Q值引导及Kappa角调整后SBK和飞秒LASIK术后高阶象差的对比  

A clinical study comparing the changes in higher-order aberrations following SBK and femtosecond laser LASIK with a customized Q-factor and Kappa adjustment

作　　者：梁刚[1] 查旭[2] 张丰菊[3] 

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, [2] 100730 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 650101 昆明医科大学第二附属医院眼科 [3] 100730,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

出　　处：《中华眼视光学与视觉科学杂志》2014年第1期25-29,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（2011BA11208）;北京市卫生系统高层次卫生技术人才基金（2013-2-023）

摘　　要：目的 比较在Q值引导及Kappa角调整的准分子切削模式下,机械刀制瓣SBK（OUP-SBK）和飞秒制瓣LASIK（FS-LASIK）2种手术方式对术眼的高阶像差的影响.方法 回顾性病例对照研究.43例患者（86眼）根据制瓣方式不同分为2组：SBK组（23例46眼）和FS组（20例40眼）,均采用Q值引导及Kappa角调整的准分子切削模式手术,分别于术前、术后1个月、术后3个月测量术眼的总高阶像差及各单项高阶像差.应用方差分析和独立样本t检验分析高阶像差在不同时间点的变化以及2组间的差异.结果 SBK组和FS组的总高阶像差均方根（RMS）值在术后1个月和3个月时均较术前增加（F=14.935、6.498,P＜0.01）;SBK组C40、C42、C4较术前有增加（F=8.326、3.202、6.195,P＜0.01）.FS组只有球差C40较术前有增加（F=9.045,P＜0.01）.2组的比较：术后1个月、3个月时SBK组和FS组的总高阶像差RMS值（t=0.26、0.88,P＞0.05）以及RMS增加量（t=0.74、1.24,P＞0.05）比较差异均无统计学意义,但在1个月时C44（t=3.08,P＜0.0l）,在3个月时C4-2（t=-2.34,P＜0.05）、C44（t=2.78,P＜0.01）2组间差异有统计学意义.结论 Q值引导及Kappa角调整后,SBK和FS制瓣的LASIK手术后术眼总高阶像差均有增加,但高阶像差的增加量两者并无差异,但个别的单项高阶像差存在差异.Objective To compare the changes in higher-order aberrations following microkeratome SBK （OUP-SBK） and femtosecond laser LASIK （FS-LASIK） with customized Q-factor and Kappa adjustment.Methods This was a retrospective clinically controlled study.Forty-three patients （86 eyes）were divided into two groups：one group （46 eyes of 23 cases） was treated with the Moria One Use-Plus SBK and the other group （40 eyes of 20 cases） with a VisuMax FS-LASIK.Both groups had customized Q-factor and Kappa adjustment during laser ablation.Higher-order aberrations were measured preoperatively and 1 month and 3 months postoperatively.An analysis of variance and independent t test were used to analyze the changes in higher-order aberrations after FS-LASIK and SBK.Results At the 1st and 3rd month postoperatively,there was an increase in all higher-order aberrations in both groups （F=14.935,6.498,P〈0.01）.In the SBK group,spherical aberrations （C40） and 4th order aberrations （C42,C44） had increased on the 1st and 3rd months （F=8.326,3.202,6.195,P〈0.01）.The C40 in the FS-LASIK group had increased on the 1st and 3rd months （F=9.045,P〈0.01）.A comparison of the SBK and FS-LASIK groups showed there were no significant differences when higher-order aberration （t=0.26,0.88,P〉0.05） and changes （t=0.74,1.24,P〉0.05） were compared postoperatively at 1 and 3 months.There were significant differences in aberration C44 in the 1st month （t=3.08,P〈0.01） and C4-2 and C44 in the 3rd month （t=-2.34,2.78,P〈0.05）.Conclusion With customized Q-factor and Kappa adjustment during laser ablation,higher-order aberrations increase with both mechanical microkeratome and VisuMax femtosecond flap creation.There is no significant difference in the total change in higher-order aberrations,but there is a difference in some single higher-order aberrations.

关 键 词：角膜磨镶术 前弹力层下 飞秒激光 角膜磨镶术 激光原位 波前像差 

分 类 号：R779.63[医药卫生—眼科]