切削术 像差 

分 类 号：R779.63[医药卫生—眼科]