波前像差引导的个体化切削治疗高度近视后视觉质量变化分析  

Visual quality changes in wave-front guided customized ablation on correcting high myopia

作　　者：杨琳[1] 吕勇[1] 

机构地区：[1]郑州大学第一附属医院眼科,河南省郑州市450052

出　　处：《眼科新进展》2011年第12期1171-1173,1176,共4页Recent Advances in Ophthalmology

摘　　要：目的观察波前像差引导的个体化切削治疗高度近视患者手术前后对比敏感度、视力及角膜波前像差的变化,评价其对视觉质量的影响。方法选取2009年6月至12月拟行波前像差引导个体化切削的高度近视患者35例(70眼),采用常规LASIK方法,按照患者波前引导的像差资料输入系统形成的切削数据文件切削角膜基质。术前、术后检查裸眼视力、屈光度、对比敏感度及波前像差。结果术前与术后1周、1个月、3个月的裸眼视力平均分别为0.10±0.06、0.98±0.14、1.03±0.06、1.05±0.10,术前与术后1周、1个月、3个月裸眼视力差异均有统计学意义(均为P<0.05),术后1周、1个月、3个月裸眼视力差异均无统计学意义(均为P>0.05)。患者术后均呈轻度远视,随时间推移远视度数有所下降。术后对比敏感度值呈降低趋势,随时间推移对比敏感度值逐渐恢复。术后1周、1个月、3个月各阶波阵面像差均方根值较术前增加,差异均有统计学意义(均为P<0.05)。结论波前像差引导的个体化切削有效地提高高度近视患者的远视力,但术后高阶像差增加和对比敏感度下降。Objective To evaluate the visual quality after wave-front guided customized ablation（WAGCA） on correcting high myopia,and observe the changes of contrast sensitivity,glare contrast sensitivity and root mean square（RMS）of coma and spherical aberration after WAGCA.Methods Patients（35 cases,70 eyes） with high myopia,who were treated with WAGCA during June 2009 and December 2009,were enrolled.With routine LASIK,wavefront guided data were input system for remotion corneal stroma.Preoperative and postoperative uncorrected visual acuity（UCVA）,best spectacled-corrected visual acuity（BSCVA）,contrast sensitivity（CS）,glare contrast sensitivity（GCS） and corneal wavefront aberrations were analyzed.Results UCVA were 0.10±0.06,0.98±0.14,1.03±0.06,1.05±0.10 at pre-operation,postoperative 1 week,1 month,3 months.And there were statistical differences between pre-operation and postoperative 1 week,1 month and 3 months（all P0.05）,while no difference was found among postoperative 1 week,1 month and 3 months（both P0.05）.All patients were with slight hypermetropia,and its degree decreased with time.Postoperative CS value had a tendency of decrease,and recovered with time.RMS of each wavefront aberrations increased compared with pre-operation at postoperative 1 week,1 month and 3 months,there were statistical differences（all P0.05）.Conclusion WAGCA is effective on improving hypermetropia of patients with high myopia,but postoperative higher order aberration increases and CS decreases.

关 键 词：高度近视 波前像差 个体化切削 对比敏感度 

分 类 号：R778[医药卫生—眼科]