角膜地形图引导的Z-调整切削矫治LASIK术后偏中心的临床分析  

Z-adjust Topography-Guided Laser in Situ Keratomileusis （LASIK） for Eccentric Cutting Induced by LASIK Keratorefractive Surgery

作　　者：李珍[1] 杜改萍 黄一飞[2] Zhen Li;Gaiping Du;Yifei Huang(Department of Ophthalmology, Chinese PLA, the 401th Hospital, Qingdao 266071, China;Department of Ophthalmology, Chinese PLA General Hospital, Beijing 100853, China)

机构地区：[1]中国人民解放军第401医院眼科,青岛266071 [2]北京解放军总医院眼科,100853

出　　处：《中华眼视光学与视觉科学杂志》2017年第11期669-672,共4页Chinese Journal Of Optometry Ophthalmology And Visual Science

基　　金：国家自然科学基金面上项目（81670830）

摘　　要：目的：观察角膜地形图引导的Z-调整个体化切削矫治准分子激光原位角膜磨镶术（LASIK）术后偏中心的疗效。方法：回顾性系列病例研究。选取2008 年6 月至2014 年12 月在中国人民解放军第401 医院就诊的LASIK术后的偏中心患者8 例（10 眼），行角膜地形图引导的Z-调整切削，术后观察手术眼裸眼视力（UCVA）、屈光状态、角膜Q值以及角膜曲率。结果：患者术前UCVA（LogMAR）为0.3～0.6，Z-调整切削术后UCVA（LogMAR）为-0.1～0.1。角膜Q值由手术前的1.26±1.55（0.26～2.25）减少到手术后的0.28±0.35（-0.27～0.50）。平均角膜曲率由手术前的40.98±3.56（39.25～43.50）D减少到手术后的37.32±1.47（36.25～38.50）D。角膜光学区直径由手术前的5.9±0.4（5.5～6.1）mm增大到手术后的6.8±1.1（6.0～7.4）mm。Z-值调整范围：X轴调整范围为＋0.005～＋0.052 mm，Y轴调整范围为＋0.007＋0.045mm。结论：Z-调整进行角膜地形图引导的个体化切削，能使偏中心得到有效矫正，明显提高视觉质量。Objective： To evaluate the clinical efficacy of Z-adjust topography-guided customized laser in situ keratomileusis （LASIK） for eccentric cutting induced by LASIK keratorefractive surgery. Methods： In this retrospective case series study, 10 eyes of 8 patients with eccentric cutting induced by LASIK surgery from June 2008 to December 2014 at Chinese PLA the 401th Hospital were enrolled. The patients were treated with Z-adjust topography-guided LASIK. The uncorrected visual acuity （UCVA）, refractive status, corneal Q-value （which describes the corneal aspherical quality）, and corneal keratometry were analyzed and compared. Results： The pre-operation UCVA （LogMAR） of all patients was 0.3 to 0.6, and the post-operative UCVA （LogMAR） improved significantly was -0.1 to 0.1. The corneal Q-value increased significantly from 1.26±1.55 diopter （D） （range 0.26 to 2.25 D） pre-operative to 0.28±0.35 D （range -0.27 to 0.50 D） at 3 months post-operative. The corneal keratometry decreased significantly from 40.98±3.56 D （range 39.25 to 43.50 D） to 37.32±1.47 D （range 36.25 to 38.50 D）. The scotopic pupil diameter increased significantly from 5.9±0.4 mm （range 5.5 to 6.1 mm） to 6.8±1.1 mm （range 6.0 to 7.4 mm）. The Z-adjust range for the X axis was adjusted from ＋0.005 to ＋0.052 mm, and for the Y axis, it was adjusted from ＋0.007 to ＋0.045 mm. Conclusions： The eccentric cutting of all eyes were corrected by Z-adjust topography-guided customized LASIK surgery, and the visual quality was greatly improved.

关 键 词：偏中心切削 准分子激光原位角膜磨镶术 角膜地形图 

分 类 号：R779.63[医药卫生—眼科]