采用Winsight准分子激光治疗系统行SBK术矫正近视及散光的疗效评价  

Analysis on the efficacy of SBK surgery for myopia and astigmatism performed by Winsight excimer laser ablation

作　　者：孙明甡 张丰菊[1] 张丽[1] 柳静[1] 张晶[1] 张秋露[1] 郭宁[1] 翟长斌[1] 

机构地区：[1]首都医科大学附属北京同仁医院北京同仁眼科中心北京市眼科学与视觉科学重点实验室, 100730

出　　处：《中华眼视光学与视觉科学杂志》2014年第1期5-9,共5页Chinese Journal Of Optometry Ophthalmology And Visual Science

基　　金：国家“十二五”科技支撑计划子课题，北京市卫生系统高层次卫生技术人才基金

摘　　要：目的 评价使用Winsight准分子激光治疗系统行SBK术矫正近视及近视散光的预测性、有效性、安全性及该手术对视觉质量的影响.方法 回顾性病例对照研究.分析2012年6月至2013年7月于北京同仁医院屈光中心行SBK手术治疗近视性屈光不正的病例78例（156眼）,根据所使用的准分子激光扫描设备的不同分为2组,其中观察组39例,应用Winsight准分子激光治疗系统行SBK术;对照组39例,应用Allegretto Eye-Q准分子激光治疗系统行SBK术.分别于术后1周、1个月、3个月和6个月定期随访,检查2组的裸眼视力,以电脑验光和显然验光检查术后屈光状态及BCVA.观察组术后1个月起增加暗室与暗室眩光对比敏感度检查.数据采用独立样本t检验、方差分析.结果 术后1周、1个月、3个月、6个月,2组裸眼视力差异无统计学意义（t=1.141、0.881、0.001、0.814,P均＞0.05）;2组等效球镜度差异无统计学意义（t=-0.007、1.583、-0.416、1.460,P均＞0.05）.术后1、3、6个月等效球镜度在＆#177;0.50 D范围内的比例,观察组均为97％,对照组分别为96％、99％、99％.术后1、3、6个月,观察组UCVA≥5.0的比例分别为100％、100％、99％.术后1、3、6个月,2组有效性指数平均值均为1.01＆#177;0.01,差异无统计学意义（t=1.551、0.796、1.662,P均＞0.05）.术后1、3、6个月时,观察组均无任何一眼BCVA下降2行以上,分别有64％、65％、63％眼BCVA提高1行,8％、3％、5％眼BCVA提高2行.安全性指数分别为1.02＆#177;0.01、1.01-0.01、1.01＆#177;0.01.观察组术后3个月暗室对比敏感度与术前相比,在12 c/d高频区较术前增加（F=15.31,P＜0.05）.除此之外,不同空间频率下暗室和暗室眩光对比敏感度在术后不同时间段有一定的波动,但与术前相比均没有出现有统计学意义的降低.结论 使用Winsight准分子激光治疗系统行SBK术矫正近视及近视散光具有良好的预测性、有效性、安全性Objective To evaluate the efficacy of sub-Bowman＆#39;s keratomileusis （SBK） surgery performed by Winsight excimer laser ablation for the treatment of myopia,to evaluate the predictability,safety and quality of vision using this procedure.Methods This was a retrospective case-control study.One hundred fifty-six eyes of 78 cases that had undergone SBK for myopia were analyzed retrospectively.Half of the eyes were treated with Winsight and half with Allegretto Eye-Q.Primary outcome variables,including uncorrected visual acuity （UCVA）,best corrected visual acuity （BCVA）,and manifest refraction spherical equivalent （SE）,were evaluated at 1 week and 1,3 and 6 months postoperatively.Dark room and dark room glare contrast sensitivity were evaluated at 1,3 and 6 months postoperatively in the test group.Data were analyzed using independent t test and ANOVA.Results There were no significant differences in postoperative UCVA and SE between the test and control groups.At 1,3 and 6 months,the respective proportions of eyes achieving postoperative SE within ＆#177;0.5 D were 97%,97% and 97% for the test group and 96%,99% and 99% for the control group.UCVA was 5.0 or better in 100%,100% and 99% of eyes in the test group.At 1,3 and 6 months postoperatively,the mean efficacy index was 1.01＆#177;0.01 for both the test and control groups （t=1.551,0.796,1.662,P〉0.05）.In the test group,no eyes had lost more than 2 lines of BCVA at 1,3 and 6 months postoperatively.The mean safety indices were 1.02＆#177;0.01,1.01＆#177;0.01 and 1.01＆#177;0.01.Although dark room and dark room glare contrast sensitivity fluctuated mildly after SBK,the measurements did not decline significantly.Compared with preoperative data,dark room contrast sensitivity at 3 months increased to 12 c/d （F=15.31,P〈0.05）.Conclusion SBK performed by Winsight excimer laser is a predictable,effective and safe procedure for myopia and astigmatism.

关 键 词：角膜磨镶术 前弹力层下 预测性 有效性 安全性 对比敏感度 

分 类 号：R779.63[医药卫生—眼科]