波前像差引导个体化切削与LASIK治疗近视术后患者视觉质量提高临床对比研究  

Clinical study on the improvement of visual quality after wavefront guided individualized ablation and LASIK for myopia

作　　者：罗建勋[1] 荣瑜[1] 

机构地区：[1]安徽省安庆市第一人民医院眼科,246004

出　　处：《临床眼科杂志》2017年第3期268-270,共3页Journal of Clinical Ophthalmology

摘　　要：目的观察波前像差引导的个体化切削与常规LASIK手术治疗近视患者手术前后视力、屈光度及波前像差的变化,评价其对视觉质量的影响。方法回顾性病例研究。对2012年10月至2016年7月在安庆市第一人民医院屈光矫治中心就诊,选取屈光度-1.75 D≤球镜≤-8.00 D,柱镜≤-2.00 D的近视患者520例(975只眼),其中行波前像差引导的个体化切削245例(465只眼),常规LASIK手术275例(510只眼)。分别检查术前及术后1周、1个月、3个月患者的裸眼视力、屈光度和波前像差的变化。统计分析使用SPSS11.0软件包的独立样本进行t检验。结果常规LASIK手术患者与波前像差引导的个体化切削患者术后裸眼视力均达到术前矫正视力,后者视力提高幅度明显大于前者,常规LASIK手术患者术后高阶像差显著增加,出现术后眩光、夜间视力下降等症状49例,发生率为17.82%;波前像差引导的个体化切削患者术后高阶像差降低,出现术后眩光、夜间视力下降等症状仅5例,发生率为2.04%,两组相比差异显著,有统计学意义(P<0.05)。结论波前像差引导的个体化切削与常规LASIK手术治疗近视比较术后均能获得较好的视力,但是波前像差引导个体化切削可以减少术后高阶像差,使患者获得更好的视觉质量。Objective To observe changes in visual acuity,refractive index and wavefront aberration before and after the operation of wavefront guided and conventional LASIK for myopia. Methods Retrospective case study. 520 myopic patients（ 975 eyes） who were treated in Anqing First People＇s Hospital Refractive Center between October 2012 to May 2016 were selected for review. Selection criteria included spherical diopter between-1. 75 D and-8. 00 D,and cylindrical diopter 〈-2. 00 D. Among these patients,245 cases（ 465 eyes） were given wavefront guided individualized ablation,and 275 cases（ 510 eyes） received regular LASIK. SPSS11. 0 software package and t test for independent samples was used for data analysis. Results Visual acuity significantly improved in both groups of patients. Patients given wavefront guided individualized ablation had better visual outcomes. Higher order aberration was significantly higher in patients received regular LASIK,and glare,reduced nocturnal visual acuity was present in 49 cases（ 17. 82%）. In contrast,higher order aberration was significantly lower in patients received wavefront guided individualized ablation,and incidence of glare and reduced nocturnal visual acuity was present in only 5 patients（ 2. 04%）. This difference was statistically significant（ P〈0. 05）. Conclusions Wavefront guided individualized ablation results in better visual acuity,reduced postoperative higher-order aberrations,and less complications.

关 键 词：波前像差 波前像差引导个体化切削 准分子激光原位角膜磨镶术 高阶像差 

分 类 号：R779.63[医药卫生—眼科]