应用Fourier分析法研究准分子激光治疗散光的准确性  

Study on the accuracy of excimer laser for myopic astigmatism with fourier analysis

作　　者：胡亮[1] 徐鹏[1] 崔贺[1] 谢文加[1] 王勤美[1] 

机构地区：[1]温州医学院眼视光学院,浙江温州325027

出　　处：《温州医学院学报》2013年第5期281-285,共5页Journal of Wenzhou Medical College

基　　金：国家"十二五"科技支撑计划课题(2011BAI12B08);浙江省重点科技创新团队项目(2011R09039-09);浙江省公共科技条件平台项目(2012E60011);温州市科技局科研基金资助项目(Y20100199)

摘　　要：目的:应用Fourier分析法评价鹰视酷眼准分子激光仪行前弹力层下激光角膜磨镶术(OUP-SBK)和飞秒制瓣准分子激光原位角膜磨镶术(飞秒LASIK)治疗中高度近视患者散光的准确性,并统计各组的正常值范围。方法:回顾性病例分组研究2012年1月至2012年3月在温州医学院眼视光医院行准分子激光手术的患者,满足散光度数≥-0.5 D,近视度数≥-3.0 D的近视散光患者271例(542眼),其中OUP-SBK组159例(318眼),飞秒LASIK组112例(224眼)。按术前等效球镜度数各自分为中度近视及高度近视两组。分别收集各组术前及术后3～6个月间最早的一次随访数据,包括主觉验光度数、角膜地形图、最佳矫正视力。应用Fourier分析法分别计算术前总散光(TJ0,TJ45),角膜散光(CJ0,CJ45)以及术后总散光(RJ0,RJ45)进行散光矫正准确性分析。统计学方法采用成组t检验及Pearson检验。结果:①残余散光:OUP-SBK术后中度近视组RJ0=(0.012±0.161)D,RJ45=(-0.012±0.128)D;高度近视组术后RJ0=(0.026±0.239)D,RJ45=(-0.029±0.194)D,两组差异无统计学意义(P=0.697,0.402)。飞秒LASIK术后中度近视组RJ0=(0.053±0.248)D,RJ45=(-0.039±0.186)D;高度近视组RJ0=(0.042±0.267)D,RJ45=(-0.044±0.261)D,两组差异无统计学意义(P=0.784,0.308)。②散光矫正率:OUP-SBK术后中度近视组CRJ0=97.98%(84.66%～111.30%),CRJ45=702.20%(-337.03%～1741.43%),两者差异有统计学意义(P<0.01);高度近视组术后CRJ0=86.52%(60.20%～94.84%),CRJ45=83.24%(-760.92%～927.40%),两者差异有统计学意义(P<0.01)。飞秒LASIK术后中度近视组CRJ0=90.96%(81.65%～100.27%),CRJ45=1 035.98%(191.04%～1 880.92%),两者差异有统计学意义(P<0.01);高度近视组CRJ0=85.61%(72.70%～98.51%),CRJ45=346.00%(-1 288.68%～1 980.69%),两者差异有统计学意义(P<0.01)。③术后散光相关性分析:OUP-SBK组高度近视组RJ45与TJ45相关性有统计学意义(r=0.361,P<0.01)。飞秒LASIK术后中度近视组RJ0与CJ0(r=0.393,P<0.01),RJ0与TJObjective： To evaluate the accuracy of Cool Excimer Laser System for myopic astigmatism in One Use-Plus Sub-Bowman＇s keratomileusis （OUP-SBK） and Femtosecond Laser In Situ Keratomileusls （FS- LASIK） with Fourier Analysis and develop a customized nomogram for astigmatic patients. Methods： Retrospectively reviewed the charts of 542 eyes （OUP-SBK： 318 eyes; FS-LASIK： 224 eyes）, who had excimer laser surgery in Eye Hospital of Wenzhou Medical College during Jan 2012 to March 2012, with an inclusion criteria as： WTR astigmatism 〉 -0.5 D, myopia 〉 -3 D. The moderate and high myopia groups were divided respectively according to baseline myopia. Preoperative and 3 to 6 months postoperative examinations included： refraction, corneal topography, pachymetry, best spectacles corrected visual acuity （BSCVA）. Fourier Analysis was used to transform preoperative astigmatism to TJ0 and TJ45; preoperative corneal astigmatism to CJ0 and Cj4s;postoperative residual astigmatism to RJ0 and RJ45. Group t test and Pearson test were used for statistical analysis. Results：① Residual Astigmatism. OUP-SBK moderate myopia group： Rj0= （0.012 ± 0.161）D, RJ45= -（0.012 ± 0.128）D; OUP-SBK high myopia group： Rj0= （0.026 ± 0.239）D, RJ45= （-0.029 ± 0.194）D, the difference between moderate and high myopia group was not statistically significant （P=0.697, 0.402）. Femtosecond LASIK moderate myopia group： Rj0= （0.053 ± 0.248）D, RJ45= （-0.039 ± 0.186）D; femtosecond LASIK high myopia group： Rjo= （0.042 ± 0.267）D, RJ45= （0.044 ± 0.261）D, the difference between moderate and high myopia group was not statistically significant （P=0.784, 0.308）. ②Astigmatism Correction Rate. OUP-SBK moderate myopia group： CRJ0= 97.98%（84.66%-111.30%）, CRJ45= 702.20%（-337.03%-1741.43%）, the difference between them was statistically significant （P〈0.01）; high myopia group： CRJ0= 86.52%（60.20%～94.84%）, CRJ45= 83.24%（-760.92%～ 927.40%）, the difference was s

关 键 词：Fourier分析法 正常值范围 激光原位 角膜磨镶术 前弹力层下 激光角膜磨镶术 散光 

分 类 号：R778.13[医药卫生—眼科]