波前像差引导SBK与常规SBK矫正近视比较研究  

Comparative study of Wavefront-guided Sub-Bowman-Keratomileusis versus conventional Sub-Bowman-Keratomileusis for correcting myopia

作　　者：刘伟民[1] 黄建忠[1] 肖信[1] 罗武强[1] 

机构地区：[1]广西壮族自治区人民医院视光科,广西视光中心,南宁530021

出　　处：《中国实用眼科杂志》2014年第3期306-310,共5页Chinese Journal of Practical Ophthalmology

基　　金：广西医疗卫生科研课题（桂卫Z2011442）

摘　　要：目的比较波前像差引导前弹力层下激光角膜磨镶术（SBK）与常规SBK矫正近视及近视散光的有效性、安全性、预测性、稳定性及术后视觉质量。方法前瞻性随机对照研究。对2009年12月至2010年12月在广西视光中心就诊122例近视的患者，采用随机数字表法分为波前引导SBK（WG—SBK组）和常规SBK（SBK组），WG—SBK组行波前像差引导的SBK手术，SBK组行常规SBK手术，术后1d、1周、1个月、3个月和6个月定期随访，检测视力、屈光度、高阶像差和对比敏感度。结果术后6个月，WG—SBK组术后裸眼视力≥1．0的比例为98．07％，与SBK组的98．57％持平（P=0．764）。两组均未出现最佳矫正视力下降达2行者，术后矫正视力提高≥1行者WG—SBK组占84．61％，高于SBK组的65．71％差异有统计学意义（P〈0．01）。WG—SBK组和SBK组术后等效球镜在±0．50D内的比例分别为69．23％和57．86％（P=0．069），在±1．00D内的比例分别为92．31％和86．43％（P=0．148）。WG—SBK组与SBK组的术后残余散光度分别为（-0．30±0．32）D和（-0．34±0．33）D（P=0．344）。两组等效球镜在术前、术后1d和1周比较差异无统计学意义（P〉0．05），但在术后1个月、3个月和6个月时点上比较差异有统计学意义（P〈0．05）。术后6个月WG—SBK组和SBK组的总高阶像差、慧差、三叶草差和球差RMS较术前的变化量分别为（0．25±0．26）、（0．05±0．15）、（0．05±0．12）（0．14±0．24）μm和（0．39±0．34）、（0．10±0．27、（0．03±0．10）、（0．29±0．26）μm差异有统计学意义（P〈0．01，P=0．089、0．157）。WG—SBK组和SBK组的3c／d，6c/d，12c／d和18c／d频率的对比敏感度变化量分别为0．17±0．36、-0．04±0．35、0．18±0．29、0．29±0．31和-0．22±0．44、-0．01±0．51，-0．05±0．40，-0．02±0．46差异有统计学意义（P〈0.01）。结论波前�Objective To compare outcomes in visual acuity, refraction, higher-order aberrations （HOAs）, and contrast sensitivity function （CSF） in myopic patients undergoing wavefront-guided sub-bowman-keratomileusis （WG-SBK） or sub-bowman-keratomileusis （SBK）. Methods In this pro- spective, randomized, comparative study, 244 eyes （122 patients） of myopia or myopic astigmatism were recruited randomized from the myopic surgery candidates and were random allocated into WG-SBK group and SBK group using random digits table. Wavefront-guided custom ablation was performed on the patients from WG-SBK group and standard ablation was performed on the patients from SBK group. Visual acuity, refraction, HOAs and CSF were measured preoperatively at 1 day, 1 week, 1 month, 3 months and 6 months postoperatively. The results were compared between the two groups. Results After 6 months, 98.07% of Wavefront-guided ablation eyes and 98.57% of stan- dard ablation had uncorrected visual acuity of 1.0 or better （P =0.764）. None treated eyes in either group lost more than two lines of best corrected visual acuity （BCVA）. The percentage of eyes gained 1 line or more improved in BCVA was 84.61% and 65.71% in the WG-SBK and SBK groups （P 〈0.01）, respectively. WG-SBK group 69.23% eyes and SBK group of 57.86% eyes spheri- cal equivalent within 4440.50 D （P =0.069）, WG-SBK group of 92.31% eyes and SBK group of 86.43% eyes spherical equivalent within 4441.00 D （P =0.148）. Mean residual astigmatism in WG-SBK group and SBK group were -0.304440.32 DC and -0.344440.33 DC, respectively （P =0.344）. There were no statistically significant in mean residual spherical equivalent between WG-SBK group and SBK group at preoperative, postoperative 1 day and 1 week, respectively （P 〉0.05）. However, there were statistically significant in mean residual spherical equivalent between WG-SBK group and SBK group at postoperative 1 month, 3 months and 6 months. Mean postoperative absolute changes of six months in HOAs, com

关 键 词：前弹力层下激光角膜磨镶术 波前像差引导 近视 比较研究 

分 类 号：R779.63[医药卫生—眼科]